WORLD HEALTH DAY 2014WHO THEME: VECTOR BORNE DISEASES

Health Talk on Vector-borne DiseasesDate: 07 April 2014, Primary Health Centre Handignur April 7, 2014 marks World Health Day and the 66th anniversary of the World Health Organization (WHO). This years theme is vector-borne diseases. Over half the world's population is at risk from vector-borne diseases such as malaria and dengue. Vectors like mosquitoes, ticks, and fleas transmit parasites, viruses, or bacteria between people or between animals and people. Each World Health Day, the World Health Organization (WHO) selects a theme that highlights a global public health issue. This year's theme is vector-borne diseases, with a first-time focus on dengue, malaria and chikungunya.Vector-borne diseases account for 17% of the estimated global burden of all infectious diseases. Global trade, rapid international travel, and environmental changes such as climate change and urbanization are causing vectors and vector-borne diseases to spread beyond borders. Small bite, Big treat.This was the slogan for the World Health Day theme which really signifies the important of the hazards possessed by these insect bites. Despite of how simple and small the problem seems to be, the effects can be disastrous as it can lead to death and various morbidities.

Some of the questions raised by the villagers of Handignur during the day are: What is the treatment available to treat the diseases? How to effectively prevent the infections caused by mosquito bites? How do we educate people to destroy all the breeding areas of mosquitoes? (eg: old tires, bottles etc) How to diagnose the infections once they developed the symptoms?

Hence, a brief health talk was given to the residents of Handignur village incorporating the theme of this year to ensure the public have their queries on these diseases solved. With the help of postgraduate students and senior health assistant, we have delivered health talks on vector-borne diseases mainly the ones caused by mosquitoes. These include Malaria, Dengue and Chikungunya. The audiences were from the nurses, ASHA workers, Anganwadi workers and also some public beneficiaries. The talk is greatly beneficial in order to educate the public about vector borne disease especially about preventive measures and how to recognize the signs and symptoms of the disease in order for them to seek early medical attention which is very crucial to reduce morbidity of the disease and prevent fatality.

Aims of the health talk: To educate them regarding the common diseases transmitted by mosquitoes To educate them regarding causes, signs and symptoms, treatment and prevention of dengue, malaria and chikungunya

CHIKUNGUNYAChikungunya is a mosquito-borne viral disease. It is a RNA virus that belongs to the alphavirus genus of the family Togaviridae. The name chikungunya derives from a word in the Kimakonde language, meaning "to become contorted" and describes the stooped appearance of sufferers with joint pain (arthralgia). Chikungunya is a viral disease transmitted to humans by infected mosquitoes. The disease occurs in Africa, Asia and the Indian subcontinent. chikungunya fever has reached epidemic proportions, with considerable morbidity and suffering. The disease shares some clinical signs with dengue, and can be misdiagnosed in areas where dengue is common.

Areas effected by Chikungunya are marked in red

Mortality and MorbidityThe East/Central/South African strain of chikungunya has been emerging in Asia since 2006, first in the Indian subcontinent, then Thailand. India reported a massive chikungunya epidemic in 2006. Chikungunya has reemerged in India since 1973, when the attack rate was 37.5%. However, in the 2006 epidemic, the attack rate increased to 45% in some places. More than 1.39 million cases across 151 districts and 10 states were reported during this period. However, unlike the epidemic in other, no deaths directly attributable to this disease were reported. The dominant vector Ae. aegypti in India. However Ae. albopictus was also implicated in Kerala State, India.

Signs and symptomsChikungunya is characterized by an abrupt onset of fever frequently accompanied by joint pain. Other common signs and symptoms include muscle pain, headache, nausea, fatigue and rash. The joint pain is often very debilitating, but usually lasts for a few days or may be prolonged to weeks.Most patients recover fully, but in some cases joint pain may persist for several months, or even years. Occasional cases of eye, neurological and heart complications have been reported, as well as gastrointestinal complaints. Serious complications are not common, but in older people, the disease can contribute to the cause of death. Often symptoms in infected individuals are mild and the infection may go unrecognized, or be misdiagnosed in areas where dengue occurs.

