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Chikungunya

Stegomyia aegypti (formerly Aedes aegypti) mos...

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Definition:
Chikungunya is viral fever caused by an alphavirus. Chikungunya is spread by the bite of Aedes and Culex mosquitoes.
This virus belongs to the genus Alphavirus in the Togaviridae family of viruses. Other Alphaviruses include the Sindbis, eastern and western encephalitis, Semliki Forest and Ross River viruses. The Togaviridae family also includes the genus Rubivirus   to which Rubella belongs.

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It is an insect-borne virus, of the genus, Alphavirus, that is transmitted to humans by virus-carrying Aedes mosquitoes. There have been recent outbreaks of CHIKV associated with severe morbidity. CHIKV causes an illness with symptoms similar to dengue fever. CHIKV manifests itself with an acute febrile phase of the illness lasts only two to five days. Followed by a prolonged arthralgic disease that affects the joints of the extremities. The pain associated with CHIKV infection of the joints persists for weeks or months.

It is a rare viral infection transmitted by the bite of an infected mosquito. It is characterized by a rash, fever, and severe joint pain (arthralgias) that usually lasts for three to seven days. Because of its effect on the joints, Chikungunya has been classified among the Arthritic Viruses. It primarily occurs in tropical areas of the world.

Chikungunya was first described in 1955, following an outbreak on the Makonde Plateau, along the border between Tanganyika and Mozambique in 1952.

Chikungunya is found in Africa, southern India, Pakistan, South-East Asia and the Philippines and occurs predominantly during the rainy season. The range of hosts includes humans, primates, other mammals, and birds. In October 2006, the World Health Organization (WHO) reported chikungunya fever outbreaks in eight states in India.

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ChickV Map

Chikungunya virus..

Between March 2005 and February 2006, 1,722 cases of chikungunya were reported in La Reunion, an island in the Indian Ocean east of Madagascar (territory of France). Two-hundred deaths were attributed to chikungunya.

Signs and symptoms:
Symptoms include:

*high fever
*joint pain with or without swelling (arthritis or arthralgia), typically in the knee, ankle and small joints of the extremities
*chills
*headache
*low back pain
*rash
*vomiting
*mild hemorrhaging may be present especially in children

Asymptomatic (“silent”) infections are common, and immunity is long lasting.

The incubation period of Chikungunya disease is from two to four days. Symptoms of the disease include a fever up to 39 C (102.2 F), a petechial or maculopapular rash of the trunk and occasionally the limbs, and arthralgia or arthritis affecting multiple joints. Other nonspecific symptoms can include headache, conjunctival injection, and slight photophobia. Typically, the fever lasts for two days and then ends abruptly. However, other symptoms, namely joint pain, intense headache, insomnia and an extreme degree of prostration last for a variable period; usually for about 5 to 7 days. Patients have complained of joint pains for much longer time periods depending on their age.

Diagnosis:
Common laboratory tests for chikungunya include RT-PCR, virus isolation, and serological tests.

*Virus isolation provides the most definitive diganosis but takes 1-2 weeks for completion and must be carried out in Biosafety level 3 laboratories. The technique involves exposing specific cell lines to samples from whole blood and identifying chikungunya virus-specific responses.

*RT-PCR using nested primer pairs to amplify several Chikungunya-specific genes from whole blood. Results can be determined in 1-2 days.

*Serological diagnosis requires a larger amount of blood than the other methods and uses an ELISA assay to measure Chikungunya-specific IgM levels. Results require 2-3 days and false positives can occur with infection via other related viruses such as O’nyong’nyong virus and Semliki Forest Virus.

Causes:
Chikungunya virus is indigenous to tropical Africa and Asia, where it is transmitted to humans by the bite of infected mosquitoes, usually of the genus Aedes. CHIK fever epidemics are sustained by human-mosquito-human transmission. The word “chikungunya” is thought to derive from description in local dialect of the contorted posture of patients afflicted with the severe joint pain associated with this disease. The main virus reservoirs are monkeys, but other species can also be affected, including humans.

