US travel advisory exposes how Telangana govt underreported Chikungunya cases

Recently, Centres for Disease Control and Prevention alerted people flying from and to the US about the large number of undiagnosed cases of chikungunya in the State

Hyderabad: The travel advisory on the large number of chikungunya cases in Telangana, released by the US Centres for Disease Control and Prevention (CDC) on November 8, is not only an embarrassment for the State’s public health department but is also a reflection of the widespread culture of underreporting of seasonal ailments.

Based on the feedback from private healthcare institutions and senior doctors in Hyderabad, it was clear that between July and October of this year, Hyderabad and the districts of Telangana were under the grip of dengue and chikungunya, the twin vector-borne ailments spread by the bite of the Aedes aegypti mosquito.

---

Since dengue and chikungunya have common symptoms, all fever and joint pain cases were being labelled as dengue infections in Hyderabad. The CDC advisory from the United States is a clear indication that the State’s Public Health department was not even inclined to look to confirm chikungunya cases, which needs additional and appropriate care, when compared to dengue.

 

What did the CDC actually say?

In its briefly worded advisory, the CDC alerted people flying from and to the US about the large number of undiagnosed cases of chikungunya in Telangana. “CDC has identified a higher-than-expected number of chikungunya cases among US travellers returning from the State of Telangana, India,” the advisory said.

Senior doctors in Hyderabad have said the advisory is a clear indication that a lot of travellers had Chikungunya but many of them were not treated fully. As a result, by the time such individuals reached the US, they still had chikungunya, which was detected by the mandatory tests that are done as a part of the disease surveillance program in the US.

 

Chikungunya vs Dengue

While both dengue and chikungunya have a common mosquito vector (Aedes aegypti), there is a lot of difference in the symptoms and treatment modalities. One of the major challenges with chikungunya is that it tends to have a long-term (chronic chikungunya) impact on patients. While patients with dengue recover quickly if diagnosis and medication is done at the right time, there are numerous chikungunya patients, who continue to struggle with the ailment anywhere from three months to several years. Even after making a recovery, a large number of chikungunya patients are likely to continue to struggle with joint pains and stiffness.

 

Difference between dengue and chikungunya

Presentation
Chikungunya: Fever with joint pains; Dengue: Fever, headache, myalgia (pain in muscles) and bleeding

Fever
Chikungunya: Abrupt onset that lasts 3-5 days; Dengue: Acute onset lasting 5-7 days

Rash
Chikungunya: Appears on day 2 or 3; Dengue: Appears between days 5 and 7

Joint pains
Chikungunya: Frequent; Dengue: Less common

Pains
Chikungunya: Joint pains are predominant; Dengue: Muscle pain is dominant

Bleeding
Chikungunya: Not common; Dengue: Common

Organ involvement
Chikungunya: Rare; Dengue: Common

Low white blood cells
Chikungunya: Not frequent; Dengue: Common

Low platelet count
Chikungunya: Not frequent: Dengue: Common