Chikungunya Virus Outbreak in India and China: How Much is Nepal at Risk?
As monsoon season begins, discussions about potential dengue outbreaks are already underway. Dengue virus is transmitted by Aedes mosquitoes, and efforts are underway to track and destroy their larvae. However, many may not know that the same mosquito also spreads another virus—chikungunya.
Current Situation in Neighboring Countries
Recent reports indicate a rapid spread of chikungunya in India, while China is already facing an epidemic. The U.S. CDC has even issued a travel notice for citizens planning to visit China. Since July, nearly 5,000 cases have been confirmed.
Chikungunya in Nepal: Past and Present
My research in 2013 first identified chikungunya in Nepal, published in an international medical journal in 2014. Since then, the virus has appeared every monsoon season, but testing in government labs has nearly stopped in recent years. As a result, we lack current data on its status in Nepal.
WHO Warning and Symptoms
The World Health Organization (WHO) has warned that chikungunya could soon become a global epidemic. Its main symptoms include sudden fever and severe joint pain. Research shows that over 50% of patients experience joint pain lasting more than three years. Other symptoms include headache, muscle pain, fatigue, and rashes.
Similarities to Dengue Make Diagnosis Difficult
Since both dengue and chikungunya share symptoms like fever, rashes, and joint pain, distinguishing them without lab tests is hard. If a patient tests negative for dengue, chikungunya should still be suspected, as outbreaks of both viruses can occur simultaneously.
Nepal’s Aedes Mosquitoes May Carry Chikungunya
Informal discussions with researchers suggest that Aedes mosquitoes in Nepal carry significant levels of chikungunya virus. This makes lab testing crucial during dengue season. Proper diagnosis is vital because treatment and medical advice differ for the two viruses.
Complications and Mortality Risk
Though chikungunya is often considered less deadly than dengue, recent outbreaks show rising death rates. In Ahmedabad, India, mortality reached nearly 12%, mostly among elderly patients. Nepal recorded its first chikungunya-related deaths in 2017. The virus can cause complications in the eyes, heart, and nervous system, something I’ve observed in my own patients.
Prevention and Vaccination
No specific antiviral treatment exists for chikungunya; care focuses on symptom relief. Prevention relies on avoiding mosquito bites, which is challenging since Aedes mosquitoes bite mostly during the day. Vaccines are available in some countries (the U.S. CDC recommends them for travelers), but their availability in Nepal is unclear.
Urgent Need for Action in Nepal
While Nepal’s current efforts focus on dengue control, ignoring chikungunya, a virus already confirmed here a decade ago, would be a mistake. Reviving lab testing is essential to assess the situation and develop action plans for prevention and treatment.
(Dr. Pun Shukraraj is the Coordinator of the Clinical Research Unit at the Tropical and Infectious Disease Hospital.)