Treatment:
There are no specific treatments for Chikungunya. There is no vaccine currently available. A Phase II vaccine trial, sponsored by the US Government and published in the American Journal of Tropical Medicine and Hygiene in 2000, used a live, attenuated virus, developing viral resistance in 98% of those tested after 28 days and 85% still showed resistance after one year.

Chikungunya fever is not a life threatening infection. Symptomatic treatment for mitigating pain and fever using anti-inflammatory drugs along with rest usually suffices. While recovery from chikungunya is the expected outcome, convalescence can be prolonged (up to a year or more), and persistent joint pain may require analgesic (pain medication) and long-term anti-inflammatory therapy.

A serological test for Chikungunya is available from the University of Malaya in Kuala Lumpur, Malaysia.

Chloroquine is gaining ground as a possible treatment for the symptoms associated with chikungunya, and as an anti-inflammatory agent to combat the arthritis associated with Chikungunya virus. A University of Malaya study found that for arthritis-like symptoms that are not relieved by aspirin and non-steroidal anti-inflammatory drugs (NSAID), chloroquine phosphate (250 mg/day) has given promising results. Research by an Italian scientist, Andrea Savarino, and his colleagues together with a French government press release in March 2006 have added more credence to the claim that chloroquine might be effective in treating chikungunya. Unpublished studies in cell culture and monkeys show no effect of chloroquine treatment on reduction of chikungunya disease. The fact sheet on Chikungunya advises against using aspirin, ibuprofen, naproxen and other NSAIDs that are recommended for arthritic pain and fever.

DNA vaccine: ….>click  &  see
DNA vaccination is a technique for protecting an organism against disease by injecting it with genetically engineered DNA to produce an immunological response. Nucleic acid vaccines are still experimental, and have been applied to a number of viral, bacterial and parasitic models of disease, as well as to several tumour models. DNA vaccines have a number of advantages over conventional vaccines, including the ability to induce a wider range of immune response types.A recent study report that a novel consensus-based approach to vaccine design for Chikungunya virus, employing a DNA vaccine strategy. The vaccine cassette was designed based on CHIKV Capsid and Envelope specific consensus sequences with several modifications, including codon optimization, RNA optimization, the addition of a Kozak sequence, and a substituted immunoglobulin E leader sequence. Analysis of cellular immune responses, including epitope mapping, demonstrates that these constructs induces both potent and broad cellular immunity in mice. In addition, antibody ELISAs demonstrate that these synthetic immunogens are capable of inducing high titer antibodies capable of recognizing native antigen. Taken together, these results support further study of the use of consensus CHIKV antigens in a potential vaccine cocktail.

Prognosis:
Recovery from the disease varies by age. Younger patients recover within 5 to 15 days; middle-aged patients recover in 1 to 2.5 months. Recovery is longer for the elderly. The severity of the disease as well as its duration is less in younger patients and pregnant women. In pregnant women, no untoward effects are noticed after the infection.

Ocular inflammation from Chikungunya may present as iridocyclitis, and have retinal lesions as well.

Pedal oedema (swelling of legs) is observed in many patients, the cause of which remains obscure as it is not related to any cardiovascular, renal or hepatic abnormalities.

Prevention:
The most effective means of prevention are those that protect against any contact with the disease-carrying mosquitoes. These include using insect repellents with substances like DEET (N,N-Diethyl-meta-toluamide; also known as N,N’-Diethyl-3-methylbenzamide or NNDB), icaridin (also known as picaridin and KBR3023), PMD (p-menthane-3,8-diol, a substance derived from the lemon eucalyptus tree), or IR3535. Wearing bite-proof long sleeves and trousers (pants) also offers protection. In addition, garments can be treated with pyrethroids, a class of insecticides that often has repellent properties. Vaporized pyrethroids (for example in mosquito coils) are also insect repellents. Securing screens on windows and doors will help to keep mosquitoes out of the house. In the case of the day active Aedes aegypti and Aedes albopictus, however, this will only have a limited effect, since many contacts between the vector and the host occur outside. Thus, mosquito control is especially important.

