Outbreak Of Chikungunya Epidemic Biology Essay

Reports of large-scale eruptions of febrility caused by CHIKV virus infection in several parts of the state particularly in Southern India have confirmed the re-emergence of this virus. In 2006, Southern India states Andhra Pradesh, Karnataka, Tamil Nadu and Kerala together contributed more than 70 % of the entire state ‘s incidence out which Karnataka province entirely contributed about 55 % of incidence. In 2008, Karnataka and Kerala together contributed more than 95 % of the sum suspected instances and in 2009 besides 41,649 suspected CHIKV instances have been reported and 3,239 instances were confirmed for Karnataka. There is no specific intervention ( therapies ) or vaccinums are available for CHIKV. But the Homoeopathic system of medical specialty claims to hold medical specialties every bit good as preventative steps against this disease.

Cardinal words: CHIKV, Aedes aegypti, dandy fever, incidence and eruption.

1. Introduction

Chikungunya ( CHIKV ) virus has late re-emerged as an of import pathogen doing epidemics of the disease in several states. Epidemic revival of CHIKV was recorded in 2000 in the Democratic Republic of Congo ( DRC ) , in Indonesia during 2001-2003 and in India during 2005-2006, after a spread of 39, 20 and 32 old ages severally. In December 2006, there were eruptions of 3,500 confirmed instances in the Maldives, and over 60,000 suspected instances and over 80 deceases in Sri Lanka. The widespread eruption of CHIKV in India is in the provinces of Maharashtra, Gujarat, Madhya Pradesh and chiefly in southern provinces Andhra Pradesh, Tamil Nadu, Karnataka, and Kerala. In Kerala province, 43,138 suspected instances and 125 deceases were occurred due to this eruption, with the bulk of the casualties reported in the territory of Alapuzha, chiefly in Cherthala. In early 2007, CHIKV spread from Kerala and Tamil Nadu to Sri Lanka and many people were infected. CHIK outbreaks in E, South, West and cardinal Africa have been documented ( see Fig 1. for planetary distribution of CHIKV ) .

Fig 1. : Chikungunya ( CHIKV ) planetary distribution map ( states affected )

Beginning: WHO report, 2007

2. Spread of the Epidemic:

CHIKV virus is autochthonal to tropical Africa and Asia, where it is transmitted to worlds by the bite of septic mosquitoes, normally of the genus Aedes mosquito. Aedes albopictus is considered to be the vector in Reunion and other islands of the Indian Ocean. Although both Aedes aegypti and Aedes albopictus mosquitoes are prevailing in India, the former is the chief responsible vector for the spread ( Yergolkar et al. , 2006 ) . CHIKV febrility is a comparatively rare signifier of viral febrility caused by an alphavirus that is spread by the bite of an septic “ Aedes aegypti mosquito ” . The mosquito normally transmits the disease by seize with teething an septic individual and so seize with teething person else.A An septic individual can non distribute the infection straight to other individuals ( i.e. it is non a contagious disease ) ( see Fig 2 ) . In Makonde linguistic communication, CHIKV means “ that which bends up ” . Although it may feed at any clip, the extremum seize with teething periods of mosquitos are few hours after morning and in the late afternoon until a few hours after dark. The mosquito ‘s preferable genteelness countries are in countries of dead H2O, such as flower vases, exposed barrels, pails, and discarded tyres, but the most unsafe countries are wet shower floors and lavatory bowls, as they allow the mosquitoes to engender right in the abode ( www.cdc.org 2006 ) . CHIKV virus is extremely morbific and disenabling but is non catching between people. In India, the first CHIKV eruption was recorded in 1963 in Kolkata ( Calcutta ) followed by epidemics in eastern coastal countries Chennai ( about 4,00,000 instances ) , Pondicherry and Vellore of Tamil Nadu province in 1964, Visakhapatnam, Rajmundry and Kakinada of Andhra Pradesh province in 1965 ( Rao, 1966 ) , Nagpur and Barsi of Maharashtra province in 1965 and 1973 severally ( Padbidri and Gnaneswar, 1979 ) . In position of the long absence of CHIKV epidemics, it was under the feeling that CHIKV virus had disappeared from India and South-East Asia ( Burke et al. , 1985 ; Pavri, 1986 ) . Serologic studies supported this position ( Neogi et al. , 1995 ) , see besides Vidya et Al ( 2007 ) . The eruption of CHIKV febrility that started in the Indian Ocean Islands in early 2005 spread through bordering islands and appeared in peninsular India by late 2005. It has been estimated that over 1, 80,000 suspected instances of CHIKV fever have occurred in India since December 2005 ( Ravi, 2006 ) . Andhra Pradesh ( AP ) was the first province to describe this disease in December 2005, and one of the worst affected provinces ( over 80,000 suspected instances ) ; it spread to Tamil Nadu in April 2006 and to Karnataka and Kerala in May. However, studies of large-scale eruptions of febrility caused by CHIKV virus infection in several parts of Southern India have confirmed the re-emergence of this virus ( Enserink, 2006 ) , see besides Fig 3. and Fig 4. for the suspected instances of CHIKV during 2006-2009 and distribution in India peculiarly in south-India severally.

