Viral epidemic continues to plague Kerala, takes lives every day

28 June, 2007:

A severe epidemic of never-before magnitude – fatal to some and debilitating to most of the affected – has been sweeping Kerala for over a month now. It is generally suspected that the epidemic is chikungunya.

But even now there is no consensus among medical experts on whether the frightful epidemic is actually chikungunya or something else. However, there is a broad consensus among the medical fraternity that the epidemic is caused by virus.

Whereas a similar outbreak of viral fever in 2006 was mainly confined to Kerala’s coastal district of Alappuzha, in 2007 the epidemic started and spread fast in Kerala’s eastern districts of Kottayam, Pathnamthitta and Idikki. These three districts are very unlikely to be affected by such a disease since all the three lie away from the sea or backwaters and comprise mostly hilly regions. And, these three districts in Kerala are relatively mosquito-free thanks to their high altitude general cleanliness.

When the epidemic started acquiring gigantic proportions, the Army’s medical wing was called in to assist the Kerala government mainly in its cleanliness drive to tackle the mosquito-borne viral disease.

Reports available on June 28 say that the viral epidemic has spread to other parts of Kerala, including Palakkad, where over 2,000 people have sought medical help with fever and other symptoms.

Since the epidemic that has been scaring and killing people in Kerala for over a month now has not yet been diagnosed, hospitals are groping in the dark regarding treatment. Most hospitals prescribe paracetamol tablets. And, almost all hospitals in the affected areas of Kerala are overflowing with epidemic patients.

Anyway, the common notion among the general public is that the epidemic is chikungunya, the same as the one which hit Kerala in October 2006.

Chikungunya is a relatively rare form of viral fever caused by an alphavirus that is spread by mosquito bites from Aedes aegypti mosquitoes, though recent research by the Pasteur Institute in Paris claims the virus has suffered a mutation that enables it to be transmitted by Aedes albopictus (Tiger mosquito). This was the cause of the plague in the Indian Ocean region and a threat to the Mediterranean coast at present.

The name chikungunya is derived from the Makonde word meaning “that which bends up” in reference to the stooped posture of the patient developed as a result of the arthritic symptoms of the disease.

Chikungunya fever resembles dengue fever, and is characterised by severe, sometimes persistent, joint pain (arthritis) as well as fever and rash. It is rarely life-threatening. Nevertheless it could be fatal – as has been for many – especially for the aged and the sick.

In October 2006, 151 districts of eight states/provinces in India were affected by chikungunya. The affected states are Andhra Pradesh, Andaman & Nicobar Islands, Tamil Nadu, Karnataka, Maharashtra, Gujarat, Madhya Pradesh, Kerala and Delhi.

Symptomatic treatment for mitigating pain and fever using anti-inflammatory drugs along with rest is usually enough. While recovery from chikungunya is the expected outcome, convalescence can be prolonged up to a year or more, and persistent joint pain may require analgesics and long-term anti-inflammatory therapy.

No vaccine is available against chikungunya. Prevention solely depends on taking steps to avoid mosquito bites and elimination of mosquito-breeding sites.

The Aedes mosquitoes that transmit chikungunya breed in a wide variety of manmade containers which are common around human dwellings. These containers collect rainwater, and include discarded tires, flowerpots, oil drums, water storage vessels, and plastic food containers.