Preventive measures include the same as those for other mosquito-associated diseases (e.g. malaria, malaria, yellow fever, west nile virus).

No vaccine is available against this virus infection. Prevention is entirely dependent upon taking steps to avoid mosquito bites and elimination of mosquito breeding sites.

To avoid mosquito bites:
* Wear full sleeve clothes and long dresses to cover the limbs;
* Use mosquito coils, repellents and electric vapour mats during the daytime;
* Use mosquito nets – to protect babies, old people and others, who may rest during the day. The effectiveness of such nets can be improved by treating them with permethrin (pyrethroid insecticide). Curtains (cloth or bamboo) can also be treated with insecticide and hung at windows or doorways, to repel or kill mosquitoes.

Mosquitoes become infected when they bite people who are sick with chikungunya. Mosquito nets and mosquito nets and mosquito coils will effectively prevent mosquitoes from biting sick people.

To prevent mosquito breeding
The Aedes mosquitoes that transmit chikungunya breed in a wide variety of manmade containers which are common around human dwellings. These containers collect rainwater, and include discarded tires, flowerpots, old oil drums, animal water troughs, water storage vessels, and plastic food containers. These breeding sites can be eliminated by

*Draining water from coolers, tanks, barrels, drums and buckets, etc.;*Emptying coolers when not in use;
* Removing from the house all objects, e.g. plant saucers, etc. which have water collected in them
* Cooperating with the public health authorities in anti-mosquito measures.
Role of public health authorities
* National programme for prevention and control of vector borne diseases should be strengthened and efficiently implemented with multisectoral coordination

* Legislations for elimination of domestic/peridomestic mosquitogenic sites should be effectively enforced

*Communities must be made aware of the disease and their active cooperation in prevention and control measures elicited .
Read about other arboviral infections:

*Rift Valley Fever

*Dengue Fever

*Yellow Fever: The Disease and Symptoms

*Yellow Fever Infection: Historical Perspective

*Yellow Fever Vaccine: Disease Prevention

Epidemiology
Chikungunya virus is an alphavirus closely related to the O’nyong’nyong virus,[15] the Ross River virus in Australia, and the viruses that cause eastern equine encephalitis and western equine encephalitis

Chikungunya is generally spread through bites from Aedes aegypti mosquitoes, but recent research by the Pasteur Institute in Paris has suggested that chikungunya virus strains in the 2005-2006 Reunion Island outbreak incurred a mutation that facilitated transmission by Aedes albopictus (Tiger mosquito). Concurrent studies by arbovirologists at the University of Texas Medical Branch in Galveston Texas confirmed definitively that enhanced chikungunya virus infection of Aedes albopictus was caused by a point mutation in one of the viral envelope genes (E1). Enhanced transmission of chikungunya virus by Aedes albopictus could mean an increased risk for chikungunya outbreaks in other areas where the Asian tiger mosquito is present. A recent epidemic in Italy was likely perpetuated by Aedes albopictus.

In Africa, chikungunya is spread via a sylvatic cycle in which the virus largely resides in other primates in between human outbreaks.

History
The name is derived from the Makonde word meaning “that which bends up” in reference to the stooped posture developed as a result of the arthritic symptoms of the disease. The disease was first described by Marion Robinson and W.H.R. Lumsden[22] in 1955, following an outbreak in 1952 on the Makonde Plateau, along the border between Mozambique and Tanganyika (the mainland part of modern day Tanzania).

According to the initial 1955 report about the epidemiology of the disease, the term chikungunya is derived from the Makonde root verb kungunyala, meaning to dry up or become contorted. In concurrent research, Robinson glossed the Makonde term more specifically as “that which bends up.” Subsequent authors apparently overlooked the references to the Makonde language and assumed that the term derived from Swahili, the lingua franca of the region. The erroneous attribution of the term as a Swahili word has been repeated in numerous print sources. Many other erroneous spellings and forms of the term are in common use including “Chicken guinea”, “Chicken gunaya,” and “Chickengunya”.

