Now, chikungunya rises to brain fever

Hyderabad: Officials of the Integrated Disease Surveillance Programme say that chikungunya is escalating to brain fever or meningitis in very severe cases in the country. This led to five deaths in New Delhi recently, which has got the IDSP officers on alert. They have been asked to monitor chikungunya cases very closely.

General physician at Apollo Hospitals, Dr Hari Kishan, said, “Chikungunya escalating to fever in the brain is very rare, but it is not unheard of. These cases are recorded in medical history but are seen only in very severe cases where there are other conditions or underlying diseases in the body. In 95 per cent of the cases, the chikungunya virus is self-limiting but in 5 per cent cases there are chances of complications.”

These complications arise if the patients are elderly, suffering from diabetes, cancer, transplant patients or having any other underlying non-diagnosed disease. The five deaths occurred at Delhi’s Sir Ganga Ram Hospital.

Virus remains invisible during initial testing
Delhi’s Sir Ganga Ram Hospital chairman of microbiology department Dr Chand Wattal said, “The existing chikungunya virus has not shown up in the ‘IgM chikungunya serology test’. This has caused a lot of confusion as the disease is not immediately identified.” But such instances are not uncommon.

Dr K. Narsimulu, of Guntur Medical College who was earlier associated with Gandhi Medical College, said, “In some cases, the virus does not show up in the first test. It is only when the patient’s condition becomes severe does the virus show up. This was noticed in a few cases during a major outbreak in 2006, during which 32,000 people from undivided AP had contracted the disease,” he said.

The present strain of chikungunya virus has to be closely monitored and studied. A senior doctor said, “We need to check if the virus has mutated or is it a virulent strain or a variant strain. This must be evaluated with the existing cases that are being seen in the country.” He said, earlier, the swine flu H1N1 virus was seen only during the winter months but had become part of the Indian climatic condition and was soon seen round the year. “Hence there is a variant strain existing in the Indian environment,” he said.

With chikungunya being seen in large numbers after 2006, when 1.5 lakh cases were recorded in the country, the IDSP wing has been asked to check on the reported cases. In Telangana state alone, 30 cases have been reported so far — from July to September 10 — of this year.  “Twelve cases are from Mahbubnagar and 10 are from Hyderabad,” a doctor said.