EIACP Programme Centre on Climate Change & Public Health

The mosquito-borne viral disease Chikungunya, erupted in Kerala towards May-end this year, claiming 40 lives while 7,000 people were admitted in hospitals in the South and Central districts of Kollam, Pathanamthitta, Kottayam and parts of the capital city. Of the 870 confirmed Chikungunya cases reported this year in India, as many as 559 were from Kerala alone. Union Health Minister Anbumani Ramadoss remarked in June that the deaths were not due to Chikungunya. Committees appointed by the Centre had reported that despite rumors about Chikungunya cases, Chikungunya being a self- limiting but not fatal disease did not cause any casuality but precise reasons for these deaths could not be found. The Southern districts of Pathanamthitta, Kollam, Alappuzha and Thiruvananthapuram are in the grip of viral fever with several cases of Chikungunya reported during the last couple of months.

Fig. The map showing location of Kerala in India and Chikungunya affected districts in Kerala

Fig. COMFORTING PATIENTS: Deputy Speaker Jose Baby visits patients suffering from Chikungunya at the Pathanamthitta General Hospital

The present outbreak, which has seen more than 40 people dying in the past two weeks in the south and central districts of Kollam, Pathanamthitta, Kottayam and parts of the capital city has raised questions about how good healthcare system in Kerala really is. According to sources, more than 100,000 people are down with fever in the south and central districts of the state and the disease is now spreading to the northern districts as well. The possibility of an outbreak was pointed out clearly in the past owing to high index of mosquitoes in certain pockets in studies taken up by the Health Department in earlier part of this year. Despite of the weekly vector studies to check the population of mosquitoes and the plea to adopt precautionary measures, Outbreak of this magnitude clearly marks the lacunae in the healthcare system and our preparedness to tackle such conditions. Once considered among the best in Healthcare, Kerala government failed to keep its health system in order. Nothing shows that better than the state of the Kerala Virology Lab meant to be the state's premier scientific center which is a picture of neglect. No serious steps had been taken to improve the conditions of virology lab taking cue from the last year outbreak that resulted in enormous morbidity in the state.

However, health department authorities could not give a clear picture on the number of patients who died of viral fever or Chikungunya in the state so far. Mr. V.S. Achuthanandan ensured to provide financial relief to victims of Chikungunya afflicted persons. The state had allotted about Rs 50 million to battle Chikungunya.



Fig. Fact-finding mission: Chief Minister V.S. Achuthanandan addressing a meeting of officials at the Collectorate Conference Hall in Pathanamthitta

M Radhakarishna Pillai, Director of Rajiv Gandhi Centre for Biotechnology reported a unique mutation in the Chikungunya virus isolated from one case in this district. ''This mutation has not been reported in India before, but was detected during the Chikungunya epidemic that occurred in the Reunion Island,'' he added. As the viral fever was associated with severe joint pain that lasted for a few months, there was an acute shortage of labourers in plantation and agriculture sectors. Production of rubber had come down drastically in these districts due to shortage of labourers for tapping. According to KTDC Chairman Cheriyan Philip, an aftermath effect of this outbreak may result in serious losses to the tourism industry in Kerala if this epidemic is not checked.