Since its discovery in Tanganyika, Africa in 1952, chikungunya virus outbreaks have occurred occasionally in Africa, South Asia, and Southeast Asia, but recent outbreaks have spread the disease over a wider range.

You may click to learn more about Chikungunya.:->.………………(1)………(2)……..(3)

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://en.wikipedia.org/wiki/Chikungunya
http://microbiology.suite101.com/article.cfm/chikungunya

http://www.webmd.com/a-to-z-guides/chikungunya

http://www.searo.who.int/en/Section10/Section2246.htm

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A Step Forward

The Jaipur foot is now even better, thanks to a dedicated group of students from the Massachusetts Institute of Technology.

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Looking for a project to do in his third undergraduate year, Goutam Reddy was sure he would not do anything “fashionable”. He was studying electrical engineering and computer science at the Massachusetts Institute of Technology (MIT) in the US. “I wanted something that would find application in the developing world, not the next fast car,” he says.

Reddy grew up in Michigan State, but his parents were of Indian origin. During one of his visits to India, he came to know about the Jaipur foot, which was being fitted to patients by the Bhagwan Mahaveer Viklang Sahayata Samiti in New Delhi. He visited this organisation, trying to understand and improve the technology as part of his project. But he could not find anything to do immediately.

Anyone who sees the Jaipur foot being fitted to patients will never forget the experience. It was no different for Reddy. The Jaipur foot, developed in the 1970s by the late P.K. Sethi, an orthopaedic surgeon, and artisan Ram Chandra, is the one of the best options in the world if you lose your leg. It is lightweight and strong, made of easily available materials like rubber, and costs only $28. An artificial foot in the US would cost a few thousand dollars at least. It was popular among soldiers in war-ravaged countries like Afghanistan. Soldiers who lost their legs came to Jaipur to be fitted with this low-cost miracle. At least 250,000 of these have been fitted to poor people who have lost their legs.

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The Jaipur foot (above) gave Sudha Chandran(a great dancer) a new lease of life after she lost a leg in a 1981 accident.

Yet the Jaipur foot is far from perfect. Reddy realised that the manufacturing methods needed improvement. Several devices used in the Jaipur foot could be improved as well. This was expected, because they were still using techniques developed 30 years ago. If the knee is also amputated, as often happens, the patient will not be able to bend his or her leg — in this case, the artificial foot. This is a common problem with most low-cost artificial legs. Although he could not develop a project immediately, Reddy realised that he could improve the Jaipur foot sometime in the future. The fitting process, in particular, seemed in need of betterment.

The traditional way of fitting was to use plaster of paris moulds. A year and a half ago, the Centre for International Rehabilitation in Chicago developed a new process. This consisted of making the amputees put their leg inside sand and then applying a vacuum. The vacuum made the sand rock solid, and the resulting impression a perfect mould. The vacuum is created using an air compressor, and this necessitated the use of a generator. Reddy, along with other MIT students, found a way to eliminate this generator. They also gave a new name to the Samiti: the Jaipur Foot Organisation (JFO).

After Reddy finished his master’s degree at MIT, he set up a non-profit organisation called Developing World Prosthetics. Other MIT students also joined him. These students were also studying engineering at MIT, and they chose improving the Jaipur foot as their undergraduate project. Some of them travelled to India — using a grant from MIT’s public Service Centre and a $7,500 prize from a competition — to work on this. Finally, they developed a method using a cycle pump and human power to generate a vacuum in the fitting process. The students returned with a better perspective of the developing world. “I want to work on developing world prosthetic projects,” says Philip Garcia, one of the students.

Meanwhile, Reddy has initiated a course at MIT on wheelchair design in developing countries. He remains deeply interested in robotic prosthetics, and in improving the Jaipur foot farther. Members of the JFO rarely get the time to improve the original invention. “Our primary aim is to make and fit the foot,” says Sanjeev Kumar, manager of the Delhi branch of the JFO. Reddy and his organisation will now attempt this task.

