Best practices for protecting children from chikungunya

Overview 

We all know, as a matter of fact, that children have a fondness for outdoor activities and frequently explore open spaces that may be infested with mosquitoes; this is primarily the reason why they are easily affected by chikungunya. As they typically wear shorts, dresses, and short-sleeved shirts, their limbs are left exposed, making them an easy target for mosquito bites. Consequently, they become more susceptible to contracting chikungunya. Given this circumstance, medical practitioners and healthcare experts nationwide caution parents to take measures to safeguard their young ones from acquiring this debilitating disease. 

Chikungunya 

Chikungunya, or CHIKV, is transmitted to humans through mosquito bites. Specifically, it is spread by the Aedes aegypti and Aedes albopictus mosquitoes. Infection occurs when a mosquito carrying the virus bites a person. It is important to note that the virus does not spread from person to person through bodily contact or saliva, although there is a possibility of transmission through blood. 

The symptoms of chikungunya include fever and severe joint pain, which is why the illness is named “bent over” in some languages. Unfortunately, no medication or vaccine is available to treat or prevent chikungunya. The focus of treatment is on managing the symptoms. While most individuals recover within a week, some may experience lingering joint pain.

The best way to prevent chikungunya is to avoid mosquito bites. This can be done by wearing pants and long sleeves and applying insect repellent. Individuals travelling to areas with active chikungunya transmission should be particularly cautious in avoiding mosquito bites. It is essential to prevent additional mosquito bites for approximately one week after contracting the virus, as an uninfected mosquito could bite and become infected, leading to the further spread of the virus. 

Causes of chikungunya in children 

Transmission of the virus occurs when an infected mosquito bites an individual. It is important to note that the virus does not spread from person to person through bodily fluids or contact. 

Therefore, if someone is infected with chikungunya, they will not transmit it to their caregiver or family member. However, there have been rare cases where healthcare providers have contracted the virus while handling an infected person’s blood. Although transmission through blood is possible, it is not shared. 

Symptoms of chikungunya in children 

Symptoms of the disease may appear between 2 to 12 days after infection. The clinical signs can vary from no symptoms to a severe form. Children may have different presentations of symptoms, while adults tend to have more consistent symptoms. Children with chikungunya may experience a combination of symptoms. The most common ones include: 

• Children may experience gastrointestinal issues such as stomach pain, vomiting, and diarrhoea. 
• They can develop a high fever of over 104o F. 
• Once the fever disappears, they may develop an itchy rash on their hands and legs.  
• Joint pain or arthralgia can also occur in some children. 
• Burst blood vessels can cause purpura or red patches on the skin. 
• Bleeding from the nose and gums may be observed. 
• Children may experience headaches. 
• Children experience a shorter recovery period due to their developing joints, resulting in less prolonged arthritic pain. The virus primarily affects larger joints, such as the hip and knee, in children, making the pain more bearable. Conversely, adults are prone to the attack of smaller, more painful joints like the wrists. 
• For infants, IgG antibodies in the mother’s placenta protect against life-threatening diseases during the initial six months after birth. However, this protection gradually diminishes after that. 

Diagnostics of chikungunya 

During the initial week of illness, blood samples can be used to directly detect the presence of the Chikungunya virus through tests like reverse transcriptase-polymerase chain reaction (RT-PCR). 

After the first week of infection, alternative tests can be employed to determine a person’s immune response to the Chikungunya virus. These tests are designed to detect antibodies against the virus. 

Typically, antibody levels become detectable within the first week of illness and can continue to be detected for approximately 2 months. 

What are the treatment options for chikungunya in children? 

Chikungunya does not have a specific treatment. However, doctors focus on managing the symptoms in children. This includes using fever medications, ensuring proper hydration, and relieving pain. Children must rest entirely during the febrile period when they have a fever. 

It is essential to avoid giving children NSAIDs or Aspirin as they can thin the blood and increase the risk of bleeding due to platelet loss. 

Parents should remember that the primary treatment for high-grade fever is always paracetamol.

Since chikungunya shares similarities with dengue, hydration is essential in both cases. If a child experiences convulsions, febrile seizures, bleeding, difficulty in consuming liquids, or if the fever persists despite medication, it is advisable to take the child to a medical centre and consult a doctor. 

Scientists have developed a new vaccine for chikungunya, but its effectiveness is questionable as it worsens joint pain in patients. 

Prevention and control of chikungunya 

The most effective way to prevent infection is by avoiding mosquito bites. Individuals suspected of having CHIKV infection should take precautions to prevent further transmission to mosquitoes, which can then infect others.  

Controlling the mosquito vectors is the primary method to reduce the spread of CHIKV. This requires the active involvement of communities in eliminating mosquito breeding sites by regularly emptying and cleaning containers that hold water, properly disposing of waste, and supporting local mosquito control programs. 