Fig 2. : Transmission Cycle of CHIKV

Beginnings: Directorate of National Vector Borne Disease Control Programme

Fig.3: CHIKV suspected instances of South India during 2006-09

Fig 4. : Spread of Chikungunya febrility ( shaded area- provinces affected ) in India during 2006-2010.

Beginning: Krishnamoorthy et Al. ( 2009 )

3. Effectss of the Epidemic:

CHIKV virus is an arborvirus, of the genus, Alphavirus, that is transmitted to worlds by virus-carrying Aedes mosquitoes. There have been recent eruptions of CHIKV associated with terrible morbidity. CHIKV causes an unwellness with symptoms similar to dengue febrility. CHIKV manifests itself with a drawn-out arthralgic disease that affects the articulations of the appendages. The ague feverish stage of the unwellness lasts merely two to five yearss. The hurting associated with CHIKV infection of the articulations persists for hebdomads or months. All age groups were affected, including neonates. Recovery from the disease varies by age. Younger patients retrieve within 5 to 15 yearss and middle-agers recover in 1 to 2.5 months. Recovery is longer for the aged. The badness of the disease every bit good as its continuance is less in younger patients and pregnant adult females. In pregnant adult females, no indecent effects are noticed after the infection.

4. Epidemic Status of Karnataka province:

Karnataka was the worst affected province during 2006 CHIKV eruption, 27 territories of the province reported over 7, 62,026 ( 54.74 % of the sum ) suspected instances. Several territories of the province such as Gulbarga, Tumkur, Bidar, Raichur, Dharwad, Bellary, Chitradurga, Davangere, Kolar and Bijapur have recorded big figure of CHIKV virus related febrility instances in 2006, Bijapur ( over 80,00 instances ) and Gulbarga ( more than 52,353 instances ) are the worst affected territories during the epidemic eruption. In 2007, merely 1705 suspected CHIKV instances were reported and whereas in 2008, the province reported 45,618 instances, more than 64 per centum of the full suspected instances in India in 2008, the Mangalore ( over 27,408 reported instances ) was the worst affected territory of the province. Unofficial studies suggested that more figure of persons were suffered from symptoms of CHIKV. In 2009, 41,649 suspected CHIKV instances have been reported and 3,239 instances were confirmed for CHIKV ( Table 1, 2 and 3 ) . There has besides been a pronounced lessening in CHIKV instances in 2010 in the province with 5,244 instances reported and 528 instances were confirmed ( by the terminal of grand 2010 ) . There is no statistical relationship between CHIKV and Dengue instances ( though CHIKV causes an unwellness with symptoms similar to dengue febrility ) , refer Table 2 and 3.

Table1: Chikungunya ( CHIKV ) Fever Situation in the Country during 2006 ( Prov. ) .

