ISLAMABAD - National Institute of Health (NIH) on Tuesday issued fresh health advisories after continuous increase in the number of reported cases of infectious diseases in the country.

The advisory has been issued for the diseases of Chikungunya, dengue fever, chickenpox and measles. Field Epidemiology and Disease Surveillance Division of the NIH has developed and disseminated following advisories to upscale preparedness and preventive measures to minimise the spread of diseases.

As per new direction, it has been advised to authorities in provinces to be vigilant in collecting maximum information about the suspected cases of Chikungunya, confirming the disease.


, advising preventive measures and take certain steps to decrease further transmission.

Chikungunya is a mosquito-borne viral disease, which occurs in tropical countries and has been reported from Africa and Asia. Chikungunya fever is caused by Chikungunya Virus (CHKV), which is transmitted through the bite of an infected Aedes mosquito.

Due to some common clinical signs it can be misdiagnosed with dengue where dengue is common. However, the CHKV infections are rarely fatal without significant hemorrhagic manifestations. The proximity of mosquito breeding sites to human habitation is a significant risk factor. The viruses can circulate in the same area and cause occasional co-infections in the same patient.

Dengue is transmitted by mosquitoes of the genus Aedes (Aedes aegypti & Aedes albopictus), which are widely distributed in subtropical and tropical areas of the world.

There is no specific treatment for both diseases (Chikungunya, dengue fever) and mainly relies on the management of symptoms.

Older adults, young children (especially under 1 year), pregnant women and people with pre-existing chronic diseases (diabetes, hypertension) are at high risk of dengue fever.

However, it is important for the attending physicians to exclude other treatable diagnoses.

The measures recommended by the NIH advisories included inspection and cleaning the interior and exterior of the home and its surrounding areas every week, draining tanks, barrels, drums and buckets, animal water troughs, water storage vessels, plastic food containers, used coconut shells and air coolers before refilling.

Air coolers must be emptied when not in use and water should be changed in flower vases besides scrubbing the insides of vases to remove mosquito eggs.

During March and April 2017 sporadic clusters of Chickenpox (varicella) have been reported from Faisalabad, Punjab.

This ‘Advisory’ is therefore intended to alert the health professionals to timely diagnose the Chickenpox disease, manage the cases and undertake standard prevention and control measures including awareness/ education and vaccination to minimize its incidence in upcoming summer season.

Primary infection leads to acute varicella or ‘chickenpox’, usually from exposure either through direct contact with a skin lesion or through airborne spread from respiratory droplets.

After initial infection, VZV establishes lifelong latency in cranial nerve and dorsal root ganglia, and can reactivate years to decades later as herpes zoster (HZ) or ‘shingles’.

During March and April 2017, measles outbreaks have been reported from few districts of Sindh, Balochistan, Khyber Pakhtunkhwa and Islamabad capital territory.

There is no specific treatment for measles and most people recover within 2–3 weeks.  However, complicated cases may be referred to tertiary care settings for further management.

Moreover, all children under 6 months-5 years of age should also receive prophylactic Vitamin A in two doses given 24 hours apart.

Through above all these advisories, NIH calls upon hospital managements to build their capacity for management of patients to keep rapid response arrangements in place, and to maintain regular liaison with relevant departments.