Answer 1 of 3: Have recently read that in and this year there were several outbreaks of Chikungunya fever in India including seems there is no. PDF | India was affected by a major outbreak of chikungunya fever caused by Chikungunya virus (CHIKV) during Kerala was the. Chikungunya virus (CHIKV) is a mosquito-transmitted alphavirus that is emerging as a .. One lac people were again infected with CHIKV in in Kerala.

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Chikungunya virus outbreak in Kerala, India, Kerala was the worst affected state during with a contribution of However, except for clinically reported case records, no systematic information is available on infection status of CHIKV in the region.

Hence, we carried out a post-epidemic survey to estimate seroprevalence status [immunoglobulin G IgG ] in the community using commercially available indirect immunofluorescence test. The study area selected was the worst affected mid-highlands region of Kerala which harbour vast area of rubber plantations.

This may be due to high occupational risk of the male population engaged in plantation activities exposed to infective bites of Aedes albopictus. Chikungunya virus – serosurveillance – India – rubber plantation gunyaa Kerala – Aedes albopictus.

Chikungunya fever is caused by an arthropod-borne Alphavirusbelonging to family Togaviridaeprimarily transmitted to humans through the bite of infected Aedes mosquitoes Pialoux et al.

The rapid geographic spread of the virus led to a large chikungunya disease epidemic in India during Mavalankar et al.

The Department of Health and Family Welfare of the Government gnya Kerala reported 24, cases as suspected chikungunya fever duringdistributed across all 14 administrative districts of the state. This state is a land strip lying in the extreme southern region of India bordered by Western Ghats the mountain range along the western side of India in the east and Arabian Sea in the west.

‘Chikungunya in Kerala after 30 years’ | india | Hindustan Times

The state enjoys tropical climate with about 3, mm rainfall annually, fed by south-west and north-east monsoons. Topographically the state could be divided broadly into three regions, viz. The hilly and forested districts of Kottayam and Pathanamthitta located in the mid-high lands region of Kerala were the worst affected by CHIKV, contributing to These districts have abundant rubber plantations [, ha in Kottayam the largest area in the state and 61, ha in Pathanamthitta], which supported prolific breeding of Aedes albopictusthe main vector of chikungunya infection Kumar et al.

They breed in the rainwater that accumulates in the hemispherical containers, fitted to the trunks of rubber trees, for latex collection, in the region Kumar et al. Earlier studies showed that east central South African strain was responsible for the outbreak in Kerala Kumar et al. No reliable data exist on the actual prevalence of chikungunya infection in the state during this outbreak, except for the clinically suspected CHIKV case records maintained by the state health machinery, which remains a severe underestimate of the problem Kumar et al.

Hence, we carried out a systematic study to estimate the magnitude of CHIKV infection in Kerala during outbreak and the results are presented here. Persistence of IgM antibodies was found to be varying in different studies and it did not persist normally more than three-four months period, at detectable levels Chia et al.

However, IgG antibodies are reported to be detectable in convalescence and remains so for years Chia et al. A recent multi-country study carried out reported the better utility of IgG in detection of chikungunya infection compared to IgM Niedrig et al. The population size in Chethackal, Malankara and Aimcompu was 2, 1, and 1, respectively.

While the former two study villages were large plantations 1 under the ownership of government organization and the other owned by a corporate agencythe latter was a village with unorganized sector of small scale mostly below 2 ha per owner rubber plantations.


In the organized sector villages the human dwellings were restricted to two-three agglomerations labour lines inside plantation area, while in the unorganized sector human dwellings were more dispersed, each family living in the midst of the small scale rubber plantation they owned.

The entire population in these villages is found to be natives of Kerala, except a minor proportion employed as staff at the Government sector maintained Chethackal plantation. On enquiry, it was understood that all these migrants to the state were transferred to the state prior to and were residing in the plantation belt itself with their families. Sample size and survey method – Initially, a preliminary study to estimate the sample size of the population to be surveyed was carried out, including all the three study areas.

Age and gender of the specific population in the study areas were obtained through door to door enumeration. This sample size was distributed across the study areas in proportion to the population size. To survey, required number of individuals a systematic sampling technique with random start household in each study area was adopted and intravenous blood samples were collected during day time from all the available individuals in the selected households during March-October Details on the previous clinical history of chikungunya fevers were also collected from the patients, simultaneously.

