Does chikungunya kill? Yes, minister, it does
FATAL WHO data shows chikungunya outbreaks have caused death across the world. In 2005-06, 254 deaths reported from Reunion Islands in the Indian Ocean
NEW DELHI: “Chikungunya can’t be cause of death,” Union health minister JP Nadda told the nation on Wednesday, the day 10 people died of chi kunguny arelated complications.
“Medically, there are no deaths due to chikungunya, but media is showing deaths due to this disease. I want to make it clear that chikungunya is not fatal,” said Delhi health minister Satyendar Jain on Tuesday, the day two hospitals confirmed five chikungunya deaths in Delhi. They are both wrong. Chikungunya outbreaks have caused death across the world, shows World Health Organisation (WHO) data.
In 2005–2006, Réunion Island in the Indian Ocean reported around 2.6 lakh chikungunya cases and 254 deaths.
Till April 2015, 13.79 lakh chikungunya cases and 191 deaths attributed to the disease have been recorded in the Caribbean, Latin America, and the US.
The WHO confirms that while most people have mild disease and recover fully, some may develop eye, neurological and heart complications.
“Serious complications are not common, but in older people, the disease can contribute to the causes of death,” states the WHO on its Chikungunya factsheet. NO DEATHS OR MISSED DATA? India’s worst outbreak was in 2006, when 13.9 lakh chikungunya cases were reported but there are no deaths that can attributed to the disease. “Cases, as well as deaths may be missed if the symptoms are mild and the infection is not diagnosed or goes unrecognised. People often don’t get tested if the disease is not endemic in the area,” said Dr Sandeep Budhiraja, clinical director and director, internal medicine, Max Healthcare.
Epidemiologists say the mosquito that spreads the disease could also be affecting disease outcomes.
“The dominant vectors (mosquitoes that spread the disease) in Réunion Island are aedes albopictus, but it’s aedes aegypti in India, which could be a reason why India had no deaths. We need to investigate the disease more closely,” said a microbiologist with the National Centre for Disease Control, Delhi.
The aedes albopictus thrives on open spaces that have waterfilled breeding sites. But aedes aegypti, the mosquito behind the Delhi outbreak, breeds in flower vases, water storage vessels and concrete water tanks in bathrooms. UNSOLVED DEATHS The 2006 chikungunya outbreak in India affected 151 districts in eight states/union territories — Andaman & Nicobar Islands, Andhra Pradesh, Delhi, Gujarat, Karnataka, Kerala, Madhya Pradesh, Maharashtra and Tamil Nadu — with Karnataka, Maharashtra, Kerala and Gujarat the worst hit.
Ahmedabad (with a then population of 3.8 million) reported 60,777 suspected cases between August and October.
To assess the effect of the outbreak, public health experts at the Indian Institute Management-Ahmedabad compared the death rates in 2006 with those in 2002–2005 for the same period and found that the death rates had increased by 22% in August, 57% in September and 33% in October.
They found 2,944 excess deaths occurred during the chikungunya epidemic when compared with the average number of deaths in the same months during the previous four years.
“These excess deaths may be attributed to this epidemic,” the authors said in their study published in the journal Emerging Infectious Diseases.
They said since “hidden or unexplained cause of death is also possible, public health authorities should thoroughly investigate this increase in deaths associated with this epidemic”.