State

No. of territories affected

Entire febrility cases/Suspected CHIKV febrility instances

( per centum values )

No. of samples sent to NIV/NICD

No. of confirmed instances

Andhra Pradesh

23

77535 ( 5.57 )

1,224

248

Karnataka

27

762026 ( 54.74 )

5,000

298

Maharashtra

34

268333 ( 19.28 )

5,421

786

Tamil Nadu*

35

64802 ( 4.66 )

648

116

Madhya Pradesh

21

60132 ( 4.32 )

892

106

Gujarat

25

76012 ( 5.46 )

1,155

225

Kerala

14

70731 ( 5.08 )

235

43

A & A ; Nicobar

2

4469 ( 0.32 )

0

0

GNCT of Delhi

12

560 ( 0.04 )

560

67

Rajasthan

1

102 ( 0.01 )

44

24

Pondicherry

1

542 ( 0.04 )

52

9

Goa

2

287 ( 0.02 )

75

2

Orissa

13

6461 ( 0.46 )

171

34

West Bengal

1

21

21

Lakshadweep

2

35 ( 0.003 )

6

6

Entire

213

13,92,027

15,504

1,985

Beginnings: Directorate of National Vector Borne Disease Control Programme

Table 2: As on 19-9-2008, the sum of 70740 suspected instances of CHIKV have been reported from 8 States in the India. The State-wise suspected instances of CHIKV are as follows

State

CHIKV instances

( per centum values )

Dengue instances

( per centum values )

Andhra Pradesh

5 ( 0.01 )

24 ( 1.15 )

Goa

16 ( 0.02 )

18 ( 0.86 )

Gujarat

168 ( 0.24 )

250 ( 11.94 )

Haryana

20 ( 0.03 )

739 ( 35.29 )

Karnataka

45618 ( 64.49 )

221 ( 10.55 )

Kerala

24505 ( 34.64 )

308 ( 14.71 )

Maharashtra

398 ( 0.56 )

252 ( 12.03 )

Tamil Nadu

10 ( 0.01 )

282 ( 13.47 )

Entire

70740 ( 100.0 )

2094 ( 100.0 )

Beginnings: Directorate of National Vector Borne Disease Control Programme

Table 3: As on 30-04-2009, the sum of 2717 suspected instances of CHIKV have been reported from 7 States in the India. The State-wise suspected instances CHIKV are as follows

State

CHIKV instances

( per centum values )

Dengue instances

( per centum values )

Andhra Pradesh

549 ( 20.21 )

20 ( 2.45 )

Goa

64 ( 2.36 )

6 ( 0.73 )

Karnataka

1913 ( 70.41 )

45 ( 5.51 )

Kerala

38 ( 1.40 )

485 ( 59.36 )

Maharashtra

102 ( 3.75 )

75 ( 9.18 )

Tamil Nadu

16 ( 0.59 )

113 ( 13.83 )

West Bengal

35 ( 1.29 )

73 ( 8.94 )

Entire

2717 ( 100.0 )

817 ( 100.0 )

Beginnings: Directorate of National Vector Borne Disease Control Programme

A Case of Mangalore District ( Karnataka State ) during 2008:

As on 05-07-2008, the entire 27408 suspected instances of CHIKV have been reported from all the Taluks of Mangalore territory. The Taluk-wise suspected instances are as follows

Table 4: The District-wise suspected instances of CHIKV of Karnataka State in 2008.

District

Suspected Cases

Blood sample collected

Number of positives

Dengue instances

D.K.

27,408

396

122

24

Kodagu

1,074

85

20

0

Shimoga

454

41

8

0

Udupi

357

165

40

0

Mysore

343

53

23

0

Dharwad

325

19

18

0

Belgaum

267

20

10

1

Hassan

171

36

10

0

Bangalore

30

30

12

1

U.K.

23

23

0

0

Tumkur

21

21

11

1

Gadag

24

4

3

18

Table 5: The Taluk-wise suspected instances of CHIKV in 2008

Taluk

Suspected Cases

Number of positives

Dengue instances

Mangalore

2426

32

7

Beltangadi

3252

17

2

Bantwal

9628

20

4

Puttur

9419

13

5

Sulya

2683

22

6

Entire

27,408

104

24

In some countries of Mangalore territory about 50 % of the population is affected by this disease. Besides a big figure of infections are unreported or are misdiagnosed ( Table 4 and 5 ) .

5. Decision:

There is no specific intervention ( therapies ) or vaccinums are available for chikungunya. But the Homoeopathic system of medical specialty claims to hold medical specialties every bit good as preventatives against this disease. The effects of these medical specialties are non scientifically proved. They claim to hold used these efficaciously in recent eruptions in Kerala State of India. The most effectual agencies of bar are those that protect against any contact with the disease carrying mosquitoes.