Strange malaria-like disease hits Uganda

By John Agaba

Health experts have confirmed a strange viral infection in Uganda. Chikungunya, transmitted by mosquitoes and whose signs and symptoms are similar to those of malaria, has no known vaccine or cure at the moment.

Dr. Myers Lugemwa, the head of the malaria control programme at the health ministry, confirmed cases of the chikungunya infection in Uganda, especially around River Semliki and in the West Nile region.

He, however, said there were few incidences, so there was no need for panic.

Symptoms

 Patients bitten by a mosquito carrying the virus present with severe muscle pains, high temperature, lymph node pains and swellings and may develop a rash that eventually bleeds if unattended to.

They develop red eyes and also have severe headaches and backaches and may start vomiting.

Who is prone?

The World Health Organisation (WHO) has already sounded a concern regarding the growing incidences of the viral infection, especially around the Caribbean Islands in the Atlantic Ocean.

The Centres for Disease Control and Prevention have sent out a health advisory to doctors in the United States to consider chikungunya infection in patients with acute onset of fever and joint pain.

How it is spread

Chikungunya, which was first isolated in Tanzania in 1953, is commonly spread by the aedes and aegypti mosquitoes that also transmit dengue fever, a similar but more serious illness with a deadly haemorrhagic form.

Unlike the female anopheles mosquito that transmits malaria plasmodium and is common in Uganda, Lugemwa says the aedes and aegypti mosquitoes are rare, except around the prone areas surrounding River Semliki and the West Nile region.

Incubation period

Lugemwa says once bitten by a mosquito carrying the virus, the incubation takes between three and 12 days before symptoms manifest. The illness is still not life-threatening, but there is no vaccine.

Diagnosis

The diagnosis is carried out using specialised equipment, lest the disease is mistaken for malaria or another form of haemorrhagic fever.

Several methods can be used for diagnosis. Lugemwa says the infection can also inhibit in other animals, especially monkeys and can also be transmitted from mother-to-child when the baby is still in the womb.

“There are many types of mosquitoes and some transmit viruses. For instance, the West Nile virus is transmitted by a mosquito. It is only because these mosquitoes are not common in Uganda,” he adds.

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However, the fact that mosquitoes can also transmit viruses should not cause alarm because mosquitoes cannot transmit the human immunodeficiency virus (HIV).

“The mosquitoes aedes and aegypti transmit a virus scientifically called alphavirus, whereas HIV is a retrovirus (a family of enveloped viruses that replicate in a host cell),” he adds.

Lugemwa explains that HIV cannot survive inside the body of the mosquito, while the chikungunya can. He says cases of the chikungunya virus have, in the past, also been reported in Asia, Latin America, the Congo and in Europe.

Lugemwa says in Tanzania, chikungunya means “break your back” because the person with the disease has a severe backache.

Prevention

He says the ministry’s antimalarial interventions like indoor spraying and distributing free mosquito nets, also help in the prevention of these and other diseases such as malaria.  

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FACTS ON CHIKUNGUNYA

By Dr. Cory Couillard

Chikungunya outbreaks represent the first time mosquitos in the Americas have been infected and spreading chikungunya to people.

There is no cure for the disease and international travel can easily cause a global resurgence in this infectious disease. The European Centre for Disease Prevention and Control urges health providers to heighten their vigilance against the disease, especially with travels abroad.

Since 2004, chikungunya fever has reached epidemic proportions, with considerable morbidity and suffering in Africa, Asia and the Indian subcontinent. In Africa, chikungunya commonly occurs in Benin, Burundi, Cameroon, Central African Republic, Comoros, Congo, Equatorial Guinea, Guinea, Kenya, Madagascar, Malawi, Mauritius, Mayotte, Nigeria, Senegal, South Africa, Sudan, Tanzania, Uganda and Zimbabwe.

The virus causes similar symptoms as dengue and is often misdiagnosed in areas where dengue is common.

The virus is commonly spread through bites from mosquitos that live around buildings in urban areas. These bites pose the greatest risk to those who sleep during daytime, especially young children and the elderly.

With no cure, treatment is often only focused on relieving accompanying symptoms.

The World Health Organisation’s website reveals that most patients recover fully, but in some cases joint pain may persist for several months, or even years. Occasional cases of eye, neurological and heart complications have been reported, as well as gastrointestinal complaints. Individuals are urged to protect themselves by covering exposed skin with long pants and long-sleeved shirts.

 Insect repellents can also serve as an effective way to prevent mosquito bites.

Dr. Cory Couillard is an international health columnist that works in collaboration with the World Health Organisation's goals of disease prevention and control. Views do not necessarily reflect endorsement