Sandhya Raghavan
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Written By: Sandhya Raghavan | Updated : June 30, 2017 9:11 PM IST
Cases of vector-borne diseases are on the rise in the country. The quick transition from dry to moist weather is also creating a perfect breeding ground for mosquitoes and viruses. Chikungunya, an arthropod-borne viral disease transmitted by the Aedes aegypti mosquito, has already infected 96 people in Delhi this year. This debilitating illness can result in severe side effects like joint paint and depression that can last for months after the infection. Children, in particular, are more susceptible to contracting the illness more than adults.
Dr Yogesh Gupta, pediatrician and neonatologist from Fortis, Bangalore says, "This is mostly because children love playing outdoors and often venture out into open areas that can be infested with mosquitoes. Since they wear shorts, frocks and short-sleeved shirts, their limbs are exposed for the mosquitoes to feed on. This makes them more vulnerable to chikungunya." In the light of the situation, doctors and health care professionals all over the country are warning parents to protect young ones from contracting this crippling illness.
How does the chikungunya virus spread in the body?
When an infected aedes mosquito bites the victim, the chikungunya virus is injected into the blood of the human being through the skin. "From there, the virus goes to various stations in the human body and infects the fibroblasts or connective tissues and epilithial cells," says Dr Gupta. Once these places are infected and the virus starts replicating itself, the circulating white blood cells carry the virus into the bloodstream.
In case of infants, vertical transmission of from the mother to the child is possible, if the mother is infected with the virus four days before delivery.
What are the symptoms of chikungunya in children?
Symptoms of the disease will start showing within 2-12 days after infection. Clinical signs of the disease can range from asymptomatic to severe form. "The presentation of symptoms can be varied in children," says Dr Gupta, "whereas in adults, they are somewhat fixed." He adds that a combination of symptoms can be seen in children suffering from chikungunya. In most cases, some commonest ones are:
Gastrointestinal complaints like stomach ache, vomiting and diarrhoea.
A sudden onset of fever of more than 104o F can be seen.
After the fever subsides, an itchy rash may develop on the child's hands and legs.
Joint pain or arthralgia is seen in some children.
Purpura or red patches on the skin caused by burst blood vessels.
Bleeding from the nose and gums can be seen.
Some children can suffer from headaches.
The good news is that in children, the recovery period is shorter. The doctor says,"Since their joints are developing, the arthitic pain doesn't last long. Also, the virus targets larger joints of a child's body like the hip joint and knee, making the pain comparatively tolerable. But in adults the smaller more painful joints like the wrists are attacked."
"In case of infants, IgG antibodies present in the mother's placenta protects the child from the deadly diseases for the first six months after they are born. After which, it will start wearing off," says Dr Gupta.
How is chikungunya treated in children?
"There is no specific treatment for chikungunya," says Dr Gupta, "the doctor will try to manage the fever in children with the help of fever medications, hydration and pain killers." During the febrile period (when the patient exhibits fever), complete bed rest is advised. "Under no circumstances should the child be given NSAIDs or Non Steroidal Anti Inflammatory Drugs or Aspirin. They are blood thinners. There is always the risk of bleeding in the patient due to extreme platelet loss."
"Parents need to remember that the first line of treatment for the high grade fever is always through paracetamol," says Dr Gupta. "The disease shares a lot of its features with dengue. So in both cases, hydration is a must," he adds."If there are convulsions, febrile seizures, bleeding, difficulty in taking liquids or if the fever doesn't subside despite the medication, take the child to a medical centre and consult a doctor," says Dr Gupta.
"A new vaccine for chikungunya has been developed by scientists. But its efficacy is questionable since it is known to worsen joint pain in patients," says Dr Gupta.
How to prevent chikungunya in children?
Like in the case of most diseases, prevention is anytime better than cure says Dr Gupta. Personal protection against aedes mosquito is a must.
Prevent mosquito bites at any cost through mosquito repellents, nets, mats or mosquito sprays.
Keep the premises clean and ensure there is no chance for water to accumulate anywhere. Clear garbage accumulation near residential premises.
Treat pools of stagnant water with larvicides.
Make children wear long-sleeved shirts and full pants when they venture out to play.
Dress them in light-coloured clothes because mosquitoes are attracted towards darker colours.
Some families use mosquito repellents only during the evening or during bed time. It is important to remember that the Aedes mosquito is active during the day. So ensure you take preventive care also during day time. "In any case, it is a self-limiting illness," says Dr Gupta. "It will take 7-10 days for the child to recover from chikungunya."
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