Saturday, November 18, 2017

How Dangerous is Chikungunya?

Chikungunya mosquito photoUp until a few months ago, Chikungunya [chik-en-gun-ye] was not only a hard name to pronounce; it was a word that most people in the Dominican Republic had never heard of. As this mosquito-borne viral disease is spreading throughout the country, local doctors and health departments stress the fact that under normal circumstances Chikungunya is not a lethal disease. However, Chikungunya patients will experience some mild to strong discomfort for a specific period of time, and vulnereable individulas such as infants and older people will need to be monitored. 


According to the World Health Organization (WHO), Chikungunya is transmitted from one human to the next via the bite of infected female mosquitos. Especially the Aedes mosquito, easily recognizable by the white markings on its legs, are the ones mostly responsible for transmitting Chikungunya as well as other mosquito-borne viruses such as Dengue Fever. 

The origin of Chikungunya
Chikungunya was first identified in an outbreak in Southern Tanzania in 1952, and got its name from the Kimakonde language, spoken by the local Makonde tribe people. ‘Chikungunya’ means: "that which bends up”. The disease was given this name, because it describes the stooped posture adopted by affected people, due to the musculoskeletal pain caused by the disease.

In December 2013, the WHO reported for the first time that local mosquitoes on Saint Martin (little island in the Caribbean) had been infected with Chikungunya and were spreading the disease to people. 

Chikungunya within The Dominican Republic
The Pan American Health Organization & World Health Organization reported the first case of Chikungunya in the Dominican Republic in April 2014.

The latest PAHO Chikungunya data updated on 8 August 2014 identifies 33 countries and territories in the Americas that have local mosquitoes spreading the disease. A total of 32 deaths and 570,972 suspected Chikungunya cases have been reported from these areas and so far the Dominican Republic accounts for the majority, with more than 370,141 suspected cases.

Chikungunya within Cabarete
Clarifying the Chikungunya situation in the Cabarete area, Dr. Johandy Céspedes at SERVIMED Urgent Care Clinic in Cabarete explained that she has seen more Chikungunya cases as of late, but that the situation is not too bad here. “The situation is worse in the south of the Dominican Republic, where many people are affected by Chikungunya,” she added.

Céspedes has also noticed a change in the severity of the symptoms. “For some reason that I cannot explain, the symptoms of Chikungunya patients are now less severe than when we first became familiar with the disease.” Céspedes, who was infected with Chikungunya a few months earlier, reported that her worst symptoms were itching rashes. 

Main symptoms to look out for
The Center for Disease Control and Prevention (CDC) reports that most people infected with the Chikungunya virus develop symptoms that are similar to those of Dengue Fever. Misdiagnosis can therefore happen in areas where Dengue is common. However, most Chikungunya related symptoms are relatively mild and sometimes the infection may go unrecognized.  

Most common symptoms:

*      Abrupt onset of fever

*      Joint pain

Common symptoms:

*      Headache

*      Muscle pain

*      Nausea

*      Fatigue

*      Joint swelling

*      Rashes

Occasional – less common symptoms:

*      Persisting joint pain (months-years)

*      Eye complications

*      Heart complications

*      Neurological complications

The WHO highlights that the symptoms usually occur between four to eight days after the mosquito bite. It is also reported that the illness usually lasts from two to 12 days.

Risks & dangers
Although Chikungunya tends to be an unpleasant and painful experience, both the CDC and WHO report that Chikungunya does not often result in death itself. However, for certain vulnerable groups of people the Chikungunya virus can be a contributing factor to the cause of death.

Vulnerable individuals include:

*    Newborns infected around the time of birth

*    People with arthritis

*    People older than 65

*    People with high blood pressure

*    People with diabetes

*    People with heart disease.

*    Pregnant women

Unfortunately, once infected there is no medication or treatment that can cure Chikungunya. However, there are ways to ease the symptoms.

*      Rest

*      Drink plenty of fluids to prevent dehydration

*      Painkillers, such as ibuprofen or acetaminophen, can help relieve fever and pain.

Dr. Johandy Céspedes informs that in general her Chikungunya patients are ambulant. “We give them medication to ease their symptoms: paracetamol to ease the fever and joint pains, and antihistamines and Zink lotion to help ease the itchy rashes.”

She added that vulnerable groups of people are monitored more closely, including women in their late pregnancy. “The high fever can cause complications for the unborn baby”, she explains, “but so far I have not seen any bad Chikungunya complications here.”

How to prevent getting Chikungunya
Currently no vaccine exists against the Chikungunya virus infection. The only way to avoid getting the disease is to prevent mosquito bites.

It is commonly known that mosquitos usually bite during the hours around sunrise and sunset. However, the Aedes mosquitoes are active and bite throughout the day as well.For people who normally attract mosquitos it is highly recommendable to use mosquito repellent, wear long sleeves and pants and use mosquito screens in their homes. Read here for some ideas for natural ways to battle the mosquitos: Natural Ways to Battle Dominican Mosquitos.

Good news for those visiting
Although highly contagious, Chikungunya seems to be relatively harmless for most people.

When asked whether any visitors to the Caberete region had fallen ill with Chikungunya, Dr. Johandy Céspedes replied that “it might be due to the several days incubation time, but so far I have not had any tourist patients with Chikungunya.”

Finally when asked if people should worry about Chikungunya she has a clear answer. “No, people should not worry about Chikungunya.”

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