WHO mission warns authorities to act timely to thwart threat of Zika virus

Virus mostly affects pregnant women and hampers development of fetus in womb; calls for eradication of mosquitoes to control Chikungunya; several hospitals in Karachi charging around Rs5,000 for fake anti-Chikungunya vaccination

KARACHI: A World Health Organization (WHO) mission visiting Karachi to investigate the Chikungunya outbreak in the city has asked the Sindh health department to involve the Karachi Metropolitan Corporation (KMC), Karachi Water and Sewerage Board and other stakeholders to improve environmental conditions for vector control as the epidemic could only be controlled by eradicating the mosquito responsible for the epidemic.

The WHO mission comprising epidemiologists, entomologists, disease surveillance experts and doctors had been invited by the Sindh health department to visit Karachi and assist the authorities in controlling the Chikungunya epidemic, which has affected thousands of persons in the three districts of Karachi since December 19, 2017.

Disease Surveillance Officials of the WHO from Islamabad and other provinces of the country warned that if environmental and sanitation conditions were not improved, Zika virus could also play havoc in Karachi as its carrier was also the same vector, which causes the dengue fever and Chikungunya disease and asked the authorities to act timely to thwart the threat of Zika virus, which mostly affects pregnant women and hampers the development of fetus in womb.

The team of experts, which visited various areas of the city including Ibrahim Hyderi, Kermari, Lyari, Orangi Town and Korangi, also expressed their dissatisfaction of health department’s ill-preparedness in dealing with the viral disease or any other kind of epidemic and recommended to the health authorities in the province to enhance capacity of healthcare providers including doctors, paramedics, nurses and even administrative officials to deal with the Chikungunya outbreak.

“We have recommended involvement of all the stakeholders including government agencies, private sector, media and people in this campaign to improve the environmental conditions and vector control or the eradication of mosquito responsible for the Chikungunya outbreak in Karachi. Without collaborative efforts, this task cannot be achieved”, a senior member of the WHO mission in Pakistan told The News after a meeting with the Sindh health authorities in Karachi on Thursday.

The official lamented that neither the healthcare providers nor the people had any information about the viral infection and called for capacity building of healthcare providers as well as creating awareness among the masses so that they could take preventive measures to prevent themselves from the infectious diseases.

Deploring that there exists no lab in the public sector which is capable enough to diagnose Chikungunya and other viral infections in Sindh, WHO officials recommended to the health department to immediately establish a Diagnostic Virology Laboratory in the province, which should be designed for Biosafety Level 2 (BSL2).

“Currently, samples of suspected Chikungunya cases are being sent to NIH, Islamabad, which is not recommended and advisable if they are serious to contain an epidemic like this. We have recommended to establish a virology diagnostic lab immediately in the province,” the WHO expert said.

The visiting team of experts also expressed their dissatisfaction over the existing diagnostic facilities and also called for strengthening them immediately as no quality diagnostic service exists in the province at the public sector hospitals.

Director General Health Services Sindh Dr. Muhammad Taufiq said the experts from WHO and Sindh health department discussed the factors behind the Chikungunya outbreak in Karachi and it was recommended that KMC and other civic bodies should be taken onboard to improve the sanitation conditions and eradicate mosquitoes responsible for the spread of Chikungunya and other viral diseases.

The experts also urged the people to take precautionary measures on their own, improve sanitation conditions around their homes and offices and not to let freshwater accumulate inside and around their abodes so that mosquitoes could not breed there and cause viral infections like Chikungunya, he added.

According to him, the WHO experts suggested that Chikungunya virus may have come to Karachi from India as its cases were reported in Karachi in December last year when there was an outbreak of the mosquito-borne disease in India. “It is possible that some infected persons may have traveled to Karachi where we had the conducive environment and presence of mosquitoes in abundance,” he added.

Despite absence of any vaccine to prevent people against Chikungunya infection, some public and private hospitals in the city are injecting some kind of serum to the bodies of patients, claiming it to be ‘anti-Chikungunya vaccine’ although no such vaccine has been developed yet in the world.

Several patients and their attendants said many hospitals in Karachi were charging around Rs5,000 for anti-Chikungunya vaccination and even patients who had been diagnosed for having the viral infection, were being injected some drug portrayed as ‘cure’ for Chikungunya viral infection.

Pakistan Medical Association (PMA) also expressed serious concern about the spread of Chikungunya in Karachi, and deceiving ordinary people at some public and private hospitals by injecting an unknown type of serum as vaccination to protect against Chikungunya at exorbitant prices.

PMA Karachi General Secretary Dr. Ahmed Bhimani said no specific treatment is available against the viral disease and there is no vaccine to prevent Chikungunya. Vector (mosquito) control is the only public health strategy to prevent and control the outbreaks.

Environmental factors and community behaviors plays a significant role in the Chikungunya outbreak and spread, he said adding that socioeconomic burden of the disease can be devastating in the outbreak areas due to very high attach rate affecting a large proportion of the population.

“PMA Karachi demands KMC and Sindh health department to take immediate measures for control and eradication of this disease because the population mostly affected by this disease is from the slums areas of this city, especially in Malir, Orangi, Keamari and Korangi, and they are already facing huge problems of scarcity of resources,” he added.