During outbreaks, insecticides may be used to kill adult mosquitoes in flight, applied to surfaces where mosquitoes land, and used to treat water in containers to eliminate immature larvae. Health authorities may also implement emergency measures to control the mosquito population. 

It is recommended to wear clothing that minimises skin exposure to mosquitoes that bite during the day to protect against chikungunya during outbreaks. Window and door screens should be used to prevent mosquitoes from entering homes.

Repellents containing DEET, IR3535, or icaridin can be applied to exposed skin or clothing, following the instructions on the product label. Insecticide-treated mosquito nets should be used by individuals who sleep during the daytime, such as young children, sick patients, or older people. 

Individuals travelling to areas with active CHIKV transmission should take basic precautions, including using insect repellents, wearing long sleeves and pants, and ensuring that rooms are equipped with screens to prevent mosquitoes from entering. 

Six best practices for protecting children from chikungunya 

It is essential to educate children about the significance of preventing mosquito bites. Motivating them to remain indoors when mosquitoes are most active, typically at dawn and dusk, is advisable. Emphasise the importance of using mosquito repellents, wearing protective clothing, and avoiding areas with a high concentration of mosquitoes, such as stagnant water bodies. 

Implementing these preventive measures can effectively minimise the risk of chikungunya transmission to children. It is important to remember that community-wide mosquito control and education efforts are essential in creating a safe environment for the health of our children. Let us remain vigilant and prioritise their protection against mosquito bites. 

Mosquito coils and vaporisers 

Ensure that you utilise mosquito coils or vaporisers in the morning as well. Our practice involves keeping the vaporiser running overnight and turning it off in the mornings. This serves as a way to extend a warm welcome to the Aedes aegypti mosquito. Therefore, it is essential to remember to keep the mosquito coil or vaporiser on in the mornings, too, ensuring the protection of you and your loved ones. 

Clean your surroundings 

Maintaining cleanliness in and around your house is essential to create an unfavourable environment for mosquitoes. Here are some key points to remember: 

1. Ensure that you remove any objects that can collect water. Stagnant water serves as a breeding ground for these pesky insects. Dispose of empty containers and tires, and store necessary containers properly. 
2. Avoid overwatering your plants if you have a garden, as excess water can accumulate and stagnate. 
3. Add kerosene to open drains to deprive the mosquito larvae of oxygen. 
4. If you have a pond nearby, consider introducing fish species that feed on mosquito larvae. 
5. Remember, clean or dirty, water can become a breeding ground for mosquitoes.

Mosquito repellent 

Ensure that you apply personal mosquito repellent every time you venture outside. Are you using mosquito repellent for your child when they go outdoors? You may remember to do so when they go out to play, but what about when they go to school? Many of us need to remember. Make sure to apply a personal mosquito repellent to your children before sending them to school to protect them from the Aedes mosquito, which is active during the daytime. It is important to use mosquito repellents that contain DEET, picaridin, or IR3535 and follow the instructions for age-appropriate use. Choose formulations that are child-friendly and reapply as directed. Remember not to apply repellent to infants under two months old and consult a healthcare professional for guidance. 

Mosquito-proof your home 

Ensure your home is protected from mosquitoes by installing meshes or screens on your windows and doors. This will keep the pesky insects out and allow fresh air and natural light to enter. Be sure to inspect the meshes and screens regularly to ensure there are no tears or holes. 

Additionally, take precautions to protect your child from mosquito bites by ensuring they sleep securely under a mosquito net. For added convenience, you can also use anti-mosquito patches on baby cots, eliminating the need to set up mosquito nets. 

Protective clothing 

Ensure your child is dressed in long-sleeved t-shirts and tops, and choose leggings or trousers instead of shorts. Aedes aegypti mosquitoes tend to target the ankles, so it is essential to keep them covered. Avoid bright prints and colours, as mosquitoes are attracted to them. Opt for light-coloured clothing, as it may help deter mosquitoes. Additionally, consider clothing that is treated with insect repellent for added protection. 

Eliminate potential breeding grounds 

It is crucial to eliminate potential breeding grounds for mosquitoes indoors. While we often associate mosquito breeding with stagnant water, it is essential to note that even a tiny amount of water, regardless of its cleanliness, can serve as a breeding site for mosquitoes. 

To prevent the accumulation of water inside your house, take the following measures: 

1. Avoid overwatering indoor plants to prevent water from collecting in the plates under the pots. 
2. Regularly clean the water trays of coolers and air conditioners. 
3. Ensure that water cans are adequately covered. 
4. Fix any leaky pipes and faucets to prevent water from pooling. 
5. Additionally, if you have pets at home, maintain cleanliness by regularly cleaning their feeding bowls and removing leftover food. Keep their sleeping area clean as well. 

Summary 

Parents are willing to go above and beyond to safeguard their children from illnesses. These suggestions will assist you in your efforts to do the same. Sometimes, a single mosquito alone can exacerbate the situation for the entire family. Hence, ensure your safety and protection by adhering to these recommendations. 

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