Wed, 19 Mar 2003

`Chikungunya' disease leaves painful effects

Sri Wahyuni, The Jakarta Post, Yogyakarta

Since she was infected with the chikungunya disease two weeks ago, Kasminten still cannot walk as she used to, with her torso and knees swelled as well as wrists and elbows.

"I still feel pain in my joints, especially in the groin, but I force myself to work or I'll run out of money," the 57-year-old resident of Kuncen hamlet in Wirobrajan, Yogyakarta said while preparing food at her stall.

Her husband, Sarjo, 60, had the same condition. Although he was hit by the disease a month ago, he still has difficulty moving his arms and legs, and is essentially bed-ridden.

"In the first few days, I was unable to move at all... I was so afraid at the thought that I would be paralyzed for good," Kasminten said.

Another resident, Surip, 65, was so weak she fell and injured herself and was unable to walk to a doctor's office. "I had to crawl from my bathroom and forced myself to reach the bedroom because no one was at home when I fell," Surip recalled.

The so called "mysterious" disease was first recognized as an epidemic in Tanzania in 1952, it has continued to cause major epidemics in Africa, India and Southeast Asia.

In Indonesia, the mosquito-borne disease was first reported in 1973 in Samarinda, East Kalimantan, then in 1980 in Kuala Tungkal, Jambi, 1983 in Martapura, Ternate and later in Yogyakarta.

After a nearly 20-year hiatus, it broke out again in early 2001 in Muara Enim, South Sulawesi and recently in several cities including Yogyakarta.

According to head of Yogyakarta mayoralty's health office, Choirul Anwar, Wirobrajan was one of two villages considered most prone to the disease. The other village was Tegalgendu in Kotagede subdistrict.

He said that so far, some 400 people in the municipality were hit by the disease, saying that the only thing his office could do was cut down the life cycle of the disease's main carriers, the Aedes albopictus and Aedes aegypti mosquitoes, since the disease had no specific medicinal cure.

"Chikungunya is not a lethal disease. So don't panic if you experience the symptoms," Choirul said.

He advised people with the symptoms to take over-the-counter pain relief medicine to deal with the fever and eat healthy food and drink plenty of water and fruit juice or fresh fruit to improve stamina.

A healthy environment, he said, was also a crucial factor to prevent infection. For instance, houses should be thoroughly cleaned of any possible places where the mosquitoes can breed. Doors and windows should also be open as much as possible let fresh air and sunshine in.

Once the virus infects a human, it will grow, causing fever to the infected people for about five straight days. The virus usually has an incubation period of some three to 12 days before it shows its symptoms.

In many cases, according to Choirul, the sufferers would also feel pain in their joints and muscles. At times, the pain can cause temporary paralysis.

He explained that the acute symptoms, including paralysis, will last for some six to 10 days. But the pain in the joints might come and go for some two to four months without the fever.

"The time required to recover completely from chikungunya depends very much on the infected persons' health. The healthier they are, the shorter time they need to recover," Choirul said. He added that chikungunya was a self-limiting disease, meaning people would recover as time went by.

In some cases, sufferers also vomit like those with an ordinary flu and get a rash on their skin. Bleeding sometimes also follows the symptoms, just like in the case of dengue fever but the case, known as CHF or chikungunya hemorrhagic fever, rarely occurs.

Clinical symptoms of the disease, which is also called bone fever or bone flu, are actually similar to other Arbovirosis- related diseases like dengue fever, O' Nyong Nyong, West Nile fever, Mayaro, group C viral fever and Rift Valley fever.

"But the most important comparative diagnosis needed here in Indonesia is between chikungunya, dengue fever and dengue hemorrhagic fever (DHF)," Choirul said.