C. Maya

Pathanamthitta: Last year, when chikungunya broke out in Alappuzha, a few cases were reported in the low lands in Pathanamthitta too, in the areas bordering Upper Kuttanad.

This year, chikungunya first appeared in the hills, at Chittar and Ranni-Perunad, before spreading to the midlands.

Till July 17, about 1,35,545 cases of viral fever, including 3,396 suspected cases of chikungunya, have been reported in the district. The number of fever-related deaths is 80.

The epidemic took its toll on the fragile public health system and all hospitals struggled to manage the thousands that crowded the outpatient clinics and wards.

The district health administration had another uphill task on its hand — mobilising the community for vector-control activities.

“When fever clusters began to be reported in April, we intensified vector- control activities in and around Chittar. But source reduction proved to be a major problem in the vast pineapple and rubber plantations,” says P.N. Vidyadharan, doctor coordinating the Fever Containment Cell at Pathanamthitta.

The combination of wet, humid climatic conditions and the peculiar terrain favoured the breeding of Aedes albopictus mosquito.

The vector indices, which seemed to be coming down by April-end, shot up once the rains began.

By May-June, viral fever suspected to be chikungunya was raging in about 118 wards in eight panchayats.

The health administration deployed more doctors to the affected areas and engaged hundreds of health workers in the field. Vector indices are now down as a result of sustained activities, says District Medical Officer N. Damodaran.

“Every epidemic goes through a natural course before it tapers off. The number of suspected chikungunya cases has come down to single digits now. But seasonal viral fever will continue to be reported till the rains last,” says Thomas Mathew, Professor of Community Medicine, Government Medical College, Alappuzha.

However, public health experts, many of whom had been camping at Pathanamthitta since April to battle chikungunya, are a dejected lot today.

The furore kicked up over the skin manifestations of chikungunya and the political dimensions that the epidemic seems to have acquired have belittled the efforts of hundreds of doctors and health workers who had worked sincerely, many feel.

“Once a virus has been introduced into a community, it will spread vigorously to new areas where the immune status is naïve. It is true that we failed to anticipate the geographic spread of the virus, but the public health system has never before mobilised itself so strongly to control an outbreak,” Dr. Mathew says.

Viral infections such as chikungunya and dengue fever are a direct result of increasing urbanisation and environmental degradation. Unless long-term steps are adopted to sustain vector control and systematic garbage disposal throughout the year, viral epidemics will become an annual feature in the State.