Dengue is the most important emerging tropical viral disease of humans in the world today. It is estimated that there are between 50 & 100 million cases of dengue fever (DF ) and about 5,00,000 cases of Dengue Haemorrhagic fever (DHF) each year which required hospitalization. Over the last 10 - 15 years, DF / DHF has become a leading cause of hospitalization and death among children in the South East Asia Region of WHO, following diarrhoeal diseases and acute respiratory infections. All four dengue virus (Den 1,2,3,4) infections may be asymptomatic or may lead to undifferentiated fever, dengue fever (DF), or dengue haemorrhagic fever (DHF) with plasma leakage that may lead to hypovolemic shock Dengue Shock Syndrome (DSS).

CHIKUNGUNYA FEVER

The name is derived from the Swahili word meaning " that which bends up" in reference to the stooped posture developed as a result of the arthratic symptoms of the disease. The disease is not considered to be fetal.

The clinical features of Chikungunya (CHK) are fever, headache, nausea, vomiting, myalgia, rash and arthralgia. The clinical diagnosis is often confused with that of Dengue fever because CHK virus circulates in regions where Dengue (DEN) virus is also endemic. The most significant symptom is arthralgia which is present in large number of cases. Some cases may develop morbilliform rash on 2nd to 5th day of onset. Hemorrhagic manifestation though not common occurs in few cases and consisted of bleeding gums, epistaxis haematemesis and very rarely blood in stool.

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 and characterized by marked weakness and pain in joints.

Morbidity :- Ranging from 30% to 70% of population in affected village / ward
Mortality : - Negligible

Distribution and Epidemiology

Basically recognized as an urban disease, clinically very similar to Dengue, mis-diagnosis is not unusual. Imported cases are common. The virus was first isolated from the serum of febrile human case in Tanzania in 1953. Chikungunya have spread to tropical parts of Africa, America and Asia.

In India first outbreak was recorded in Kolkotta in 1963 followed by East coastal area like Chennai, Pondichery Vellore and Vishakapattanam in 1964. Later it was recorded in 1965 in central part of India i.e Rajmundri, Kakinda (A.P.) and Nagpur (MS).

Epidemiological investigation of a febrile illness episode at Nagpur in 1965 showed that incidence was as high as 40 to 70% in certain wards. Mortality was negligible. The Sera from contacts showed antibodies to CHK virus in 45% cases. All the age-groups were affected.

In Maharashtra state sporadic cases were reported in 1973, 1983 & 2000. Morbidity in Barsi, Maharashtra (1973) was about 37.5%. Recently the cases of Chikungunya are reported from villages Mungi, Balamtakli & Madhi (district Ahamadnagar), Malegaon city (district Nashik ) and all 8 districts of Marathwada region, in vidharbh region 7 districts Akola, Washim, Buldhana, Yeotmal, Nagpur, Wardha & Chandrapur.