Chikungunya: another mosquito borne illness
It may not be here yet but Chikungunya,
another Mosquito borne illness, is knocking our doors. With our recent
track record in controlling mosquito borne illnesses, we are likely to
struggle a lot more if this illness makes its way to Maldives.
We have now conceded that Dengue is probably endemic to the Maldives. Cases keep trickling in daily to Hospitals across the country. The cases have never stopped coming. In fact, in recent day we are beginning to see a slight increase in cases. This is not surprising as the number of mosquitoes (just from personal observation) seems to have increased following the recent rainy period.
For those of you keeping tabs on recent regional news, you would know that both Chikungunya and Dengue are causing major outbreaks in India. Dengue in the north has caused many deaths and Chikungunya in the south has caused much debilitation.
We have been alerted about Chikungunya by international agencies for many months now. Luck more than anything else has played a bigger role in keeping it away from our shores. With huge number of air transport passengers shuttling between Maldives and ports in south India it is largely a question of when, not if, Chikungunya would arrive in Maldives. When it does, it is anyones guess how it would spread in our mosquito infested habitat.
By the way, Chikungunya (an African Phrase meaning "that which bends") is a viral illness characterised by fever, aches and pain, vomiting and fatigue. The name itself is quite descriptive of the condition: the severe muscular and joint pain causes victims to double over in pain. And quite commonly the pain lingers on for many weeks to months.
In our current Dengue endemic state, Chikungunya is likely to cause a few more headaches and not just to patients. The illness resembles in its early days other viral illnesses like viral fever (Gadha hun) and Dengue Fever.
Fortunately in Maldives, our population is usually very quick in seeking medical assistance, especially when a child is unwell. Except in a few cases, this allows for early clinical detection and initiation of management. Fever management and supportive fluid management remains the hallmark of current best practice and should be started at home without delay.
The more pressing issue has been and continues to be the same: Effectively controlling our mosquito population (Aedes or otherwise). A concerted effort with measures at the individual level, house-hold level, community level and official government level are needed for any success worth the label.
Where we have succeeded in the past (the Malaria eradication program) the major work was done by the communities in association with public health authorities. And where we have recently, repeatedly, failed we have not had that level of co-operation and dedication. Participation in such efforts should not be dependent on whether one is rich or poor, neither on whether one is pro- or anti-; that virus-carrying mosquito looking for a blood meal would not consider any of it before it bites.
Discussion (moved from niyaf.blogspot.com)
7 comments:
We have now conceded that Dengue is probably endemic to the Maldives. Cases keep trickling in daily to Hospitals across the country. The cases have never stopped coming. In fact, in recent day we are beginning to see a slight increase in cases. This is not surprising as the number of mosquitoes (just from personal observation) seems to have increased following the recent rainy period.
For those of you keeping tabs on recent regional news, you would know that both Chikungunya and Dengue are causing major outbreaks in India. Dengue in the north has caused many deaths and Chikungunya in the south has caused much debilitation.
We have been alerted about Chikungunya by international agencies for many months now. Luck more than anything else has played a bigger role in keeping it away from our shores. With huge number of air transport passengers shuttling between Maldives and ports in south India it is largely a question of when, not if, Chikungunya would arrive in Maldives. When it does, it is anyones guess how it would spread in our mosquito infested habitat.
By the way, Chikungunya (an African Phrase meaning "that which bends") is a viral illness characterised by fever, aches and pain, vomiting and fatigue. The name itself is quite descriptive of the condition: the severe muscular and joint pain causes victims to double over in pain. And quite commonly the pain lingers on for many weeks to months.
In our current Dengue endemic state, Chikungunya is likely to cause a few more headaches and not just to patients. The illness resembles in its early days other viral illnesses like viral fever (Gadha hun) and Dengue Fever.
Fortunately in Maldives, our population is usually very quick in seeking medical assistance, especially when a child is unwell. Except in a few cases, this allows for early clinical detection and initiation of management. Fever management and supportive fluid management remains the hallmark of current best practice and should be started at home without delay.
The more pressing issue has been and continues to be the same: Effectively controlling our mosquito population (Aedes or otherwise). A concerted effort with measures at the individual level, house-hold level, community level and official government level are needed for any success worth the label.
Where we have succeeded in the past (the Malaria eradication program) the major work was done by the communities in association with public health authorities. And where we have recently, repeatedly, failed we have not had that level of co-operation and dedication. Participation in such efforts should not be dependent on whether one is rich or poor, neither on whether one is pro- or anti-; that virus-carrying mosquito looking for a blood meal would not consider any of it before it bites.
Discussion (moved from niyaf.blogspot.com)
7 comments:
Innaaa lillaaahi vainnaa ilaihi raaajiooon.
I have heard that cyclopamine is being used in Maldives. Can you verify this for me please. Below is the reason why i am interested in this issue.
http://www.wired.com/news/technology/medtech/0,71569-0.html?tw=rss.index
http://blog.wired.com/oneeyed_child/
To the extent that I am aware of the drug is not being used at all in the Maldives. Our health care system is not equipped for using an experimental agent like that in any trial.
I am of the opinion that it is not available in the country.
However, having said that, we do have many Maldivian getting treatment from overseas medical centers including ones in India. Therefore it is practically impossible to say if any Maldivians have ever used the Medication or not.
NOW: What is the authenticity of the report that you have referred to??
Cancer Center, Ordway Research Institute, Albany, New York 12208, USA. mblagosklonny@ordwayresearch.org
Most anticancer drugs are teratogens, merely because they target vital cellular functions. Conversely, some plants produce agents that intentionally target embryonic signaling pathways, precisely to cause birth defects if pregnant animals eat such plants. Cyclopamine, a teratogen produced by a flowering plant, inhibits the Hh/Gli pathway, causing developmental defects such as cyclopia (one eye in the middle of the face). In theory, selective teratogens may suppress cancer cells that reactivate embryonic pathways, while sparing most normal cells. I discuss the potential (and limits) of teratogens in cancer therapy, linking diverse topics from morning sickness of pregnancy, embryonic pathways and poisonous plants to the mechanism of action of anticancer teratogens and their combinations with less selective cytotoxic agents.
There is no denying the teratogenicity of the agent in question.
That is why its use is restricted in many places.
I believe the majority of the public is under the impression that chikungunya can be potentially fatal, especially when older people contract this relatively new mosquito borne disease, following an article on Minivan Daily. I have tried to gather information about the illness that provides more ground to this doctrine without success. Could you forward your view.. isaeed@avasmail.com.mv
Chikungunya is not a new illness, it just hadn't hit the headlines until recently. The current understanding of the natural history of the illness suggests that chikungunya itself is non fatal.
That does not however mean that no individual would die of it. It is known that people could die from it (although rare).
The impact of the disease is obviously greater on the elderly. The immune mediated illness that follows the acute viral (CKV) infection can, as we are witnessing, cause exacerbation of co-morbidities (other illnesses and medical conditions the person suffers from).
This is perhaps one of the reasons why elderly fare less well. They are more likely to have age induced organ insufficiencies and even may have acquired (disease induced) organ damage over the years. These insufficiencies become more marked and manifest during the immune mediated illness phase of chikungunya.
My understanding is that chikungunya is in itself non fatal in the great majority of cases. The likelihood of poor outcome, as you have correctly indentified, is greater in the very elderly. However, I must say that even in that age group most recover.