Keeping in view the recent continuous increase in the number of suspected Chikungunya, Dengue Fever, Chickenpox and Measles across the country, National Institute of Health (NIH) has issued ‘Disease Prevention Advisories’ in order to minimise the spread of these diseases.
The Field Epidemiology and Disease Surveillance Division of the NIH has developed and disseminated advisories to upscale preparedness and preventive measures to curtail the surge of the diseases.
According to the advisory, it is imperative to be vigilant in collecting maximum information about the suspected Chikungunya cases, confirming the disease, advising preventive measures and take certain steps to decrease further transmission.
Due to some common clinical signs, Chikungunya can be misdiagnosed with dengue where dengue is common. However, the CHKV infections are rarely fatal without significant hemorrhagic manifestations. The proximity of mosquito breeding sites to human habitation is a significant risk factor. The viruses can circulate in the same area and cause occasional co-infections in the same patient.
Older adults, toddlers, pregnant women and people with preexisting chronic diseases (diabetes, hypertension) are at high risk of dengue fever. However, it is important for the attending physicians to exclude other treatable diagnoses.
The measures recommended by the NIH advisories include inspection and cleaning the interior and exterior of the home and its surrounding areas every week, draining tanks, animal water troughs, water storage vessels, plastic food containers, used coconut shells and air coolers, etc.
Insecticide spraying by a trained professional is also recommended on a monthly basis. There is a need to promote awareness among the population to protect the body from mosquito bites. Steps must also be taken to ensure that women of childbearing age, and particularly pregnant women, have the necessary information to reduce the risk of exposure.
During March and April 2017, sporadic clusters of Chickenpox (varicella) have been reported from Faisalabad, Punjab. This ‘Advisory’ is therefore intended to alert the health professionals to timely diagnose the Chickenpox disease, manage the cases and undertake standard prevention and control measures including awareness/ education and vaccination to minimise its incidence in the summer.
During March and April 2017, Measles outbreaks have been reported from few districts of Sindh, Balochistan, Khyber Pakhtunkhwa and Islamabad Capital Territory.
There is no specific treatment for measles and most people recover within 2–3 weeks. However, complicated cases may be referred to tertiary care settings for further management. Moreover, all children under 6 months – 5 years of age should also receive prophylactic Vitamin A in two doses given 24 hours apart.
Through above all these advisories, NIH calls upon hospital managements to build their capacity for management of patients, to keep rapid response arrangements in place, and to maintain regular liaison with relevant departments.