Fever all around

In a gap of three months, the capital is witnessing a second outbreak of mosquito-borne chikungunya virus, raising a new public health concern in addition to dengue.

Moreover, patients with viral fever and cough have also been thronging city hospitals over the last few weeks.

“Over 80 cases of chikungunya have been recorded between the last week of December and May 14 this year,” said Prof Meerjady Sabrina Flora, director of the Institute of Epidemiology, Disease Control and Research (IEDCR).

Most of these were identified between mid-April and May, at least 25 in the first 14 days of this month, and 19 between late December and mid-January, she said.

People showing symptoms of the viral disease are coming in every day, but only half are testing positive, Sabrina said.

Zakir Hossain, deputy director of Dhaka Medical College Hospital (DMCH), said the outdoor section was treating 80 to 85 people for fever every day. The number was 60 to 70 earlier.

“Some are found to have been suffering from dengue ... We do not go for chikungunya tests,” he told The Daily Star.

Shagufa Anwar, chief of communication of United Hospital, said 15 to 20 patients with fever, cough and joint pains visit the hospital every day. Some of them get admitted, and very few are diagnosed with dengue.

“Such a rise in fever patients is quite unusual,” she said. The hospital does not have test facilities for chikungunya.

Prof Saifullah Munshi of virology department at Bangabandhu Sheikh Mujib Medical University (BSMMU) said yesterday that they received about 60 patients with fever and joint pains in the last 17 days, and 18 of them were diagnosed with chikungunya.

SYMPTOMS OF CHIKUNGUNYA

The illness causes fever, muscle pain, headache, nausea, fatigue, rash and often very debilitating joint pain which can last for days.

Aedes aegypti mosquito is the carrier of both chikungunya and dengue viruses.

While dengue can be at times fatal, chikungunya is largely non-lethal.

According to World Health Organisation (WHO), there is no cure for the disease. Treatment is focused on relieving the symptoms.

Sabrina said a good number of the chikungunya cases were reported from Kathalbagan and Kalabagan areas, where the outbreak occurred late December.

WHY IS THERE A CHIKUNGUNYA OUTBREAK?

According to epidemiologists, Bangladesh has been witnessing a rapid rise in the number of dengue cases in recent years. For example, the Directorate General of Health Services (DGHS) received reports of 3,162 dengue cases in 2015 and 6,020 last year.

Until May 14 this year, at least 194 dengue cases were reported alongside chikungunya, DGHS said.

Female Aedes mosquitoes breed all year round but require stagnant pools of clean water. Early and frequent rains this year and stagnant water on dug-up roads are the primary factors behind the spread of dengue and chikungunya, health experts said.

“We suspect that many people have developed immunity to dengue … they are being infected with chikungunya,” said Prof Saifullah of BSMMU.

Though many people come to the hospital with chikungunya symptoms, not all are diagnosed with the disease, he said.

“This may be because they show up two to three days after they have fever. Usually, it takes five days for the chikungunya virus to develop in the body and only then can it be successfully diagnosed,” Saifullah said.

SHOULD WE PANIC?

Prof Saifullah said people should not panic over the symptoms. The good thing about chikungunya is that it is not fatal, but the pain at times can linger.

As there are similarities between the symptoms of dengue and chikungunya, patients can go for tests for both the viruses, he observed.

IEDCR Director Sabrina suggested taking rest and drinking lots of water. She recommended taking painkillers only on doctor's advice.

If fever and pain linger, patients should visit the doctor and undergo tests as they may also suffer from dengue, she said.

CHALLENGES AHEAD

Sabrina said mosquito control was one of the main challenges along with the fact that the symptoms do not ring a bell in most doctors.

“We've already held meetings with the city corporation officials and communicated the urgency of mosquito control,” she said.

The IEDCR director said the DGHS and IEDCR last week organised a workshop for doctors of private and public hospitals and instructed all civil surgeons to report to the IEDCR for any suspected case.

People also need to prevent water stagnation in and around their homes so that mosquitoes do not get a place to breed.