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  3. 3. The Disease…..• The Chikungunya name is derived from theSwahili word meaning “ that which bends up “inreference to the stooped posture developed as aresult of the arthralgia (severe joint pains).•The clinical features of Chikungunya ( CHK )are fever, headache, nausea, vomiting, myalgia,rash and
  4. 4. The Disease…….► The clinical diagnosis is often confused withthat of Dengue fever because CHK viruscirculates in regions where Dengue ( DEN )virus is also endemic.► The most significant symptom is arthralgiawhich is present in large number of cases.► Some cases may develop morbilliform rash on2nd to 5th day of onset.► Hemorrhagic manifestation though not commonoccurs in few cases; are consisted of bleedinggums, epistaxis, hematemesis and very rarelyblood in stool.
  5. 5. Period of Illness• Illness is often acute and lasts for 3 to 5 days.• In few cases it may be upto 10 days or more.• Convalescence is usually prolonged andcharacterized by marked weakness and pain injoints.Incubation period• It is usually 2 to 12 days (Commonly 3 to 5days).
  6. 6. Age group•The disease affects all age groups.Morbidity• Ranging from 30 % to 70 % of population in affectedvillage / ward.Mortality• NegligibleThe virus• CHK virus belongs to family Togaviridae, genus Alphavirus and subgroup semliki forest Venezuelan ( SFV )equine
  7. 7. Distribution and Epidemiology• Basically recognized as a urban disease, clinically verysimilar to Dengue, mis-diagnosis is not unusual.• The virus was first isolated from the serum of febrilehuman case in Tanzania in 1953.• Chikungunya have spread to tropical parts of Africa,America and Asia.• In India first outbreak was recorded in Kolkata in1963 followed by East coastal area like Chennai,Pondichery, Vellore and Vishakhapattanam in 1964.• Later it was recorded in 1965 in central part of Indiai.e. Rajmundri, Kakinada ( AP ) and
  8. 8. Distribution and Epidemiology• Epidemiological investigation of a febrile illness episode at Nagpurin 1965 showed that incidence was as high as 40 to 70 % in certainwards.• Mortality was negligible. The Sera from contacts showed antibodiesto CHK virus in 45 % cases.• All the age-groups were affected. In Maharashtra state sporadiccases were reported in 1973, 1983 & 2000.• Morbidity in Barshi, Maharashtra in 1973 was about 37.5 %.• Recently the cases of Chikungunya are reported from villagesMungi, Balamtakli & Madhi in Ahemadnagar dist; Malegaon city inNashik dist and Purna town in Parbhani dist.• In India the virus was known to be involved in large scaleepidemics.• However, in recent studies the virus has been isolated in Dengueendemic areas, suggesting involvement of virus in endemic
  9. 9. Maintenance of CHK virus in nature• The virus is maintained in nature at a low levelin man-mosquito-man cycle.• The survival of CHK virus in nature is alsothrough transovarial transmission ( TOT ) inAedes aegypti
  10. 10. Diagnosis1. Isolation of virus.2. Demonstrating four fold or greater rise inantibody titer.3. ELISA testing for IgM antibody.4. Diagnosis by RT – PCR Test.The antibody titer will be positiveafter 5th day of illness
  11. 11. Treatment• No vaccine is available for prevention ofCHK.• The treatment of patient is symptomaticparticularly by anti inflammatory drugs.• The steroids are not to be used
  12. 12. Vectors• In India Aedes aegypti is the principal vector of thisvirus.• It can be transmitted by Aedes albopictus &
  13. 13. Life Cycle of Aedes
  14. 14. About Aedes aegypti………..Feeding Habit• Day biter• Mainly feeds on human beings in domestic andperidomestic situations• Bites repeatedlyResting Habit• Rests in the domestic and peridomestic situations• Rests in the dark corners of the houses, on hangingobjects like clothes, umbrella, etc. or under the
  15. 15. About Aedes aegypti………..BREEDING HABITS• Aedes aegypti mosquito breeds inany type of man made containers orstorage containers having even a smallquantity of water• Eggs of Aedes aegypti can live withoutwater for more than one
  16. 16. About Aedes aegypti………..FAVOURED BREEDING PLACES• Desert coolers, Drums, Jars, Pots, Buckets.• Flower vases, Plant saucers, Tanks, Cisterns.• Bottles, Tins, Tyres, Roof gutters.• Refrigerator drip pans, Cement blocks.• Bamboo stumps, Coconut shells, Tree holes andmany more places where rainwatercollects or is
  17. 17. Prevention and Control of ChikungunyaMeasures for prevention and control ofCHK are the avoidance of mosquito bites andreduction in density of vector.Control measures are centered on:• Avoidance of mosquito bites and reduction in the densityof vectors.• Mosquitoes receiving sub-lethal dosages of insecticidesmay have effect on CHIK virus- susceptibility ofAe.aegypti• All the preventive measures advocated for control ofAe.aegypti needs to be
  18. 18. 1.PERSONAL PROPHALATIC MEASURES• Use of mosquito repellent creams, liquids, coils, matsetc.• Wearing of full sleeve shirts and full pants with socks.• Use of bed nets for sleeping infants and young childrenduring day time to prevent mosquito bite.2. BIOLOGICAL CONTROL• Use of larvivorous fishes in ornamental tanks, fountains,etc.• Use of
  19. 19. 3. CHEMICAL CONTROL• Use of chemical larvicides like abate in big breedingcontainers.• Aerosol space spray during day time.4. ENVIRONMENTAL MANAGEMENT & SOURCEREDUCTION METHODS• Detection & elimination of mosquito breeding sources.• Management of roof tops, porticos and sunshades.• Proper covering of stored water.• Reliable water supply.• Observation of weekly dry
  20. 20. 5. HEALTH EDUCATION• Impart knowledge to common people regarding thedisease and vector through various media sources likeNews paper, Pamphlets, Exhibitions, TV, Radio, Cinemaslides, etc.6. COMMUNITY PARTICIPATION• Sensitilizing and involving the community for detectionof Aedes breeding places and their
  21. 21. DO’S AND DON’TS• Remove water from coolers and other small containersat least once in a week.• Use aerosol during day time to prevent the bites ofmosquitoes.• Do not wear clothes that expose arms and legs.• Children should not be allowed to play in shorts and halfsleeved clothes.• Use mosquito nets or mosquito repellents while sleepingduring day
  22. 22. Aedes aegypti mosquito Breeding
  23. 23. Aedes aegypti mosquito Breeding
  24. 24. Aedes aegypti mosquito Breeding
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  48. 48. THANK