DENGUE, MALARIA AND CHIKUNGUNYA

                                                                                                Health & Welfare Services

                                                                                                Powai

                                                                                                October 5, 2006

 

 

OUTBREAK OF INFECTIOUS DISEASES

(DENGUE, MALARIA AND CHIKUNGUNYA)

 

 

There has been an outbreak of infectious diseases like Dengue, Malaria and Chikungunya, in different parts of the country, mainly caused by mosquito bite.

 

Though this has not been reported as an epidemic, large numbers of people are falling sick due to these diseases.

 

All these diseases start with fever; only a clinician and laboratory investigations can diagnose these diseases.

 

Following are the characteristics of theses three diseases

 

 

 

	Malaria	Dengue	Chikungunya fever
What is it?	Infectious disease caused by the parasite called Plasmodia. (P.vivax and P.falciparum are more common)	It is an acute viral fever occurring in two forms – Dengue Fever – Dengue Hemorrhagic Fever Caused by Dengue virus	It is an acute viral fever caused by the Chikungunya virus
Mode of spread	Bite of infected female Anopheles mosquito. (Night biter)	Bite of an infected Aedes aegypti mosquito. (Day biter)	Bite of an infected Aedes aegypti mosquito. (Day biter)
Onset of symptoms	§         8-12 days after bite of infected mosquito	§         2-5 days after bite of infected mosquito	§         3-12 days after bite of infected mosquito
Symptoms	§         Fever recurring every 2 days §         Chills §         Headache, muscle ache §         Tiredness §         Nausea, vomiting and diarrhea may occur §         Jaundice(Yellow colorings of skin and eyes)	§         High fever §         Severe headache §         Pain behind the eye §         Severe joint and muscle pain §         Nausea and vomiting §         Rash §         In hemorrhagic dengue, there is damage to blood, lymph vessels, bleeding from nose, gums or under skin	§         High fever of sudden onset §         Headache §         Joint pain and/or swelling of joints §         Nausea and vomiting §         Infection of conjunctiva of eye and sensitivity to light §         Rarely rash
Complications	§         Commonly seen in P. falciparum infection. §         Cerebral malaria (affecting the brain), bleeding disorders, jaundice, kidney failure, respiratory distress and death.	§         Bleeding disorders leading to bleeding from the nose, mouth and gums or skin bruising §         Very low blood pressure leading to shock	§         Life-threatening complications are rare §         Can affect the brain in new-born children
Diagnosis	§         Based on Clinical features and Peripheral blood smear §         Negative blood test DOES NOT rule out malaria	§         Based on Clinical features §         Laboratory tests such as Serology and PCR are used to confirm diagnosis.	§         Based on Clinical features §         Laboratory tests such as Serology and IgM antibody are used to confirm diagnosis.
Treatment	§         Very effective drugs are available, Eg. Chloroquine, Quinine, Primaquine, Sulphodoxine+Pyrimethamine, Arteether and artemether.   §         Early diagnosis and treatment can prevent complications.	§         No specific anti-viral treatment available. §         Symptomatic treatment is given, consisting of Pain relieving drugs (such as paracetamol, ibuprofen and diclofenac) plenty of fluids and rest. §         Aspirin is to be avoided
Prevention	There is no vaccine available for all these diseases.  Always notify the public health authorities if any of these diseases occurs in your locality. Preventive measures include-   ¨       Using Personal protective measures:   §         Preventing mosquitoes from entering the house- Apply nets to windows §         Protection from mosquito bites by using ­        Protective clothing ­        Mosquito repellents ­        Insecticide vapourizers ­        Mosquito nets   ¨        Elimination of mosquitoes   §         Avoiding or eliminating water collections, as these mosquitoes lay eggs in clean stagnant water. Most such collections are artificial, temporary and man made such as buckets, coconut shells, tyres thrown in open and overhead water tanks, etc.   §         Use of Larvicides such as Temiphos and Fenthion   §         Killing adult mosquitoes using Space sprays, Thermal fogs. Commonly used insecticide sprays are Organophosphate insecticides and Pyrethroids

 

Recommendations:

 

Ø       If there is stagnant water near sites / offices / residential colonies notify  Health / Sanitary authority for drainage / anti larva measures ( spray of insecticides)

 

Ø      Drain stagnant water from potted plants, air coolers , old tins, old tyres etc.

 

Ø      Enforce stringent sanitary measures in and around our sites to reduce mosquito population by fogging and spraying pesticides.

 

Ø      To avoid mosquito bites:

Ø      Use mosquito repellant creams while going outdoors

Ø      Ensure mosquito nets on windows

Ø      Use electric insecticide vapourisers as indoor mosquito repellants

Ø      Use mosquito nets in highly endemic areas

 

Ø      Do not ignore fever (with or without chills) more than 38^oc / 104^oF. Consult your family physician

 

Ø      All local coordinators/ site in charge and doctors are requested to translate this information into local language and spread awareness.

 

Ø      In case you have a suspect case please provide us information about location, telephone number of the employees, his / her attending physician’s / hospitals for follow up and better coordination in order to provide best healthcare.

 

 

 

 

Dr. K J Kamat

                                                           

(Director – Medical, Health & Welfare Services)