Since the Ministry of Health and Population (MoHP) has decided to conduct a surveillance in Kathmandu on chikungunya, a strange-sounding viral illness, it is relevant to find out more about this disease. Clearly even healthcare experts in Kathmandu do not know much about this 'new' illness.
Chikungunya is a viral illness that is closely related to the dengue virus which is known to be present in Kathmandu. Both are transmitted by the vector mosquito (Aedes Aegypti) and result in a similar set of symptoms.
The patient complains of fever, headache, back pain along with skin rash. A remarkable distinction between chikungunya and dengue fever is the inflammation (arthritis) of small joints of the hands which is usually not found in dengue fever.
For chikungunya, as in dengue, there is no specific treatment, only paracetamol and other symptomatic treatment. There is also no vaccine available. Protective clothing, use of insect repellents (odomas) and other measures to prevent daytime mosquito bites (as opposed to nighttime mosquito bites for malaria transmission) are important prevention methods. Public health measures like not letting water collect in used tyres, flower pots, and plastic containers where mosquitoes breed are also vital. The good news is that in most instances like dengue fever, this disease is self-limiting and most people recover.
Both dengue and chikungunya may be brought to Kathmandu by large number of migrant workers and others from the Tarai (where both dengue and chikungunya are thought to be more prevalent). The specific mosquito vectors are in plentiful supply there, and when people afflicted with the disease come to the Valley, the Aedes Aegypti mosquito enjoys a hearty blood meal including the virus from them. The same mosquito then happily bites another victim and transmits the virus.
With the Kathmandu surveillance, MoHP is trying to determine the extent of the problem as the stage is set for both specific mosquitoes and the virus to create outbreaks. This preemptive approach (surveillance and follow up public health measures) of the ministry has to be lauded because our health institutions are usually known to simply respond to health crises.
Finally, the emergence of chikungunya is a good example of travellers from rich countries being sentinels for diseases from poor countries. Since 2005, thousands of travellers from South Asia have been afflicted with this disease, and as a result, investigators in well-resourced countries were able to study and provide information about this emerging illness.