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Chikungunya Chaos in Karachi: A Public Health Challenge Unfolds

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Karachi, Pakistan’s largest city, is grappling with a rise in cases of chikungunya, a viral disease transmitted by Aedes mosquitoes, which has strained the city’s public health infrastructure. Hospitals in Karachi are facing a substantial surge in patients, many of whom exhibit symptoms like joint pain, fever, and rash—a typical presentation of chikungunya.

Current Outbreak Status

Between May and September 2024, Karachi saw over 140 confirmed chikungunya cases, with 211 suspected cases reported, highlighting a sharp increase compared to previous periods. The situation has escalated to the point where public health experts have issued a national advisory to control the spread of the disease. This surge in cases is not isolated; the city is also seeing a rise in other mosquito-borne illnesses, including dengue and malaria, especially following the rainy season which created optimal mosquito breeding conditions.

Factors Behind the Spread

Environmental and Socioeconomic Challenges

One of the critical factors contributing to this outbreak is the accumulation of stagnant water in various parts of the city, exacerbated by Karachi’s recent rains. Health officials from key hospitals like Jinnah Postgraduate Medical Centre and Dr. Ruth Pfau Civil Hospital Karachi (CHK) noted that stagnant water has led to an increase in mosquito breeding sites, making vector-control measures urgent. However, these measures are hindered by the city’s limited resources and the lack of proactive initiatives, such as regular fumigation and public awareness campaigns.

Furthermore, the cost of diagnostic tests is a significant barrier. In Karachi, PCR tests for chikungunya, which are the most accurate diagnostic measure, cost between PKR 7,000 to 8,000 ($25 to $28), making them unaffordable for many. Dr. Altaf Hussain Khatri, a senior general physician, revealed that the high test costs often lead to reliance on clinical symptoms for diagnosis, leading to potential underreporting of cases.

Health System’s Struggles

Government hospitals like Jinnah Postgraduate Medical Centre have been overwhelmed with cases and lack separate wards for chikungunya patients, forcing hospitals to admit patients in general wards without mosquito nets. This inadequacy risks further spreading the infection within hospital premises. Patients with severe symptoms often require intensive care, which is another strain on already stretched resources. According to the Aga Khan University Hospital, severe cases have exhibited neurological complications and heart problems, requiring intensive medical care.

Public Health Response

To counter the rising outbreak, the government has initiated measures, including a nationwide advisory that emphasizes vector-control strategies like eliminating mosquito breeding sites, conducting fumigation drives, and increasing public awareness. The National Institute of Health (NIH) has underscored the importance of removing standing water, wearing protective clothing, and using mosquito repellents. However, residents have expressed dissatisfaction with the government’s efforts, highlighting the lack of consistent fogging operations in critical areas of Karachi and Lahore.

Comparison with Global Context

The chikungunya outbreak in Karachi is not an isolated phenomenon but part of a larger trend. According to data from the European Centre for Disease Prevention and Control (ECDC), chikungunya cases have been increasing globally, with countries like Brazil and India reporting the highest numbers. As of 2024, around 460,000 cases were recorded worldwide, with significant outbreaks in Brazil and India.

Chikungunya Vaccine and Challenges

Although a chikungunya vaccine (IXCHIQ) has been developed and approved for use in the U.S., Canada, and Europe, Pakistan does not yet have WHO approval to adopt it, complicating efforts to immunize at-risk populations. This leaves Pakistan vulnerable to outbreaks, particularly among groups like the elderly and people with pre-existing conditions such as diabetes and hypertension.

Recommendations for the Future

Health experts urge the authorities to enhance their public health efforts by focusing on long-term solutions like improving urban infrastructure to prevent water stagnation and strengthening the healthcare system. Additionally, increased accessibility to affordable diagnostic tests and broader vaccine approval could significantly reduce the disease burden.

For now, the situation in Karachi remains dire, with health officials warning that the outbreak could extend into winter without adequate preventive measures. The city’s residents are advised to remain vigilant and adhere to safety guidelines to protect themselves and their families from this debilitating virus.

References

  • Devdiscourse. (2024). Karachi Faces Surge in Mosquito-Borne Diseases as Winter Approaches.
  • Times of Karachi. (2024). Surge in Chikungunya Cases Alarms Karachi Health Officials.
  • ECDC. (2024). Global Update on Chikungunya Virus Cases.
M Moiz
M Moiz
M Moiz, is Research Student at Islamabad research Institute and work with THE THINK TANK JOURNAL

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