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The dancer enthralls her audience in the hugely popular TV show Jhalak dikhla ja

For example, they are trying to improve the sand-casting system for adoption in rural areas. Another project is to improve the flexibility of the device. If the Jaipur foot is fitted above the knee, the patient has to walk with a straight leg — they can bend the “knee” only when they want to sit. The MIT students and Developing World Prosthetics are now working on this problem. The spring session at MIT has a course on developing world prosthetics, and solving the straight knee problem will be one of their primary tasks.

SourcesL : The Telegraph (Kolkata, India)

Common Cold

Alternative Names :
Upper respiratory infection – viral; Cold
Definition :
The common cold generally involves a runny nose, nasal congestion, and sneezing. You may also have a sore throat, cough, headache, or other symptoms. Over 200 viruses can cause a cold.

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Description:
There are at least 200 contagious viruses that cause the common cold. These viruses are easily transmitted in minute airborne droplets from the coughs or sneezes of infected people. In many cases, the viruses are also spread to the nose and throat by way of hand-to-hand contact with an infected person or by way of objects that have become contaminated with virus, such as a cup or towel.

Colds can occur at any time of the year, although infections are more frequent in the fall and winter. About half of the population of the us and europe develops al least one cold each year. Children are more susceptible to colds than adults because they have not yet developed immunity to the most common viruses and also because viruses spread very quickly in communities such as nurseries and schools.

Causes:
We call it the “common cold” for good reason. There are over one billion colds in the United States each year. You and your children will probably have more colds than any other type of illness. Children average three to eight colds per year. They continue getting them throughout childhood. Parents often get them from the kids. Colds are the most common reason that children miss school and parents miss work.

Children usually get colds from other children. When a new strain is introduced into a school or day care, it quickly travels through the class.

Colds can occur year-round, but they occur mostly in the winter (even in areas with mild winters). In areas where there is no winter, colds are most common during the rainy season.

When someone has a cold, their runny nose is teeming with cold viruses. Sneezing, nose-blowing, and nose-wiping spread the virus. You can catch a cold by inhaling the virus if you are sitting close to someone who sneezes, or by touching your nose, eyes, or mouth after you have touched something contaminated by the virus.

People are most contagious for the first 2 to 3 days of a cold, and usually not contagious at all by day 7 to 10.

Symptoms :

The initial symptoms of a cold usually develop between 12 hours and three days after infection. Symptoms usually intensify over 24-48 hours, unlike those of influenza, which worsen rapidly over a few hours. The three most frequent symptoms of a cold are:
Runny nose
Nasal congestion
Sneezing

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Adults and older children with colds generally have minimal or no fever. Young children, however, often run a fever around 100-102°F.

Once you have “caught” a cold, the symptoms usually begin in 2 or 3 days, though it may take a week. Typically, an irritated nose or scratchy throat is the first sign, followed within hours by sneezing and a watery nasal discharge.

Within one to three days, the nasal secretions usually become thicker and perhaps yellow or green. This is a normal part of the common cold and not a reason for antibiotics.

Depending on which virus is the culprit, the virus might also produce:

Sore throat
Cough
Muscle aches
Headache
Postnasal drip
Decreased appetite
Still, if it is indeed a cold, the main symptoms will be in the nose.

For children with asthma, colds are the most common trigger of asthma symptoms.

In some people, a common cold may be complicated by a bacterial infection of the chest or of the sinuses. Bacterial ear infections, which may cause earache, are a common complication of colds.

Colds are a common precursor of ear infections. However, children’s eardrums are usually congested during a cold, and it’s possible to have fluid buildup without a true bacterial infection.

The entire cold is usually over all by itself in about 7 days, with perhaps a few lingering symptoms (such as cough) for another week. If it lasts longer, see your doctor to rule out another problem such as a sinus infection or allergies.

Treatment :
Get plenty of rest and drink lots of fluids. Over-the-counter cold remedies may help ease your symptoms. These won’t actually shorten the length of a cold, but can help you feel better.

