Sunday, December 10, 2006

Chikungunya reunion

Malaria remains a scourge of much of the developing world. It kills somewhere between one and five million people a year. Only pneumonia and AIDS kill more people outside the Western World. The World Health Organisation believes that 300 million are infected annually. Closer to the ground, the Kenyan Medical Research Institute says there are actually 515 million cases a year of the deadliest form of malaria alone.

But now some of malaria’s lesser known cousins are now starting to share the limelight. One of the most virulent at the moment is from a bite by Aedes aegypti. Better known in English as the Yellow Fever Mosquito, Aedes aegypti is a tolerable host to a number of fevers that are dangerous to humans. As well as the yellow fever itself, it is home to dengue fever and a new, previously non-fatal disease that is now killing people in the South. It is called chikungunya (“chicken gunya”) Chikungunya is Makonde (a Tanzanian language similar to Swahili) for ‘that which bends up.’ People struck by the disease end up with a hunched back and intense pain.

Chikungunya was never considered fatal, until recently. Acute chikungunya fever typically lasts a few days to a couple of weeks, but similar to other fevers, it can have prolonged fatigue lasting several weeks. One million people a year are infected with chikungunya which is minute compared to malaria. But its recent change of behaviour is cause for alarm. Now it is starting to kill.

On the island of Reunion, an outre-mer department of France in the Indian Ocean chikungunya has killed 315 people since it broke out in March 2005. The French occupied the island in the 17th century and the name Reunion commemorates the union of French revolutionaries from Marseille with the National Guard in Paris in 1792. It is now a busy country with 775,000 people crammed into its two and half thousand square kilometres. It is the 4th densest department of France and only Paris, Martinique and Calais have more feet per foot. Chikungunya was first noticed on Reunion in February 2005. Barely one year later, 50,000 people on the island were infected.

Now over ten percent of the population has Chikungunya. There is a twenty four hour mission every day to spray insecticide with the French Army involved by day and volunteers by night. In the country they are looking for mosquito larvae anywhere they can find standing water. But chikungunya is winning the battle. By March, a local French newspaper reported there was 186,000 cases - a quarter of the island.

Chikungunya started to crop up in other Indian Ocean islands. It moved around from Madagascar and the Comoros, to Mayotte and the Seychelles. Across the islands chikungunya has infected more than 1.3 million people in the last 20 months. By 24 November, half a dozen US states have reported cases of travellers from Asia and East Africa returning to the States with the virus.

One day later, a Sri Lanka health official confirmed the epidemic arrived in the country. Dr Nihal Abeysinghe, director of the state epidemiology department, says it has infected 5 000 people in the island's Tamil controlled far north. The people of Tamil capital Jaffna residents are living on rations shipped in by sea. Medicines and food are in short supply. Local residents said doctors had recommended paracetamol as a fever preventive, but most shops had run out. On the same day, Taiwan reported its first ever case.

No vaccine or specific antiviral treatment for chikungunya fever is available. Unconfirmed reports have stated the US military has a vaccine as of March 2006. But if they have it, they aren’t sharing. The last known trials were in 2000 but were discontinued due to lack of funding. Meanwhile on Reunion, the pain goes on. Islander Louise Maillot has been suffering from intense pain in her legs and depression since chikungunya struck. I'm waiting to die," she told Al Jazeera. "I'm praying for the good Lord to take me."

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