Investigating First Ever Chikungunya Outbreak in KP, Pakistan
PHE ePoster Library. Bettani A. 09/12/19; 274289; 101
Asif Bettani
Asif Bettani
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Abstract
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Abstract Chikungunya, an emerging disease in Pakistan as few cases appeared in Lahore during 2011 Dengue outbreak, followed by an outbreak in Karachi(2016). It never occured in KP province until in June 2017, a cluster of mysterious disease was reported in village, Muneem (Haripur (KP) at a time when an outbreak of Dengue was active. Situation was alarming since presence of the vector Aedes was evident from ongoing Dengue outbreak. Chikungunya carries a low mortality rate but morbidity may include acute&chronic Arthritis alongside other health & psycho-socio-economic implications. Objective of investigation was to control & to understand reasons for occurrence of outbreak.Retrospective observational study was conducted. Interviews for case finding&contact tracing revealed that cases travelled from Karachi to attend a wedding. An outbreak of Chikungunya was active in part of Karachi from where the CASES travelled 5-7 days prior to illness. With masked symptoms of Dengue, it was the travel history which changed direction of investigation to hypothesis Chikungunya.18 cases (13 female, 5 male) met inclusion criteria. All cases(100%)complained of joint pains. Headache(78%), fever(61%), eye pain(50%)& rash(11%) were among other symptoms. None required inpatient care. Blood samples from 7 cases tested for ELISA. 3/7 (42%) were IgM ELISA positive with two male (aged 35 and 55 yrs)&one female (24 yrs)Suggestive symptoms of Dengue, made the travel history overlooked. Chikungunya never emerged in KP because “Agent” was missing from enhanced “epi-triad”. With presence of Agent, robust measures were placed to prevent infection of Aedes mosquito& to limit disease spread. External funding details
Abstract Chikungunya, an emerging disease in Pakistan as few cases appeared in Lahore during 2011 Dengue outbreak, followed by an outbreak in Karachi(2016). It never occured in KP province until in June 2017, a cluster of mysterious disease was reported in village, Muneem (Haripur (KP) at a time when an outbreak of Dengue was active. Situation was alarming since presence of the vector Aedes was evident from ongoing Dengue outbreak. Chikungunya carries a low mortality rate but morbidity may include acute&chronic Arthritis alongside other health & psycho-socio-economic implications. Objective of investigation was to control & to understand reasons for occurrence of outbreak.Retrospective observational study was conducted. Interviews for case finding&contact tracing revealed that cases travelled from Karachi to attend a wedding. An outbreak of Chikungunya was active in part of Karachi from where the CASES travelled 5-7 days prior to illness. With masked symptoms of Dengue, it was the travel history which changed direction of investigation to hypothesis Chikungunya.18 cases (13 female, 5 male) met inclusion criteria. All cases(100%)complained of joint pains. Headache(78%), fever(61%), eye pain(50%)& rash(11%) were among other symptoms. None required inpatient care. Blood samples from 7 cases tested for ELISA. 3/7 (42%) were IgM ELISA positive with two male (aged 35 and 55 yrs)&one female (24 yrs)Suggestive symptoms of Dengue, made the travel history overlooked. Chikungunya never emerged in KP because “Agent” was missing from enhanced “epi-triad”. With presence of Agent, robust measures were placed to prevent infection of Aedes mosquito& to limit disease spread. External funding details
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