NOTE: Some medical experts have recommended against using cough suppressants in many situations. Talk to your doctor before you or your child — especially those under age 2 — take any type of over-the-counter cough medicine, including those specifically labeled for children.

Antibiotics should not be used to treat a common cold. They will not help and may make the situation worse. Thick yellow or green nasal discharge is not a reason for antibiotics, unless it doesn’t get better within 10 to 14 days. (In this case, it may be sinusitis.)

New antiviral drugs could make runny noses completely clear up a day sooner than usual (and begin to ease the symptoms within a day). It’s unclear whether the benefits of these drugs outweigh the risks.

Chicken soup has been used for treating common colds at least since the 12th century. It may really help. The heat, fluid, and salt may help you fight the infection.
Ayurvedic Recommended Product: Curill
Ayurvedic Recommended Therapy: Nasya

Herbal Treatment of Common Cold

Click for Homeopathic Remedies for Common Cold….……………………………(1)….(2).(3)

Home Remedy for Cold

CL ICK & SEE : Simple and Inexpensive Trick to Cure a Common Cold

Take A Foot bath & in heal Steam with little camphor 2 to 3 times a day  Best way to get rid of common cold

Prognosis:
Most people recognize their symptoms as those of a common cold and do not seek medical advice.

The symptoms usually go away in 7 to 10 days.The common cold usually clears up without treatment within 2 weeks, but a cough may last longer.

Possible Complications:
Despite a great deal of scientific research, there is no cure for a common cold, but over-the-counter drugs can help relieve the symptoms. these drugs include analgesics to relieve a headache and reduce a fever, decongestants to clear a stuffy nose, and cough remedies to soothe a tickling throat. It is also important to drink plenty of cool fluids, particularly if you have a fever. Many people take large quantities of vitamin c to prevent infection and treat the common cold, but any benefit from this remedy is unproved.

If your symptoms do not improve in a week or your child is no better in 2 days, you should consult a doctor. if you have a bacterial infection, your doctor may prescribe antibiotics, although they are ineffective against cold viruses.

Bronchitis
Pneumonia
Ear infection
Sinusitis
Worsening of asthma

When to Contact a Medical Professional :

Try home care measures first. Call your health care provider if:

1. The symptoms worsen or do not improve after 7 to 10 days
2.Breathing difficulty develops
3.Specific symptoms deserve a call

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Prevention:
It might seem overwhelming to try to prevent colds, but you can do it. Children average three to eight colds per year. It is certainly better to get three than eight!

Here are five proven ways to reduce exposure to germs:

Switch day care: Using a day care where there are six or fewer children dramatically reduces germ contact.
Wash hands: Children and adults should wash hands at key moments — after nose-wiping, after diapering or toileting, before eating, and before preparing food.
Use instant hand sanitizers: A little dab will kill 99.99% of germs without any water or towels. The products use alcohol to destroy germs. They are an antiseptic, not an antibiotic, so resistance can’t develop.
Disinfect: Clean commonly touched surfaces (sink handles, sleeping mats) with an EPA-approved disinfectant.
Use paper towels instead of shared cloth towels.

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Here are seven ways to support the immune system:

Avoid unnecessary antibiotics:
The more people use antibiotics, the more likely they are to get sick with longer, more stubborn infections caused by more resistant organisms in the future.
Breastfeed: Breast milk is known to protect against respiratory tract infections, even years after breastfeeding is done. Kids who don’t breastfeed average five times more ear infections.
Avoid second-hand smoke: Keep as far away from it as possible! It is responsible for many health problems, including millions of colds.
Get enough sleep: Late bedtimes and poor sleep leave people vulnerable.
Drink water: Your body needs fluids for the immune system to function properly.
Eat yogurt: The beneficial bacteria in some active yogurt cultures help prevent colds.
Take zinc: Children and adults who are zinc-deficient get more infections and stay sick longer.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose

Resources:
http://www.charak.com/DiseasePage.asp?thx=1&id=115
http://www.nlm.nih.gov/medlineplus/ency/article/000678.htm