Wed, 26 Feb 2003

No mystery surrounds 'chikungunya' disease

Tantri Yuliandini, The Jakarta Post, Jakarta

"Chiku-what? Is that Sundanese?"

A fair enough question coming from someone who knows nothing about the so called "mysterious" disease currently spreading through West Java and parts of East Java and North Sulawesi.

Actually the chikungunya disease is far from local. First recognized in epidemic form in East Africa in 1952, it has continued to cause major epidemics in Africa, India and Southeast Asia.

In Indonesia, the disease -- also known as epidemic polyarthritis and rash, and buggy creek virus -- was first reported in 1973 in Samarinda, East Kalimantan, then in 1980 in Kuala Tungkal, Jambi, 1983 in Martapura, Ternate, and in Yogyakarta, according to the Kompas daily newspaper.

After a hiatus of almost 20 years, chikungunya broke out again in early 2001 in Muara Enim, South Sulawesi, and Aceh, then in October of the same year in Bogor, West Java. Last year, the epidemic struck Bekasi in West Java, and Purworejo and Klaten in Central Java.

The name of the disease itself, chikungunya, is Swahili for "that which contorts or bends up", referring to the contorted posture of patients afflicted with the disease's common symptom, severe joint pain (arthralgia).

Having similar symptoms to dengue fever, chikungunya however is characterized by a briefer episode of fever, persistent arthralgia is some cases, and by the absence of deaths.

According to Health Canada on its website www.hc-sc.gc.ca, chikungunya is a self-limiting febrile virus that is transmitted -- just like dengue -- through the bite of an infective Aedes aegypti or Aedes africanus mosquito.

After an incubation period of three to 12 days, there will be a sudden onset of flu-like symptoms including severe headaches, chills, fever, joint pain, nausea and vomiting.

Arthralgia or arthritis typically in the knee, ankle, and small joints of the extremities may occur, sometimes followed by a maculopapular rash on the trunk and limbs. Hemorrhaging is rare but may occur in children, in addition they may also display neurological symptoms.

Thomas Suroso, the Ministry of Health's director of control for animal-related diseases, said the illness tended to last three to 10 days, with the arthralgias remaining a problem for weeks to several months after the initial phase.

"Take analgesics and painkillers, which can be bought at a warung (kiosk). The important thing is having enough rest and eat nutritious foods," he said, as quoted by Kompas. Anticonvulsants may also be prescribed by doctors, and mild exercise is recommended to improve arthralgia.

The virus itself can be killed by common disinfectants such as 70 percent ethanol, one percent sodium hypochlorite, two percent glutaraldehyde, lipid solvents, as well as by moist heat and drying.

Since there is currently no antiviral available, prevention of the disease focuses at controlling mosquitoes and avoiding mosquito bites.