Wednesday, 6 June 2007

Chikungunya and dengue occur in tandem in Andhra Pradesh, says WHO

June 28, 2007
By Syed Akbar
Hyderabad, June 27: The World Health Organisation has bracketed Andhra Pradesh as one of the very few places where chinkungunya is prevalent with dengue.
Though chinkungunya is prevalent in quite a number of places across the globe, it is not generally associated with other infections. But in Andhra Pradesh and Orissa cases of co-infection of chikungunya-dengue are noticed complicating the matters for medical doctors. The WHO lists AP, Orissa and Malegaon (in Maharashtra) as the only places "with occurrence of dengue and or chikungunya". Treatment for chinkungunya is not disease-based but based on the symptoms the patient suffers from and this often leads to overdose of anti-biotics and other medicines.
However, the WHO in its "Epidemic and Pandemic Alert and Response (EPR)" does not feel the need for any special travel advisory to tourists visiting Hyderabad or other parts of Andhra Pradesh. Moreover, the WHO has also not updated its EPR alert after March 17 for Andhra Pradesh which means that there's no major change in chikungunya infection scenario in the State during the past three months. Also AP had the highest number of suspected chikungunya cases.
Several countries including Mauritius, Seychelles, France, Germany, Italy, Norway and Switzerland have reported cases of chikungunya but only in Andhra Pradesh and Orissa there is a "mixed outbreak of chikungunya, with sporadic cases of dengue".
Stating that several cases of "fever with arthralgia" (neuralgic pain in joints) have been reported from Andhra Pradesh, the WHO relates the cases to "high density of Aedes aegypti mosquitoes". These signs are consistent with an arbovirus (virus transmitted by mosquitoes and ticks) outbreak.
According to the WHO report, chikungunya and dengue viruses are transmitted to humans by the bites of infected mosquitoes. While Aedes albopictus is more active outdoors Aedes aegypti typically feeds and rests more indoors. Andhra Pradesh has reported cases of Aedes aegypti. Chikungunya (which in Swahili language means "that which bends up" referring to the stooped posture developed in patients due to arthritic symptoms) has assumed epidemic and pandemic proportions in the State since December last year.
"Although transmission of chikungunya and dengue is continuing in the affected areas, WHO recommends no special restrictions on travel or trade to or from these areas. However, it is recommended that individuals take precautions to protect themselves from mosquito bites, e.g., by wearing clothes that minimise skin exposure and applying insect repellents to exposed skin or clothing in accordance with label instructions," the WHO report pointed out.
Meanwhile, Hyderabad District Medical and Health Officer Dr Satyavati said of the 5326 cases screened for chikungunya only six patients in fever hospital are suspected to be suffering from the disease.

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