The Department of Health (DOH) confirmed the outbreak of chikungunya, a mosquito-borne disease like dengue, in several communities across the country. According to DOH Assistant Secretary Dr. Eric Tayag, some residents of these communities are found suffering not only of chikungunya, but from dengue as well.
Dr. Tayag named the towns as Kiamba and Maitum in Saranggani; Villareal and Daram in Western Samar; Ma. Aurora in Aurora; Sindangan in Zamboanga del Norte; Sta. Rita in Samar; Concepcion in Romblon; Santiago in Agusan del Norte; and Patnongon in Antique. These areas have been the focus of an special investigation of the health department to establish what caused the two mosquito borne diseases to surface in these areas at the same time.
Signs and symptoms
According to the World Health Organization (WHO), Chikungunya is a viral disease that is spread by infected mosquitoes. The term originated from a verb in the Kimakonde language that means “to become contorted.” The virus is transmitted from human to human by bites of infected mosquitoes. Most commonly, the mosquitoes involved are Aedes aegypti, which happened to be the carrier of dengue virus and Aedes albopictus.
Chikungunya is characterized by an abrupt onset of fever frequently accompanied by joint pain. Other symptoms include muscle pain, headache, nausea and vomiting, fatigue and rash. Chikungunya is rarely fatal. However, it shares some clinical signs with dengue and can be misdiagnosed in areas where dengue is common.
Symptoms of chikungunya are often confused with those of dengue or flu. In some cases there may also be extreme pain in the joints, difficulty in movement, and arthritis. Cases of eye, neurological and heart complications as well as gastrointestinal problems have also been reported.
The incubation period of the chikungunya virus is two to five days. Symptoms of the illness start to show once this incubation period is complete but some persons may not show signs of the illness for up to 12 days.
“Both are manifested by rashes. During the first five days of the illness, it cannot easily be distinguished if it is dengue or chikungunya,” Tayag said. Although the two diseases have nearly the same symptoms, the latter is rarely fatal and is characterized by long-term joint pains. Meanwhile, dengue could have severe complications like bleeding and respiratory diseases, that might lead to death.
Tayag explained that this worries the health department as it may cause confusion on the medication that should be administered on the patients. He also added that if chikungunya would continue to spread, doctors might have to be trained on its symptoms and management.
Chikungunya was first identified in early 1952 in Tanzania and has caused periodic outbreaks in Asia and Africa in the 1960s. Based on WHO data, chikungunya has been documented to more than 40 countries worldwide. In 2005, an outbreak occurred in islands of Indian Ocean. In 2006, a large number of imported cases in Europe were documented. In 2007, a large outbreak happened in Gabon and India. Several countries in South East Asia were also affected.
Chikungunya outbreaks in the Philippines “coincide with dengue season during the rainy months.” DOH observed that it started to spread after tropical storm Sendong hit parts of Mindanao, particularly Cagayan de Oro City and Davao in 2011.
State of calamity
As of July, the DOH confirmed the outbreak of chikungunya in 10 municipalities nationwide. Several towns in different provinces has declared state of calamity due to continuous rise of Chikungunya cases. In Ilocos Sur, local officials of San Nicolas declared the town under the state of calamity after the number of suspected cases surged to more than 200, affecting neighboring villages.
In Boac, Marinduque, the Sangguniang Bayan has also declared the state of calamity after it reported Chikungunya cases rose from 1,048 to 1,217. Barangay Poblacion in Patnongon, Antique was also declared under state of calamity wherein there has been 313 cases reported.
In July 9, the entire municipality of Tampakan was placed under a state of calamity due to the rising Chikungunya cases that then reached 306. In Barangay San Roque located at the boundary of Koronadal City and Tampakan town, the barangay council declared the state of calamity due to the rising Chikungunya cases in the area.
Rising cases were also monitored in different provinces. In Negros Occidental, the Provincial Health Officer had earlier reported 56 cases of Chikungunya. In Bacolod, the City Health Office (CHO) has confirmed 11 cases of Chikungunya. Nine of the confirmed cases were from Barangay Punta Taytay, while the remaining two were from Barangays 31 and 22.
In Camarines Norte, health officials have monitored up to 302 Chikungunya cases in Sta. Elena town. In Northern Luzon, DOH Cordillera office has recorded 703 cases. In Mt. Province, more than 100 people are suspected of being afflicted. According to the Diseases Surveillance Unit of the local DOH, three individuals have been tested positive, while 50 more are being closely monitored. Two of the chikungunya positive are residents of Paracelis town and the third is from Bontoc, the province’s capital.
The DOH-Region 11 said chikungunya cases since January have reached 72 and raised the alarm that it may be on the rise in the region. Among the provinces in the region, Davao Oriental had the highest number of cases with 32, followed by Davao del Sur, including Davao City, with 25; Compostela Valley with 10; and Davao del Norte with five.
From January to June this year, the DOH has registered a total of 2,594 suspected chikungunya nationwide, but only 157 cases were confirmed. No deaths were recorded.
Prevention and treatment
In Patnongon, Antique, the DOH traced the breeding ground of mosquito vectors to bamboo fences that are popular in the area. Health officials think that the outbreak is caused by bamboo fences that collected rain water. In Tampakan, the banana plantations were the possible breeding places of mosquitoes according to the South Cotabato Integrated Provincial Health Office.
The Centers for Diseases Control and Prevention (CDC) said the best way to prevent Chikungunya virus is to avoid mosquito bites. Since Chikungunya like dengue is mosquito-borne, preventing or reducing virus transmission depends entirely in controlling the mosquito vectors. Standing water is needed for mosquito eggs to develop and mature. Preventing standing water prevents mosquitoes. Standing water can collect in tires, flower pots, cans, wading pools, drain pipes and any other open containers.
WHO also suggested several ways of individual and household protection. It includes the use of insect repellant on exposed skin, wearing of long sleeves and pants, and securing screens on windows and doors to keep mosquitoes out. A strategic approach known as Integrated Vector Management (IVM) is promoted by WHO to control mosquito vectors.
Since there is no specific vaccine or preventive drug for the disease, treatment is directed primarily at relieving the symptoms. It is also advisable to strengthen one’s immune system by having proper diet and a healthy lifestyle.