By Life Positive November 2006 Jamuna Rangachari and Mansi AgarwalCombat chikungunya through prevention and the use of alternatives. Symptomso Fevero Rasheso Joint painso Headacheo Photophobia – avoidance of lighto Insomniao Conjunctival infectionCareo Consult doctor immediatelyo Take bed rest in a well-ventilated, cool room until the fever subsideso Stay indoors for a while, even after fever subsides, preferably under mosquito neto Take sponge bath with lukewarm water, and use Epsom salt and neem leaveso Consume extra fluids such as water, juices, vegetable soups to avoid dehydrationo Have a light diet without oilo Use extra cover with warm blankets when there is shiveringo There could be bleeding tendencies – consult doctor on how this is to be handled.o Treat joint pain with alternative therapies (ayurveda and others) after consulting doctoro Apply poultice of clove oil and/or garlic and peppero Apply acupressure on pressure points When Mr S Raman, a Chennai-based businessman, developed joint pain, he thought it was just a passing malaise, the effect of excessive strain. Then he developed fever. Even this he took lightly. When it persisted, however, he consulted his doctor who diagnosed chikungunya, and he was put on immediate medication. He soon consulted an ayurvedic doctor also and began taking some therapeutic treatments. Though much better now, he still has joint pain, which he has resolved to deal with by using alternative therapies. Sharing his experience, he says, ‘With the epidemic becoming rampant, it is imperative that we take note of the symptoms and go to the doctor without delay, when there is the slightest of suspicion.’ A relatively rare form of viral fever, chikungunya is caused by an alphavirus that is spread by mosquito bites from the aedes aegypti mosquito, though recent research by the Pasteur Institute in Paris claims the virus is also transmitted by aedes albopictus (tiger mosquito). The disease itself is believed to have originated in Africa, as indicated by its name; ‘chikungunya’ is derived from the Makonde root verb kungunyala, meaning to dry up or become contorted, or more specifically, as ‘that which bends up.’ Prevention FirstMost of us know that mosquitoes breed in stagnant water and are the carriers of many diseases, but we don’t realize that even seemingly harmless places where stagnant water is present, such as a flower vase, can be a breeding ground. Water coolers, overhead tanks, vases, pet dishes, bird baths and yes, even flower vases, are to be kept dry, if possible, or the water changed frequently without fail. Other than this, one must avoid mosquitoes by wearing clothes that protect the body and limbs such as long-sleeved salwar kameezes or long-sleeved shirts and trousers (yes, though it is still hot in some parts of India). Other measures include applying insect repellents and protecting one’s home with sunscreens and mosquito nets. It really is a battle of wits between you and the mosquito. While we may take maximum care and minimize all the stagnant water in our control, it is a fact that we are still susceptible to the virus as everything is not in our control. Dr Ashwini Chopra, Director, Aashlok Hospital, stresses that a doctor must be consulted as soon as there is a suspicion of its outbreak, as timely attention can make a world of difference. Chikungunya is a disease whose effects persist for a long time. In fact, this is one of the main differences between chikungunya and dengue, which also spreads through the same mosquito. As Dr Chopra says, ‘Even after the fever has subsided, problems such as joint pains could persist for several months.’ It is here that alternative therapies can help a great deal. Ayurveda‘The very basis of aurveda is the strong link we have with nature and the environment comprising of bhoomi (earth), jal (water) and vayu (air),’ says Dr. Ramesh, the CMO and superintendent of Arya Vaidya Sala Kottakkal, which has a branch in Delhi. Today’s lifestyle and conditioning is such that we are losing touch with this link, which results in a slow weakening of the immune system. This, combined with the irreverence we now have for the environment, makes epidemics such as chikungunya much more potent and rampant. Ayurveda can help as a complementary therapy after the epidemic has been brought under control, by medicines and external applications that strengthen the immune system and relieve joint pain. Some remedies that can help are amruta, ashwagandha, pittali, guduchi and amlakka. However, as each case is different, ‘one must do this in consultation with a doctor and avoid self-medication,’ cautions Dr Ramesh. HomeopathyIn chikungunya, the patients typically have high-grade fever and rashes. Further, the already low platelet count falls rapidly and causes bleeding. ‘These do have a remedy in homeopathy,’ says Dr Rachna K Singh, Homeopathic Consultant & Lifestyle Management Expert, Escorts Heart Institute & Research Center, Delhi, who has been treating the disease. She affirms that homeopathic remedies such as eupatorum perf, rhus tox, pyrogenum, bryonia, gelsemium and echinaciea are effective in treating the disease. NaturopathyMs Mallika Bhanot, yoga practitioner and therapist and doctor in alternative medicine in Mrityunjaya, Delhi, is clear that the initial virus must be brought under control before alternative systems are used. The remedies that can help in coping are chewing of ashwagandha, providing relief from joint pain through local application of a poultice of clove oil or garlic paste and pepper on the painful joints. Additionally, the use of epsom salt (magnesium sulphate) in slightly warm bathing water coupled with neem leaves helps both in the cure of the joint pain and also provides relief from fever. Acupressure‘Giving pressure sideways on all the fingers is a great help in relieving joint pain,’ says Ketan Shah, practitioner and trainer in acupressure, who has helped many people cope with the aftereffects. The disease affects the joints on the arms and legs, namely, elbow, wrist, knee and ankle. The middle two fingers relieve pain in the leg joints and the outer two fingers relieve pain in the arm joints. The liver and stomach also get impaired by this disease. Giving pressure on the respective pressure points, for these organs, half-inch below the little finger on the palm for the liver and the triangle formed below the palm for the stomach, is also helpful. Acupuncture‘Acupuncture is very beneficial during the first stages as it helps in expelling pathogenic factors which have invaded the body through mosquito bite,’ says Dr Sunita Kapur, an acupuncture consultant at the Gangaram Hospital. She further elaborates, ‘Acupuncture works by improving the defensive Qi and by expelling fire, which is the main cause of fever and rashes.’ She stresses upon the fact that residual heat or damp heat is the main cause of development of post-viral fatigue syndromes. Again, acupuncture works in the treatment of this post-viral fatigue syndrome by improving the defensive Qi. Dr Kapur suggests that a combination of acupuncture and moxibustion at specific points on the body surface reduces the recovery period to a great extent and the treatment should be regularly given on alternate days till the symptoms subside. Yoga and PranayamaA person recovering from chikungunya should not practice yoga postures; it is a good idea to begin with simple breathing exercises such as sama vritti, or equal breathing. This means inhaling and exhaling for an equal length. Find a comfortable seated position. Sit on a pillow or blanket, to make sure that your hips are higher than your knees. This will reduce strain on your lower back and support free movement of the breath. Exhale completely. Inhale through the nose for five counts and exhale through the nose for five counts. Continue this breathing pattern for as long as you like. Feel free to change the length of the breath to a shorter or longer count. ConclusionYes, chikungunya is a very real threat that can strike anyone, anywhere today. With a proper knowledge of its symptoms and its after-effects, however, we should be able to overcome it, and march back soon to good health.
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