The Hindu : Kerala / Thiruvananthapuram News : NIV team to do detailed studies in Cherthala

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Tuesday, Oct 03, 2006
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Kerala - Thiruvananthapuram

NIV team to do detailed studies in Cherthala

C. Maya

Department begins probe into deaths

Thiruvananthapuram: The Health Department has begun a probe into the individual deaths attributed to chikungunya viral fever in Cherthala taluk. Chikungunya is known to create complications in young children, pregnant women, the elderly and in persons with underlying diseases. However, the infection is usually self-limiting and not known to create so much fatalities as has been reported from Cherthala.

"We are investigating every death that has been attributed to chikungunya at Cherthala. Senior scientists from the National Institute of Virology (NIV), Pune, are expected to arrive on Wednesday here for field studies. Blood samples collected from the field will be subjected to Agitation PCR tests at Pune to isolate the virus or any mutant strains," a senior official said.

He said that of the 60-odd deaths, reportedly due to chikungunya, five cases had been confirmed as due to leptospirosis. In almost 80 to 90 per cent of the deaths attributed to chikungunya, the age group of the deceased is 70-90 years, he pointed out.

So far, out of the hundreds of blood samples sent from Cherthala to NIV and National Institute of Communicable Diseases (NICD), nine samples (randomly tested) have been tested positive for chikungunya. So far, the department has got 29 positive cases of the viral fever, with laboratory confirmation, from the State. These include two cases from Vizhinjam and 17 from Kozhikode.

While the Aedes species of mosquitoes are the known carriers of the virus, the high concentration of Monsonia and Culex species of mosquitoes in Cherthala has given rise to doubts whether these vectors could be carriers for chikungunya virus also. Samples of these vectors have been sent to NIV, Pune, to confirm this.

The NIV team will also be looking at whether any mutant variant of the chikungunya virus, an alpha arbovirus, is spreading the infection at Cherthala, where a large number of deaths have been directly or indirectly attributed to the infection.

The Health Department officials pointed out that none of the deaths in Cherthala so far had been confirmed through virology analysis to be directly due to chikungunya. "Test kits for isolating this virus are not being manufactured commercially in India. Even the test kits available at NIV and NICD are being imported from the U.S. The so-called confirmatory tests for chikungunya said to be conducted by private laboratories are not validated or tested for specificity and hence not dependable," an official said.

He pointed out that the outbreak had been successfully contained in Vizhinjam and in Olavanna in Kozhikode. The task has been uphill in Cherthala because of the physical properties of the terrain. Scattered cases of viral fever, clinically diagnosed as chikungunya, are now being reported from inland also.

The department has assigned a team of experts, including physicians, paediatricians, virologist, epidemiologist, entomologist, public health and community medicine specialists to do field studies at Cherthala.

"The public should be made to understand that there is no vaccine or any specific treatment for chikungunya anywhere in the world. Mosquito control is the only control and preventive measure that can be adopted in this case. Larval control by eliminating breeding grounds for mosquitoes is of utmost importance. This has to be done in individual households as well at the community level," M. K. Jeevan, Additional Director (Public Health), said.

Minimising the exposure to mosquito bites will help bring down the rate of infection. Using mosquito repellent creams and confining chikungunya patients under mosquito nets can prevent the spread of infection within a household. However, as the Aedes species are day-time vectors, these might not often be practical solutions.

Chikungunya has re-emerged in India after 32 years.

The infection, which first emerged in the French Reunion Islands the beginning of this year has been rapidly spreading from Mauritius, Seychelles.

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