WHO team to investigate chikungunya outbreak in Karachi today

Short-term plan of action will be devised, presented on Thursday


Our Correspondent May 02, 2017
The WHO team will devise a plan to deal with the situation. PHOTO: REUTERS

KARACHI: In order to provide support to the Sindh health department regarding the outbreak of chikungunya, a World Health Organisation [WHO] team has reached Karachi to develop a detailed plan of action.

The nine-member team will hold meetings today [Tuesday] with stakeholders and also visit disease stricken areas in Karachi before coming up with a plan on Thursday.

The implementation of intervention methods will prove to be effective and the outbreak can be reduced with relatively lower outbreak during the next transmission season compared to earlier, said Karachi Health Director Dr Muhammad Taufiq.

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He added that the technical help of experts belonging to international organisations was sought since the prevalence of the disease has exceeded a few months. According to Dr Taufiq, the WHO team will visit Saudabad, Malir, Orangi, Bin Qasim Town, the coastal belt of Karachi and other areas if necessary.

The WHO team will conduct epidemiological investigations of the outbreak, both at health facilities and a community level. A team of entomologists from the WHO’s Regional Office for the Eastern and Mediterranean, provincial dengue control programme and health department will conduct a detailed entomological survey in the affected towns confirming the distribution and abundance of aedes aegypti, a yellow fever mosquito, in all towns investigated, remarked WHO’s Head of Office, Sindh Dr Sara Salman.

In December, 2016, an outbreak of unknown fever causing joint pains was reported in Karachi, which was later confirmed to be chikungunya and spread through the bite of infected aedes aegypti mosquitos. From December 19, 2016 to April 4 this year, a total 1,419 suspected cases of chikungunya have been registered using the following WHO recommended case definition.

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"A person with acute onset of fever of 102° Fahrenheit and severe arthralgia or arthritis not explained by other medical conditions and who resides or has visited epidemic or endemic areas within two weeks before the onset of symptoms," explained Dr Salman.

According to her, cases were reported from all parts of Karachi and the highest numbers of cases were reported in Malir, with 659 incidences of chikungunya reported. This was followed by 286 in Keamari, 260 in Bin Qasim and 139 in Orangi.

She said the WHO country office and provincial heads of offices discussed the issue and it was decided to support to provincial health department and municipal administration to control outbreak.

Chikungunya engulfs coastal belt of Karachi

The objective of the mission is to investigate the outbreak and submit a short-term plan of action through the epidemiological investigation of the reported outbreak and develop a detailed plan of action by organising meetings with the provincial and district health authorities and brief them on the issue.
Karachi was the first hit by the dengue outbreak between 1994 and 1995, followed by the resurgent outbreaks of dengue fever that spread across the city in 2015. Since then dengue cases have been reported continuously from the city.

COMMENTS (2)

khososhams6@gmail.com | 6 years ago | Reply Treatment of Chikungunya There are no specific treatments for chikungunya. There is no vaccine currently available. Chikungunya is treated symptomatically, usually with bed rest, fluids, and medicines to relieve symptoms of fever and aching such as ibuprofen, naproxen, acetaminophen, or paracetamol. Aspirin should be avoided. Infected persons should be protected from further mosquito exposure during the first few days of the illness so they can not contribute to the transmission cycle. Since chikungunya is cured by immune system in almost all cases there is no need to worry.
khososhams6@gmail.com | 6 years ago | Reply Diagnosis Several methods can be used for diagnosis. Serological tests, such as enzyme-linked immunosorbent assays (ELISA), may confirm the presence of IgM and IgG anti-chikungunya antibodies. IgM antibody levels are highest 3 to 5 weeks after the onset of illness and persist for about 2 months. Samples collected during the first week after the onset of symptoms should be tested by both serological and virological methods (RT-PCR). The virus may be isolated from the blood during the first few days of infection. Various reverse transcriptase–polymerase chain reaction (RT–PCR) methods are available but are of variable sensitivity. Some are suited to clinical diagnosis. RT–PCR products from clinical samples may also be used for genotyping of the virus, allowing comparisons with virus samples from various geographical sources. Treatment There is no specific antiviral drug treatment for chikungunya. Treatment is directed primarily at relieving the symptoms, including the joint pain using anti-pyretics, optimal analgesics and fluids. There is no commercial chikungunya vaccine. Prevention and control The proximity of mosquito vector breeding sites to human habitation is a significant risk factor for chikungunya as well as for other diseases that these species transmit. Prevention and control relies heavily on reducing the number of natural and artificial water-filled container habitats that support breeding of the mosquitoes. This requires mobilization of affected communities. During outbreaks, insecticides may be sprayed to kill flying mosquitoes, applied to surfaces in and around containers where the mosquitoes land, and used to treat water in containers to kill the immature larvae. For protection during outbreaks of chikungunya, clothing which minimizes skin exposure to the day-biting vectors is advised. Repellents can be applied to exposed skin or to clothing in strict accordance with product label instructions. Repellents should contain DEET (N, N-diethyl-3-methylbenzamide), IR3535 (3-[N-acetyl-N-butyl]-aminopropionic acid ethyl ester) or icaridin (1-piperidinecarboxylic acid, 2-(2-hydroxyethyl)-1-methylpropylester). For those who sleep during the daytime, particularly young children, or sick or older people, insecticide-treated mosquito nets afford good protection. Mosquito coils or other insecticide vaporizers may also reduce indoor biting. Basic precautions should be taken by people travelling to risk areas and these include use of repellents, wearing long sleeves and pants and ensuring rooms are fitted with screens to prevent mosquitoes from entering.
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