Method to assess seropositivity – The protocol described by Litzba et al. Photographs of all the samples processed were taken with the help of a digital camera attached to the fluorescent microscope. Ethics – Institutional standard guidelines were followed for the collection of blood samples after obtaining their written informed consent form for participation in the study.

The number of samples collected from Chethackal, Malankara and Aimcompu wereandrespectively.

Age and gender specific distribution of population and sampling is shown gunja Fig. It was observed that among both males and females there was a fair representation of population in all the age classes.

Absence of fluorescence showed that the samples were seronegative. The seroprevalence for the study areas, viz. Comparison of age specific prevalence among males and females showed that the prevalence in males was significantly higher in the two age groups, viz.

CHIKV fever history and seropositivity – Out of the individuals surveyed, had history of CHIK fever typical fever, joint pain and other symptoms and among them Among 78 asymptomatic individuals, only 10 The population of districts of Pathanamthitta, Idukki and Kottayam Census of India is 1,, 1, and 1,, respectively. Among the fever cases, Besides, in the present study, There was an upsurge of fever cases and also suspected chikungunya fever cases in It may be presumed that the actual figure on account of chikungunya cases would have been very high, since all fever cases had been recorded as gknya fever and this might include more of chikungunya fever cases than the figures officially reported Kumar et al.

The flow of patients to the hospitals exceeded the inpatient capacity of the hospitals in the districts of Kottayam, Pathanamthitta and Idukki. Under these unprecedented circumstances, immunological diagnosis was not possible with the available facilities in the local hospitals.

Chikungunya fever? – Kerala Forum

The present study provides an insight on the magnitude of the CHIKV outbreak in the plantation sector of Kerala during and the figures actually projected could be an underestimate of the problem, as reported elsewhere. The seroprevalence rate in Italy was The higher seroprevalence rate reported in Kerala could be attributed to the exposure of the population dwelling and engaged in the rubber plantations to the infective bites of the day biting and exophilic vector species, Ae.

According to State Government Health authorities, the outbreak of chikungunya fever lasted for about six months. The mosquito control activities carried out were inefficient, owing to the vastness of area of the outbreak the area of 3 districts included in the study is 9, Km 2 and unplanned operational measures carried out without an efficient entomological surveillance mechanism and due to unpreparedness of the health authorities to handle such a widespread outbreak.


‘Chikungunya in Kerala after 30 years’

Besides, as described, rubber plantation belt in Kerala pose a special ecological and topographical situation, poorly accessible to Government Health authorities for routine surveillance due to the hilly and forested terrain, compared to urban situations. These factors could have contributed to the higher prevalence rate of chikungunya outbreak recorded in the rubber plantation belt in Kerala. Interestingly, this activity coincided with the peak hours sunrise of biting activity of Ae.

Female population engaged in plantation work was mainly limited to weeding out activities in the plantations after From these plantation practices, it could be ascertained that male population engaged in rubber tapping activity during early morning hours would have been exposed to more Ae. Similar observations on gender differences in seroprevalence had been recorded elsewhere which was attributed to exposure to infection due to community specific habits, customs or behaviours Sissoko et al.

Amongst the male population, the age group years who were engaged in plantation work was found to be in the highest risk category. Also, there are reports indicating that CHIKV IgG was higher in individuals above 15 years old, as diversity of socioeconomic status and living in makeshift housing conditions increased the risks of exposure to infection Sergon et al.

Recent studies conducted in Italy also showed that the prevalence of infection increased with age Moro et al. They viewed that age and gender are proxy-factors for specific behaviour that causes higher exposure to Ae. Studies also showed that seroprevalence was greater in the part of the village with more human activity. Besides, differences in attack rates were likely caused by local factors, including population immunity and genetic susceptibility, vector competence, environmental settings and effectiveness of outbreak control measures Ayu et al.

The present study exposes the magnitude of CHIKV infection in rubber plantation belt of Kerala and provides basic parameters for modelling the transmission potential of outbreaks and planning control measures for this arbo-viral infection in a tropical setting. Such type of studies using appropriate and reliable diagnostic measures is essential for the quantification and monitoring of epidemics, which enable development and implementation of cost effective public health measures to manage the disease outbreak situations in tropical, developing countries.

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