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The catastrophe in recent days surrounding the Dhaka related to ailments causing from Dengue, Chikungunya and seasonal fever have come to the levels of epidemic. Almost every household is facing one or combination of these. More than thirty thousand people have been admitted to the hospitals and clinic of the city for the treatment since its recent outbreak almost two and half months. The word 'chikungunya' is believed to have been derived from a description in the Mekondel language, meaning "that which bends up", of the contorted posture of people affected with the severe joint pain and arthritic symptoms associated with this disease.[The disease was first described by Marion Robinson and W.H.R. Lumsden in 1955, following an outbreak in 1952 on the Makonde Plateau, along the border between Mozambique and Tanganyika the mainland part of modern-day Tanzania). According to the initial 1955 report about the epidemiology of the disease, the term 'chikungunya' is derived from the Makonde root verb kungunyala, meaning to dry up or become contorted. In concurrent research, Robinson glossed the Makonde term more specifically as "that which bends up". Subsequent authors apparently overlooked the references to the Makonde language and assumed the term to have been derived from Swahili the lingua franca of the region. The erroneous attribution to Swahili has been repeated in numerous print sources. Many erroneous spellings of the name of the disease are also in common use.Since its discovery in Africa, in 1952, chikungunya virus outbreaks have occurred occasionally in Africa, South Asia, and Southeast Asia, but recent outbreaks have spread the disease over a wider range.The first recorded outbreak of this disease may have been in 1779. This is in agreement with the molecular genetics evidence that suggests it evolved around the year 1700.Concerted community effort is the way to combat Chikungunya
Chikungunya has been spreading its geographic reach, partly due to increased urbanization and also climate change
Masihul Huq Chowdhury
The catastrophe in recent days surrounding the Dhaka related to ailments causing from Dengue, Chikungunya and seasonal fever have come to the levels of epidemic. Almost every household is facing one or combination of these. More than thirty thousand people have been admitted to the hospitals and clinic of the city for the treatment since its recent outbreak almost two and half months. The word chikungunya is believed to have been derived from a description in the Mekondel language, meaning that which bends up, of the contorted posture of people affected with the severe joint pain and arthritic symptoms associated with this disease.[The disease was first described by Marion Robinson and W.H.R. Lumsden in 1955, following an outbreak in 1952 on the Makonde Plateau, along the border between Mozambique and Tanganyika the mainland part of modern-day Tanzania). According to the initial 1955 report about the epidemiology of the disease, the term chikungunya is derived from the Makonde root verb kungunyala, meaning to dry up or become contorted. In concurrent research, Robinson glossed the Makonde term more specifically as that which bends up. Subsequent authors apparently overlooked the references to the Makonde language and assumed the term to have been derived from Swahili the lingua franca of the region. The erroneous attribution to Swahili has been repeated in numerous print sources. Many erroneous spellings of the name of the disease are also in common use.Since its discovery in Africa, in 1952, chikungunya virus outbreaks have occurred occasionally in Africa, South Asia, and Southeast Asia, but recent outbreaks have spread the disease over a wider range.The first recorded outbreak of this disease may have been in 1779. This is in agreement with the molecular genetics evidence that suggests it evolved around the year 1700.
Chikungunya is an infection caused by the chikungunya virus (CHIKV). Symptoms include fever and joint pain. These typically occur two to twelve days after exposure. Other symptoms may include headache, muscle pain, joint swelling, and a rash. Most people are better within a week; however, occasionally the joint pain may last for months. The risk of death is around 1 in 1,000. The very young, old, and those with other health problems are at risk of more severe disease. The virus is spread between people by two types of mosquitoes : Aedes albopictus and Aedes Aegypty. They mainly bite during the day. The virus may circulate in birds and rodents other than human. Diagnosis is by either testing the blood for the viruss RNA or antibodies to the virus. After a single infection it is believed most people become immune. The best means of prevention is overall mosquito control and the avoidance of bites in areas where the disease is common.This may be partly achieved by decreasing mosquitoes access to water and with the use of insect repellent and mosquito nets. There is no vaccine and no specific treatment as yet. Recommendations include rest, fluids, and medications to help with fever and joint pain.
While the disease typically occurs in Africa and Asia, outbreaks have been reported in Europe and the America since the 2000s. In 2014 more than a million suspected cases occurred. In 2014 it was occurring in Florida in the USA , but as of 2016 there was no further locally acquired cases.
In the history of management and control of epidemics, The DRC has its own history with Ebola, having faced one short-lived outbreak in 1976 and another in the mid-90s. When Ebola briefly returned again in the summer of 2014, the country was better prepared. A trained team of field epidemiologists helped swiftly put a stop to the outbreak, limiting it to 66 cases. By the time the West African outbreak began, the DRC had a five-year history of training disease detectives through its Field Epidemiology Training Program (FETP). FETP residents and graduates serve as boots on the ground in the ongoing battle against infectious diseases.The DRC graduated its first cohort of FETP officers in 2010. When Ebola came to Guinea, three of these highly trained disease detectives quickly deployed to the area. Within hours of arriving, the team began searching for everyone who had direct contact with sick Ebola patients. Finding and monitoring all contacts proved critical to stopping the West Africa epidemic.The DRC team also authored a comprehensive contact tracing process. For us, said Ngulefac, it was key to leave the Ministry of Health in Guinea with a solid contact tracing program that they could implement on their own in the future.
