Chikungunya hits Ulhasnagar, creeps into Mumbai too

 Suspected cases flood hospitals in township, force patients to share beds

 Anjali Doshi Ulhasnagar

IT'S A muggy afternoon in Ulhasnagar and Shabana Syed Habib (24) shifts
restlessly on Bed Number 12 in the women's ward of Central Hospital.
The mother of two has a high fever and her joints hurt. She's being treated
for suspected chikungunya.

Also on Bed Number 12 is Anita Patil. The 30-year-old homemaker and mother
of four has been at Central Hospital since Sunday. She too has a fever and
severe joint pains.

There are 38 other women in the 18-bed ward of the township's only
government hospital. Most are being treated for 'suspected' chikungunya - a
viral disease transmitted through the Aedes aegypti mosquito.
The beds are so full, some women are sleeping on thin sheets on the ground.
And the men's ward next door is no better off.

"From about 500 visits to the outpatient department every day, we now have
nearly 1,200," says hospital superintendent Dr A.V. Kulkarni. "Most patients
come in with the same complaints - severe joint pains and high fever. We're
treating them all for suspected chikungunya." For two weeks, Ulhasnagar has
been reeling under the epidemic first reported in the Takli village of
Ahmednagar district in February, 33 years after it last surfaced in Barshi,
Solapur.

By March, the virus had spread to Nashik and thousands were afflicted in
Malegaon. Soon, cases began surfacing in Andhra Pradesh, Karnataka, Kerala,
Tamil Nadu, Madhya Pradesh and Gujarat.

Over two lakh cases have been re ported across the country since February.
And now, chikungunya has found its way into Mumbai.
"We get about four suspected cases every week," says Dr Ashish Tiwari of
Bombay Hospital. JJ Hospital recently treated seven suspected cases. Many
nursing homes in Dahisar and Goregaon are also treating patients for
suspected chikungunya.

Surprisingly, the state health department doesn't seem concerned.
"In July and August, 50 per cent of all fever cases were suspected
chikungunya," admits Director (Health Services) Prakash Doke. "Now, it's
only 15 per cent." So how did this obscure virus that had disappeared from
the country for over 30 years resurface? "Our suspicion is that the virus
returned through people who visited a country where it is still active,"
says Dr A. Mishra, director of the National Institute of Virology (NIV) in
Pune.

Meanwhile, in Ulhasnagar, the suspected cases keep pouring in. A consulting
physician who usually gets about 50 patients a day is now treating nearly
200. "We start at 9 am every day and finish only at 2 am," says Dr Dinesh
Shegokar.
Yet Central Hospital has confirmed only one case of chikungunya. The
Ulhasnagar Municipal Corporation (UMC) says it has been asked by the state
health department to treat all the cases on the basis of symptoms as it is
not possible to test such a huge volume of samples.
"We're still trying to come up with a plan of action to tackle the
 outbreak," says Ulhasnagar mayor Jyoti Kalani.

CASES SO FAR Maharashtra 2,16,455 Andhra Pradesh 1,10,618 Karnataka 6,70,438
Tamil Nadu 43,580 Madhya Pradesh 44,966 Gujarat 22,963 Kerala 13 Total
11,09,033* * As of August 2006 Source: National Vector Borne Diseases
Control Programme, Government of India WHAT IS CHIKUNGUNYA? Chikungunya, a
viral disease, is transmitted to humans by infected mosquitoes, typically
the daytime-biting Aedes aegypti mosquito that also causes yellow fever and
dengue.

 The name chikungunya is Swahili for 'stooped walk' or 'that which
bends'. It occurs principally during the rainy season. Chikungunya is rarely
fatal. The incubation period is four to seven days (sometimes between 12 and
22 days). A high fever and headache occur, with significant pains in the
joints (ankles, wrists), sometimes accompanied by rashes all over the body.
The joint pain can persist for several weeks. The main preventive measure is
to stop the proliferation of mosquitoes by reducing their breeding grounds.
The disease is not contagious, that is it cannot be spread one person to
another, but only through the bite of a mosquito. First discovered in
Tanzania in 1953, chikungunya first surfaced in India in Kolkata in 1963,
and resurfaced in 1965 in Nagpur and parts of south India, with thousands
afflicted by the disease.

Source: World Health Organisation and Centres for Disease Control and
Prevention


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