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As Dhaka grapples with a relentless dengue outbreak, chikungunya, another mosquito-borne disease, has begun to spread, compounding the challenges facing the city’s residents.
Since its symptoms are quite similar to dengue, it often leads to widespread confusion among patients as they are unable to identify it when infected. Without adequate testing facilities in government hospitals, many cases go undiagnosed, making it difficult to gauge the full scale of the outbreak, reports bdnews24.com.
Meanwhile, a private facility in Dhaka has treated over 300 chikungunya patients in just a month. The International Centre for Diarrhoeal Disease Research, Bangladesh, or ICDDR,B, and the Institute of Epidemiology, Disease Control and Research, or IEDCR, have confirmed chikungunya cases through diagnostic testing.
Medical experts say many people are coming in with symptoms, some of whom they suspect are infected with chikungunya.
They also fear that the mosquito-borne disease will spread more widely next year due to the untimely detection of chikungunya patients this year.
Chikungunya is transmitted by the Aedes aegypti and Aedes albopictus mosquitoes. The virus, which belongs to the Togavirus family, was first identified in Africa in 1952 and is categorised as an arbovirus because it is mosquito-borne.
In Bangladesh, the virus was first detected in 2008 in the northern districts of Rajshahi and Chapainawabganj. In 2011, an individual affected with chikungunya was found in Dhaka’s Dohar Upazila.
Sporadic cases have been reported since then, with a significant outbreak in 2017 that affected many in several places including Dhaka. Public health experts estimate that at least 100,000 people were infected during that time, though official figures are unavailable due to a lack of systematic reporting.
SYMPTOMS OF CHIKUNGUNYA
- sudden onset of fever, accompanied by severe joint pain
- severe headache
- feeling of cold or shivering in the body
- nausea or vomiting
- reddish spots or rash on the skin
- muscle pain
REMEDIES
Serology or RT-PCR tests can detect the virus in the blood within a week of the onset of symptoms. All tests for diagnosing chikungunya are done at the IEDCR, although several private hospitals and diagnostic centres also offer them.
There is no specific treatment for chikungunya. The illness typically resolves itself, but its hallmark symptom—intense joint pain—can persist for months or even years.
Treatment is limited to managing symptoms, with doctors recommending rest, hydration, and paracetamol for fever and pain. For lingering joint pain, light exercise and cold compresses may help, though severe or worsening cases require medical attention.
CHIKUNGUNYA PATIENTS IN DHAKA THIS YEAR
Qamrunnahar Sultana, a doctor at a private hospital, fell ill with a fever and mild muscle pain in the last week of October.
After testing positive for chikungunya, she decided to rest at home for eight days before going back to work.
However, a week later, severe joint pain began to set in.
“For the past few days, every joint in my body has been hurting. It has only gotten worse since yesterday. Now I am practically disabled. I can’t walk, get onto a rickshaw, or even take a tablet from its strip. I have been on painkillers since Oct 29. I can’t stand the pain without it.”
For Achintya Kumar, an official at a private institution, the experience has been equally devastating.
After falling ill with a fever in early November, he tested negative for dengue but was later diagnosed with chikungunya due to his intense body pain.
“I can’t get up if I sit somewhere, I can’t get out of bed without help. It feels like someone has used an injection in my veins in the legs and shoulder joint. It hurts particularly after I wake up in the morning. I’ve always been energetic, but this disease has completely paralysed me.”
The Directorate General of Health Services, or DGHS, regularly updates dengue and COVID-19 statistics, including the daily death count.
However, they do not have any information on chikungunya cases.
As such, due to the lack of systematic reporting, the full scale of the outbreak remains unclear.
Recently, the ICDDR,B tested 151 suspected dengue patients residing in different areas of Dhaka in October. However, all the samples came back negative for dengue NS1.
Meanwhile, at least 27 of the 151 samples (18 percent) were confirmed to have chikungunya.
In November, the IEDCR identified 47 chikungunya cases, while Square Hospital treated 314 patients in its outpatient department from Nov 1 to Nov 27. At least four chikungunya patients were admitted with severe symptoms at Square Hospital.
Square Hospital CEO Md Esam Ebne Yousuf Siddique told bdnews24.com: “We have received a significant number of chikungunya patients this year. Most of them took outdoor services.”
Medicine Specialist Dr ABM Abdullah also reported receiving chikungunya patients this year. He has also been seeing patients whose symptoms are similar to chikungunya at his private chamber.
According to Dr Abdullah, symptoms of chikungunya are similar to dengue. However, in case of chikungunya, patients suffer more due to body pain as it can last for months.
Mugda Medical College and Hospital is a primary treatment centre for dengue. On Thursday, Dr SM Hasibul Islam, the director of the hospital said that the Mugda Hospital does not have a system for testing chikungunya. As such, the doctors cannot confirm whether a patient has been infected with chikungunya.
“A lot of people come here with dengue. Many of them have signs and symptoms of chikungunya.”
PRECAUTION
- Aedes aegypti and Aedes albopictus mosquitoes usually breed in clean stagnant water. Those who have places where such mosquitoes breed are at higher risk.
- These mosquitoes usually bite during the day (dawn or dusk). In addition, the disease can also spread by receiving blood from a blood donor infected with the chikungunya virus and due to carelessness during sample testing in the laboratory.
- There is no vaccine to prevent this disease. Personal awareness is the main way to prevent chikungunya virus infection.
- Keeping most of the body covered (wearing full-sleeved shirts and full-length pants), installing nets on windows, not keeping doors and windows open unnecessarily, using mosquito nets while sleeping, and using mosquito repellent cream on the body can help prevent mosquito bites.
FEARS OF INCREASED PREVALENCE
ICDDR,B Scientist Mohammad Shafiul Alam says he is more concerned about chikungunya than dengue due to its appearance at the tail end of Dhaka’s monsoon season this year.
He told bdnews24.com: “We are more worried about chikungunya this year than dengue. Chikungunya patients are being detected in the late season this year. It is also being detected in various diagnostic centres.”
He fears the disease may spread more widely next year.
“There was a major dengue outbreak in 2023, and many people died. A major reason for this was the change in the type of virus.”
“When the serotype changes, the death and infection rates increase. One serotype dominates for at least three years. From 2019 to 2022, DEN-3 was present. DEN-2 came in 2023 and is still dominant. After that, DEN-2 will decrease in dominance, which could lead to an increase in chikungunya. I think this outbreak could happen next year or the year after.”
However, DGHS Director Md Abu Jafor has advised the public to not worry about chikungunya.
“Chikungunya outbreaks have occurred in Bangladesh before. People need to be aware so that they are not bitten by mosquitoes.”