SUNDAY 1ST FEBRUARY, 2015 – UWI TODAY
13
DavidBratt iswell known
, not just as a paediatrician, but
as a columnist and author. It was one of his columnswhich
mademe realize that the effects of the Chikungunya virus
might be much more prolonged than I had thought, and
that there was even the possibility that it might lead to
chronic conditions, especially of an arthritic nature.
He had begun keeping notes on his experiences with
ChikV, and I asked him if he would share it. Three months
into it, he had this to say.
“Like many others, I am still suffering with musculo-
skeletal pains and a rash. Every morning I get up stiffish
and achy. I limp around for the first five to ten minutes
(it depends) because of pain in my right heel. Some
weeks ago it was my left heel. After about half an hour,
the stiffness goes but the heel pain persists throughout
the day, without the limp. Getting up from the desk after
sitting for more than 15 to 20minutes is still an occasional
problem because of tightness in the lower back, which
eases with stretching or movement. No other joints
involved. The flat copper-coloured spots onmy arms have
not gone away but there is no itching,” he reports.
It is amarked improvement fromwhat he had first written
of his ChikV experience in his weekly column, when he
had noted that he got upmany times in the night and felt
suddenwaves of exhaustion during the course of the day,
making him feel that all he wanted to do was lie down.
Now, his note ends,“Energy level is good. No need to rest
in the afternoon.”
Dr Bratt seems to be past the worst of it.
I can identify with almost everything he describes, except
for the rash which I have not had, though I still have fairly
regular bouts of a kind of prickly itchiness in my palms
and soles, particularly at nights.
I have had “unconfirmed” Chikungunya (that is, two
negative blood tests, though there has been a clinical
diagnosis), since the middle of October 2014, and
although the joint pains have subsided considerably in
terms of severity, they persist, and the exhaustion sets
in suddenly and overwhelmingly often. That might be
exacerbated by the fact that I entered 2015 with dengue
(for the third time), and I might be extra tired because of
the double whammy.
I’ve had swollen fingers, which are still pudgy, painful and
given to regularly feeling as if the circulation has gone
awry. I’ve had swollen feet and ankles; dreadful pains in
my shoulders, elbows and knees, and I’ve had a generally
arthritic kind of buzz going on all the time.
Several people have told me they’ve shared these
experiences. The most similarities come from those of
about 45 years and over who are really having a hard time
with the joint pains.
It seems that the ChikV is not quite so malingering or
severe in younger people, and they are coming out of
it relatively unscathed, with very mild after effects. One
young man in his mid-twenties said that it was in and
out of him within days, but now, months later, he finds
himself experiencing pains in his knees and elbows when
temperatures fall.
Dr Bratt said he had not seen ChikV in anyone under age
six, “perhaps three from six to twelve and about 30 to 40
from12 to 18.”He noted that,“All, except one 14-year-old
boy, recovered in a fortnight, he says he occasionally gets
a pain in one knee.”
And that seems tobe the common youth story: occasional
twinges in the joints, intermittent bouts of itchiness, a
little numbness in the digits here and there.
But for older folk, it has been far more invasive. Many of
thepeople I knowover 60, have found the joint pains tobe
so debilitating that they have been driven by frustration
and depression to seek corticosteroid injections on the
sites. (These are not cheap; around $200 a pop.)
I’ve spoken with maybe 30 to 40 people of various ages
who have been carrying these symptoms, and their
complaints are very similar, but the intensity and duration
vary quite arbitrarily.
where the long term effect of Chikunguyna is going to
make itself felt, particularly in the workplaces. I asked a
psychiatrist if there had been any cases being presented
of Chikungunya-related depression at Mt Hope Hospital,
and he said there were none as far as he was aware, but
he agreed that the prolonged and incapacitating features
of ChikV would cause people to get depressed.
Dr James Hospedales, ExecutiveDirector of the Caribbean
Public HealthAgency, toldme that theNational Insurance
system in Jamaica has beenunder pressure because of the
extra demands caused by ChikV. The head of the Private
Sector Organisation of Jamaica had reported that a survey
of their members (81 companies) showed they were
feeling the impact of employees taking up to four days off
work weekly due to the virus. Its CEO, Dennis Chung, said
in October 2014 that feedback from members indicated
that some places reported 60% of staff affected.
Jamaicans have been very vocal about the impact of
ChikV on their lives. And true to the Caribbean penchant
for finding humour in even the direst of times, there have
been several comedic skits and songs conceding the
might of ChikV and its mosquito agent.
“You could have a dozenM-16 / Mi only fraida chikungunya
/ Mi no care you a which bad man / Neither which garrison
you come from/ You coulda spar wid amillion don / Mi only
fraida chicken gunman!”
is one gem from Beenie Man
and the Astronauts, and there are at least half a dozen
on the subject.
It is the raw Jamaican copingmechanismat work and the
volume alone tells you howdeeply ChikV has etched itself
into public consciousness. Michael Abrahams’ version of
Every Breath I Take (Since Me Get ChikV
) is a funny but apt
description of ChikV sufferation.
I have not yet heard any calypsos on the subject, but I am
sure ChikV is going to be a significant factor in Trinidad
and Tobago’s Carnival 2015. It only stands to reason.
If, as Dr Hospedales warns, the region has been virgin
territory for the virus with no immunity – despite
unconfirmed figures, there is a 30% attack rate – it
suggests that a large number of potential masqueraders
and feters might have been hijacked by ChikV pains.
Principal Medical Officer, Dr Clive Tilluckdharry, did not
think it was going to create a significant absence in
the festivities, reminding me that a large proportion of
participants are visitors. But the tourismfigures are bound
to be affected because there are many advisories posted
for visitors to the Caribbean urging protective measures
against mosquitoes (and other villains).
With all the concern about whether Carnival should
have been allowed in the context of Ebola, it would be
something, wouldn’t it, if the showwas allowed to go on,
but everyone is too brukk up to play a mas?
The Sufferers
I can feel it in my bones
By Vaneisa Baksh
According toDr Bratt,“In themost recent follow-up study,
published in 2013, from the La Reunion outbreak of
2005-2006, three quarters of a group of 346 adults (over
age 15) with clinical and laboratory confirmed ChikV,
still had musculo-skeletal symptoms two years after the
attack! 43% had a continuous type of pain. 32% had an
intermittent type of pain.”
The truth is, by the time you’ve spent months trying to
copewith that persistent pain, thememory of the first few
days of the excruciating “brukk up” feeling pales pretty
much in the way labour pains do.
But you have to continue with the daily grind – go to
work, function as best as you can – because precious few
of us have the luxury of caregivers or people who can
relieve the routine demands on our minds and bodies
for prolonged periods.
And this is where I think Chikungunya is going to make
its biggest impact.
Persistent painwith no clear trajectory that says well, okay
for two or three days now, there has been some relief so
I must be healing – persistent pain like that is bound to
bring your spirits down. You have good days that make
you optimistic and then wham, the pain and exhaustion
hit again and you feel there’s been no progress. This is
The
Chikungunya
Effect
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TODAY
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