KARACHI: While laboratory confirmation of suspected ‘chikungunya’ cases is still awaited, hundreds of patients with complaints of high-grade fever and severe joint pain continued to report at public and private sector hospitals in Malir, it emerged on Sunday.

According to sources, the number of suspected ‘chikungunya’ cases rose to 1,000 at a Sindh government hospital in Malir in a single day, though their number at private healthcare settings couldn’t be estimated.

Eighty staff members of the same hospital, who got infected with the disease, are recovering now. No death has so far been reported.

“The hospital has received 1,000 cases with high-grade fever and crippling joint pain today,” Dr Rehana Saba Bajwa, the medical superintendent of Sindh Government Hospital Saudabad, Malir, told Dawn.

An emergency has been declared at the 200-bed facility.

According to Dr Bajwa, patients had come from areas including Malir, Gadap, Murad Memon Goth, Pipri, Gulshan-i-Hadeed, Quaidabad, Korangi and Shah Faisal Colony. There was one case from Shahrah-i-Faisal.

“The joint pain was so severe in some case that patients couldn’t even walk,” she added.

To a question that whether these cases are of chikungunya, a viral mosquito-borne disease, she said: “We can’t say that unless diagnosis is done. A team of health experts is expected to visit us on Monday that will make arrangements for disease diagnosis.”

Patient with high-grade fever with debilitating knee pain, she said, had been coming to the hospital since the second week of November. “We thought they were of dengue and malaria. But, the situation became serious when the number of such cases rose from 500 to 1,500 in a day and 80 members of our staff that included 20 doctors also got infected.

“Their platelet level that drops in the case of dengue was normal. None of them vomited blood that we see in severe dengue cases,” she explained while requesting authorities to launch a massive cleanliness campaign in the city especially in the suburb areas.

The staff at the Al Mustafa Welfare Society Hospital, a private health facility in Malir, has also been receiving patients with high grade fever and acute joint pain since last month.

“We don’t have the facility to diagnose an unknown viral disease. Patients are being recommended to take paracetamol and they show improvement in some days,” a doctor said on condition of anonymity, adding that no government official had visited the facility.

Director health services Dr Abdul Waheed Panhwar, who has visited the Sindh government hospital in Saudabad, said: “It will take some time before the health department officially declares what has caused illness. The number of infected people is definitely high.”

According to him, patients are reporting with symptoms that are usually not observed in the case of dengue. “The joint pain is so crippling that they can’t move their lower limbs. The disease is affecting people of all age groups.”

The province, he said, had good number of experts and, hopefully, help from Islamabad wouldn’t be needed to identify the virus infecting people.

“Though this disease has been reported from regional countries like India and Bangladesh, there is no documented case of chikungunya in Pakistan,” he said.

Meanwhile, the Pakistan Medical Association has called upon the government once again to set up a state-of-the-art virology laboratory in the province to make prompt diagnosis in cases of unknown infections.

“The Indian city of Delhi has seen an outbreak of chikungunya this year, where some people have also died of the disease. So, there is an immediate need for preventive measures. Besides, a virology lab is need of the hour, which the PMA has been demanding for many years now,” Pakistan Medical Association sectary general Dr Qaiser Sajjad said.

What is chikungunya

According to the World Health Organisation's (WHO) [website][1], chikungunya is a viral disease transmitted to humans by infected mosquitoes. It causes fever and severe joint pain.

Other symptoms include muscle pain, headache, nausea, fatigue and rash.

Joint pain is often debilitating and can vary in duration. There is no cure for the disease. Treatment is focused on relieving the symptoms. The proximity of mosquito breeding sites to human habitation is a significant risk factor for chikungunya.

The disease occurs in Africa, Asia and the Indian subcontinent. In recent decades mosquito vectors of chikungunya have spread to Europe and the Americas. In 2007, disease transmission was reported for the first time in a localised outbreak in north-eastern Italy, the website added.

Outbreaks have since been recorded in France and Croatia.

Most patients recover fully in two to three weeks, 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, the website says.

According to it, 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 unrecognised, or be misdiagnosed in areas where dengue occurs.

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.

Key facts

• Transmitted to humans by infected mosquitoes.
• Causes fever and severe joint pain. Other symptoms include muscle pain, headache, nausea, fatigue and rash.
• Joint pain is often debilitating and can vary in duration.
• Shares some clinical signs with dengue, and can be misdiagnosed as dengue in areas where dengue is common.
• There is no cure for the disease. Treatment relieves symptoms.
• The proximity of mosquito breeding sites to human habitation is a significant risk factor for chikungunya.
• Disease occurs in Africa, Asia and the Indian subcontinent.