The Epidemic Intelligence Service (EIS) is a program of the US Centre for Disease Control and Prevention (CDC). Established in 1951, due to biological warfare concerns arising from the Korean War, it has become a hands-on two-year postgraduate training program in epidemiology, with a focus on field work. It is the prototype for Field Epidemiology Training Programs (FETP), which can now be found in numerous countries, reflecting the example set by this training model and the technical assistance provided by CDC in helping to set them up. The EIS program is now run through the CDCs Center for Surveillance, Epidemiology, and Laboratory Services (CSELS), in the Office of Public Health Scientific Services (OPHSS). Persons participating in the program, popularly called disease detectives, are called EIS officers (or EIS fellows) by the CDC and have been dispatched to investigate possible epidemics, due to both natural and artificial causes, including anthrax, hantavirus, and West Nike virus in the United States and Ebola in Uganda and Zaire. EIS officers have to complete a 1-month training at the CDC headquarters in Atlanta, Georgia; however, 95% of their 2-year term consists of experiential rather than classroom training. For the duration of their service, EIS officers are assigned to operational branches within the CDC as the result of a highly competitive matching process. EIS service is also a common recruiting pathway into the Public Health Service Commissioned Crops. Since the establishment of the EIS in 1951, over 3,000 EIS officers have been involved in response efforts in the US and worldwide. EIS officers have been involved in efforts in the 2014 Ebola crisis as well.Since the smallpox crusade beginning in 1967, the CDC has paired an EIS officer and a Public Health Advisor or PHA as a scientist (EIS) and operations (PHA) team. These EIS/PHA management teams have made major contribution to the management and leadership of the CDC, with several former EIS officers serving in leadership capacity and closely supported by their deputy manager, the PHA. Together EIS officers and PHAs have worked on several epidemics worldwide. The successful undertakings were ,
1950s: The EIS worked on polio, lead poisoning and Asian Influenza
1960s: Cancer Cluster and smallpox.
1970s: Legionnaires disease , Ebola , and Reye syndrome
1980s: Toxic shock, birth defects , and HIV
1990s: obacco, West Nile Virus , and contaminated water.
2000s: Ecoli, SARS, H1N1, , and the post Hurricane Katrina
2010s: The post Haiti earthquake, obesity, fungal meningitis, and Ebola.
The virus of dengue, chikungunya have been spreading its geographic reach, partly due to increased urbanization and partly due to climate change. With increasing dengue threat comes an accelerated effort to combat and control the virus. In addition to studies on preventing the transmission of the virus, progress on vaccine development has been made. Environmental management initiatives can also include major changes in a community, such as installing water systems with direct connections to residences and replacing wells and other water-storage containers, which can be mosquito-breeding habitats. Smaller-scale environmental changes can also be effective. For example, mosquito populations can be reduced when all members of a community clear blocked gutters and street drains and keep their yards free of containers with standing water. Any open containers should be emptied and cleaned each week to eliminate mosquito eggs and larvae. These efforts can reduce the number of mosquitoes living in an area.
What other measures can members of a community take to reduce mosquito populations? Community-based approaches must go hand in hand with educational initiatives that teach people about mosquito vectors and the risks of having mosquito-breeding habitats near their homes. Educational initiatives can encourage people to take an active role in participating in source reduction. Communities that understand the need to make behavioral changes are the most effective in controlling dengue. In addition to steps that communities can take, what can individuals do to protect themselves from dengue?
People can reduce the risk of mosquitoes entering their homes by using window and door screens or by keeping their doors and windows closed and using air conditioning to keep their homes cool. Aedes aegypti typically bite people during the day, so wearing long pants and long-sleeved shirts can reduce mosquito bites when spending time outdoors. In addition, mosquito repellents can be applied to exposed skin and clothing to lower the risk of mosquito bites. The Centers for Disease Control recommends mosquito repellents that contain DEET, picaridin, lemon eucalyptus oil, or IR3535 as the active ingredient. Sleeping under a mosquito net can also provide protection from being bitten, particularly in areas where people rest in the afternoon or in houses with infants. What about other methods of reducing mosquito populations?
Chemical control can be effective in controlling mosquito populations. For instance, insecticides can be used to kill mosquito larvae or adult mosquitoes. Can insecticides be widely and routinely used? The use of insecticides is recommended in emergency situations during dengue epidemics or when there is evidence that an epidemic is emerging. On a regular basis, however, sustainable, coordinated, community-based environmental approaches are favored over chemical methods for controlling mosquitoes, and limited reliance on these chemicals is preferred. Why are environmental management approaches favored? One reason is that mosquitoes can develop resistance to insecticides. In addition, insecticides are expensive, and high doses can be toxic to humans and other species. Therefore, it is best to be cautious about applying these chemicals.
New genetic approaches are also being considered as ways to control mosquito populations. Researchers at the University of Oxford and Oxitec genetically engineered female mosquitoes that cannot fly. Being flightless is a huge genetic disadvantage. The flightless female mosquitoes are unable to sing and court with male mosquitoes using their wing oscillation song. Predators can more easily prey on flightless female mosquitoes. The researchers theorize that these genetically engineered mosquitoes could be used to control mosquito populations and reduce dengue transmission. The same group of researchers recently genetically modified male mosquitoes to be sterile, and they released these mosquitoes in a trial in Grand Cayman, a Caribbean island, to wipe out dengue fever.
In the absence of an effective vaccine that protects humans from dengue, limiting contact between people and vectors is the most effective way to prevent dengue infections. Environmental management approaches involve eliminating the container habitats in which Aedes aegypti lay their eggs. Chemical control involves the use of insecticides to kill immature or adult mosquitoes. New chemical, biological, and genetic approaches are also being developed and may provide promising alternatives to control mosquito populations and prevent dengue infections. The only way to address these diseases are through community awareness and proper, concerted action plan. Let us unite and do our civic responsibilities to manage these epidemics. Its time for action and not chaos.
The writer, a banker by profession, has worked both in local and overseas market with various foreign and local banks in different positions
