Chikungunya - Indonesia (Java)

[Reasonable Rascal]

CHIKUNGUNYA - INDONESIA (JAVA) (02)
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A ProMED-mail post

Date: Sat 22 Feb 2003
From: Pablo Nart
Source The Jakarta Post, Jakarta/Cirebon, Sat 22 Feb
2003 [edited]

http://www.thejakartapost.com/detailnational.asp?fileid=20030222.D11&irec=10>


Indonesia: Chikungunya Outbreak Spreading in West and Central Java
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Health officials have warned that further outbreaks of chikungunya were possible anywhere in Indonesia, with the mosquito-borne disease already having infected hundreds of people in several towns in West and Central Java. Thomas Suroso, the director of the Arbovirus Diseases Eradication Unit at the Ministry of Health, told The Jakarta Post on Thu 20 Feb 2003 that unlike the generation of 20 years ago, which was immunized against chikungunya, the current generation was highly susceptible to the disease, as it had not been immunized [by prior exposure to the virus - Mod.CP].

He said chikungunya disease, carried by the mosquito _Aedes albopictus_ , was relatively easy to eradicate using common pesticides. Like the _Aedes aegypti_ mosquito, which carries dengue fever, _Aedes albopictus_ is usually active during the day, Thomas said. He explained that _Aedes albopictus_ tends to breed both in suburban and rural areas, whereas _Aedes aegypti_ is mostly found in densely populated urban areas.

The disease has infected more than 500 people in certain parts of Yogyakarta province and 250 others in the West Java capital of Bandung since last December [2002], local officials said. It spread last week to Cirebon, West Java, where more than 70 people have been affected since mid-January [2003].

However, a local senior health official, Sri Budiartiningsih, said on Thursday that her agency had recorded at least 94 cases of chikungunya disease in Cirebon, adding that the disease was first detected in Bojor Lor village in Klangenan subdistrict and spread to the adjacent villages of Bojong Wetan and Kreyo. Last year, the disease also hit the West Javan town of Bekasi and the Central Javan towns of Purworejo and Klaten.

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ProMED-mail
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[Chikungunya may have spread also to Palangka Raya, Central Kalimantan, but local health officials have been unable to confirm the presence of the virus, despite the fact that some people there were suffering from continuous fevers and severe muscle and joint pains. - Mod.CP]

[Reasonable Rascal]

CHIKUNGUNYA - INDONESIA (03)
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A ProMED-mail post

Date: Wed 26 Feb 2003
From: ProMED-mail <promed@promedmail.org>
Source: The Jakarta Post online, Wed 26 Feb 2003 [edited]
<http://www.thejakartapost.com/detailnational.asp?fileid=20030226.D09&irec=8>


Indonesia: Chikungunya Spreads to West Timor and Central Sulawesi
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The disease chikungunya, which first emerged in Bandung, West Java, in December 2003, has spread to East Nusa Tenggara (West Timor) and Central Sulawesi. Hundreds of people in Kupang, the capital of East Nusa Tenggara, have been treated at hospitals and public health centers after contracting the disease, whose symptoms are similar to dengue fever[caused by a flavivirus], which is transmitted by the mosquito _Aedes aegypti_.

Chikungunya [caused by an alphavirus], which is transmitted by the mosquito _Aedes albopictus_, has been spreading across the country during this rainy season, particularly in regions with high rainfall levels.

Frank Touw, head of the intensive care unit at the Kupang General Hospital, said on Monday that chikungunya had spread to urban and rural areas in Kupang regency since last week. "Though the disease is not fatal, those affected will be physically weak for a fairly long time and it takes 3 to 5 days to recover," he said. Based on The Jakarta Post's monitoring of 5 hospitals and a number of health centers in Kupang, 50 to 100 chikungunya patients have been admitted daily over the past few weeks.

Experts at Cipto Mangunkusumo General Hospital in Jakarta are investigating the outbreak. The disease affected more than 100 people in Yogyakarta, but its spread was stopped after the local administration launched an integrated health program, including medical care for sufferers.

In Palu, Central Sulawesi, seven inmates of the city's Maesa Penitentiary were found to have symptoms of chikungunya when they underwent medical check-ups at a public health center recently. The head of the Singgani public health center, Ema Sukmawati, said on Tuesday that the inmates first showed symptoms of flu, including high fever, and then they experienced body pains, focused in their legs. Her health center has established a team to monitor the prison and to [confirm the diagnosis of] chikungunya.

Meanwhile, at least 62 people in 2 districts of Majalengka regency, West Java, are suffering from chikungunya. In Jatiwangi district, 43 people are being treated for the disease and 19 others are being treated in Sumberjaya. Most of the patients are in the recuperation phase of the disease, according to the Majalengka health office. Asep Suandi, head of the health office, told the Post in Majalengka on Tuesday that the actual number of cases might be higher because many people in the regency's other districts had not reported to the health office after contracting the illness. Earlier, chikungunya hit 3 villages in Klangenan district, Cirebon regency, with no less than 94 people being admitted to health clinics in the past one and a half months. Jarmadi Kusmayadi, head of the Cirebon health office's disease monitoring section, said neither the provincial nor the central governments had taken action to stop the spread of the disease
in the region.

[Byline: Nana Rukmana and Yemris Fointuna]

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[This report indicates that chikungunya, since its appearance in West Java in December 2002, is rapidly spreading eastwards throughout the Indonesian archipelago. Chikungunya is considered to be a relatively recent introduction into Southeast Asia, and an increasing public health problem.

ProMED-mail is indebted to a correspondent, Richard W. Wilsnack, Ph.D. <wilsnac@medicine.nodak.edu>, for compiling a list of recent publications describing progress in the rapid diagnosis and characterization of the disease. Those interested should communicate directly with Dr. Wilsnack.

Perhaps of most general interest are the results of a successful phase II and immunogenicity trial of a live attenuated vaccine (Edelman R et al., "Phase II safety and immunogenicity study of live chikungunya virus vaccine TSI-GSD-218," American Journal of Tropical Medicine and Hygiene 62: 6, June 2000, 681-685), and completion of the sequencing of the genome of an African isolate of Chikungunya virus (Khan AK et al., "Complete nucleotide sequence of chikungunya virus and evidence for an internal polyadenylation
site," Journal of General Virology, 83: Pt 12, December 2002, pp. 3075-3084). The later paper confirms that Chikungunya virus and O'nyong-nyong virus, another member of the genus _Alphavirus_ of similar
disease-producing potential but as yet still restricted to the African continent, are related but clearly distinct viruses (and ranked accordingly as distinct virus species by the ICTV). - Mod.CP]