Chikungunya cases rise amid ongoing dengue crisis

Bangladesh is witnessing a rise in chikungunya cases as the country continues to grapple with a widespread dengue outbreak. 

The country had not reported any chikungunya cases since 2017, when a major outbreak caused over 13,800 people in Dhaka to seek treatment within just four and a half months, according to the Institute of Epidemiology, Disease Control, and Research (IEDCR). 

This year, 67 chikungunya cases and 11 cases of the Zika virus have been confirmed, says Prof Md Abu Zafar, director general of the Directorate General of Health Services (DGHS).

"Most of the identified chikungunya and zika virus cases have been found in residents of Dhaka. These infections were primarily detected during the diagnosis of dengue patients," Dr Abu Zafar added.

In addition to the DGHS data, chikungunya and chikungunya-like cases are also being seen at specialist clinics and private hospitals.

Doctors said that over 100 chikungunya patients were treated at Dhaka Community Medical College Hospital last month, while Square Hospital treated more than 300 chikungunya patients during the same period.

Dr Ashraful Islam Irfan, a consultant at Dhaka Community Medical College Hospital, told TBS, "Right now, we are seeing more chikungunya patients than dengue. Many patients are experiencing severe joint pain, which makes it hard for them to sit or stand. They also have other symptoms like fever and rashes."

He added, "The pain from chikungunya usually improves within 7 days, but in some cases, joint pain can last for up to one and a half months, or even up to 6 months. Painkillers are prescribed to patients. Since the season is almost over, we expect chikungunya cases to rise next year."

A study on the 2017 chikungunya outbreak in Bangladesh found that 95% of those infected in Dhaka were bedridden. About 83% of patients experienced a low to very low quality of life and nearly 30% lost more than 10 days of productivity due to severe joint pain.

Warning of potential outbreak 

Medical experts and scientists from the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) are increasingly worried that the spread of chikungunya could lead to a larger outbreak next year. 

Their primary concern is the control of the Aedes mosquito, the common vector for both dengue and chikungunya infections.

Since October, icddr,b has detected 27 cases of chikungunya, including in dengue-negative patients.

Dr Mohammad Shafiul Alam, a scientist at the Infectious Diseases Division of icddr,b, told TBS, "There is a high chance of a chikungunya outbreak next year. The country experienced a major outbreak in 2017.

"Before that, cases were slowly found outside Dhaka from 2008, and by 2014-2015, cases appeared near Dhaka. This year, many cases have been detected in Dhaka. As the season is almost over, there is a risk of a major outbreak next year."

He added, "Zika, chikungunya, and dengue are all spread by the same vector, Aedes mosquitoes. We need to improve mosquito control. City corporations should focus on how to control mosquitoes to manage all three diseases. The mosquito is our common enemy, and it must be eliminated."

Virologist Professor Dr. Nazrul Islam told TBS, "The only way to prevent mosquito-borne diseases like dengue, chikungunya, and Zika is by killing mosquitoes. Since all these diseases are spread by Aedes mosquitoes, we must focus more on eradicating them. We need coordinated efforts to eliminate Aedes mosquitoes, which is currently lacking."

In addition to the chikungunya threat, Bangladesh is also battling a dengue crisis, with more than 93,000 reported cases and nearly 500 deaths this year alone.

Ongoing efforts by city corporations 

Dr Fazle Shamsul Kabir, acting chief health officer of Dhaka South City Corporation (DSCC), told TBS, "Chikungunya and dengue are spread by Aedes mosquitoes. We continue our mosquito control efforts against all types of mosquitoes, including Aedes, Culex, and others. While chikungunya patients suffer for a long time, the death rate is nearly zero. We are aware of this."

He added that they face new challenges every year and apply lessons learned. "We create a year-round mosquito control plan with input from various stakeholders and government agencies. We also take advice from experts on the way forward."

Shamsul Kabir said, "In a few days, we will hold a meeting to discuss next year's mosquito control plan. Representatives from icddr,b, the health ministry, IEDCR, and other stakeholders will join. We will also consider this year's experiences and mistakes to improve the programme."

Dhaka North City Corporation Chief Executive Officer Mir Khairul Alam told TBS, "Our anti-mosquito programme runs year-round. If the health ministry provides us with information on chikungunya cases, we can take preventive measures. We also create a new plan each year for the anti-mosquito programme, which includes this issue."

He added, "We conduct mosquito control efforts in areas where Aedes mosquitoes are breeding and implement special programmes to prevent mosquito-borne diseases. Our goal is to ensure no one in the city dies from these diseases."