General symptoms and signs of Chikungunya

Classical Joint Pain

Rash seen in patients suffering from Chikungunya disease

TransmissionThe virus is transmitted from human to human by the bites of infected female mosquitoes. Most commonly, the mosquitoes involved areAedes aegyptiandAedes albopictus, two species which can also transmit other mosquito-borne viruses, including dengue. These mosquitoes can be found biting throughout daylight hours. Both species are found biting outdoors, butAe. aegyptiwill also readily feed indoors. The proximity of mosquito breeding sites to human habitation is a significant risk factor for chikungunya. After the bite of an infected mosquito, onset of illness occurs usually between four and eight days but can range from two to 12 days.

Treatment There is no cure for the disease. Treatment is focused on relieving the symptoms, including the joint pain using anti-pyretics, optimal analgesics and fluids. There is no commercial chikungunya vaccine.

Anti-pyretics and Analgesics

Fluids given to maintain hydration

Prevention and control for vector borne diseases

Preventive MeasuresThe proximity of mosquito vector breeding sites to human habitation is a significant risk factor for dengue, malaria and chikungunya as well as for other diseases that these species transmit. Prevention is very crucial in controlling this vector borne disease. Following are the few measures:

Reducing the number of natural and artificial water-filled container habitats that support breeding of the mosquitoes. Villagers are advised to avoid stagnant water filling and are advised to always cover containers filled with water.

During outbreaks, insecticides may be sprayed to kill flying mosquitoes, applied to surfaces in and around containers where the mosquitoes land.

For protection during outbreaks, clothing which minimizes skin exposure to the day-biting vectors is advised to the villagers. Wearing long sleeves and pants minimizes the exposure of clothing to a good extent.

Repellents can be applied to exposed skin or to clothing in strict accordance with product label instructions. Repellents should contain DEET (N, N-diethyl-3-methylbenzamide), IR3535 (3-[N-acetyl-N-butyl]-aminopropionic acid ethyl ester) or icaridin (1-piperidinecarboxylic acid, 2-(2-hydroxyethyl)-1-methylpropylester). For those who sleep during the daytime, particularly young children, or sick or older people, insecticide treated mosquito nets gives a good protection.

Mosquito coils or other insecticide vaporizers may also reduce indoor biting.

Basic precautions should be taken by people traveling to risk areas and these include use of repellents, wearing long sleeves and pants and ensuring rooms are fitted with screens to prevent mosquitoes from entering.

Vector Control Measures

1. PERSONAL PROPHALATIC MEASURES Use of mosquito repellent creams, liquids, coils, mats etc. Wearing of full sleeve shirts and full pants with socks Use of bednets for sleeping infants and young children during day time to prevent mosquito bite

2.BIOLOGICAL CONTROL Use of larvivorous fishes in ornamental tanks, fountains; in some urban areas larvivorous fish like Gambusia and Guppy are also used in certain situations where the chemical control is not feasible. Biological larvicide, Bacillus thuringiensis israelensis either wettable powder or aqueous suspension are also used for control of aquatic stages of vector mosquitoes. Use of biocides

Gambusia affinis Poecilia reticulata (GUPPY)

3.CHEMICAL CONTROL Use of Indoor Residual Spray (IRS) with insecticides Use of chemical larvicides like Abate in potable water Aerosol space spray during day time Malathion fogging during outbreaks Temephoe

4.ENVIRONMENTAL MANAGEMENT & SOURCE REDUCTION METHODS Detection & elimination of mosquito breeding sources Management of roof tops, porticos and sunshades Proper covering of stored water Reliable water supply Observation of weekly dry day

5.HEALTH EDUCATION Impart knowledge to common people regarding the disease and vector through various media sources like T.v., Radio, Cinema slides, etc.6.COMMUNITY PARTICIPATION Sensitizing and involving the community for detection of Anopheles breeding places and their elimination NGO schemes involving them in programme strategies Collaboration with CII/ASSOCHAM/FICCI

Photos taken during the health talk: