Indian state battles fever fears

By John Mary
Trivandrum, Kerala

Officials say there has been an outbreak of the disease Pic: Samson P Samuel

Authorities in India's southern state of Kerala say they are battling a fever outbreak that has claimed many lives.

Since July, at least 70 people have died - most, it is suspected, from the mosquito-borne chikungunya virus.

A team of experts from the World Health Organisation have arrived in Kerala to examine the outbreak of the disease.

Separately, Indian authorities are fighting an outbreak of dengue fever in the country's north - 28 people have died of the disease in recent weeks.

Cases of the chikungunya virus have been recorded in India in the past.

Authorities say the latest outbreak has been in the central Keralan district of Alappuzha.

The chief medical officer of Alappuzha, K Velaudhan, told the Associated Press news agency that nearly 40,000 people in the district were showing signs of the disease, and thousands had been hospitalised.

"Most of them are suspected cases of chikungunya as blood samples of some of the patients have tested positive for the disease," he said.

However, there is some confusion among the doctors about whether all the reported deaths have been caused by the virus.

Disputed

Kerala health services chief Dr TK Kuttamani said recently that only 33 cases of fever in the state had been confirmed as caused by the chikungunya virus.

"Whether there have been chikungunya deaths is a disputed issue and I do not want to comment further. Our priority is to control the spread of the fever and take preventive steps," he told the BBC.

Mosquitoes are blamed for spreading the disease

The chief of one NGO, Health Action by People, Dr CR Soman said that it "would be a revelation" if the deaths were confirmed to be caused by chikungunya because the "disease has generally been known to be non fatal".

"One has to find out whether the mutated strains of the virus have turned out to be more lethal than when it first appeared in Tanzania in 1953," he said.

The US-based Centre for Disease Control and Prevention says that chikungunya does not cause fatalities.

Since March 2005 the number of cases of chikungunya have been increasing in the islands of the Indian Ocean, particularly the island of Reunion.

Symptoms

The World Health Organisation estimates about 110,000 people were affected in an outbreak on the island between March 2005 and February 2006.

The virus is spread by the bite of a mosquito and causes a non-fatal self-limiting illness characterised by a high fever with headache, severe joint pains and a rash with nausea and vomiting.

Symptoms usually appear between four to seven days after being bitten and can persist for several weeks.

There is no vaccine against chikungunya. Treatment consists of relieving symptoms by using painkillers, taking plenty of fluids and resting.

Acute symptoms last from a few of days to a couple of weeks, whilst some patients have reported incapacitating joint pain for up to several months.

Travellers are advised to take standard precautions against mosquito bites.

These include using insect repellents and wearing long trousers and long sleeved shirts, particularly during daylight when the Tiger mosquitoes which carry the virus tend to be most active.