Last weeks were quite turbulent. After a great start of the Viruskenner project 2015 in the Erasmus Medical Center, I first flew to Surabaya, in Indonesië, to start the project over there as well. Back from Surabaya I flew almost directly to beautiful Suriname for the last participating country in Viruskenner 2015. The adventures we went through and people we met, made me having so many ideas for writing a blog. To be honest, the subject of my blog has changed three times. That is the reason that I challenged the editor of the website by missing the deadline every time. After a long doubt, I chose to write about the current chikungunya epidemic and the background of this virus. The fight against this virus and the impact of the infection on Suriname and Indonesia have impressed me. But let we go first back in history…

Chikungunya (from now on shortened as CHIKV) is a virus that is known for decennia. The virus was first wrote about in Africa. In Swahili (the language of Tanzania) it means ‘the bowed man’. This is because the main symptoms of CHIKV are joint and body pains. These pains can be so heavy that people will stoop or can’t even get up from their bed.

Like dengue and yellow fever, CHIKV is transmitted by mosquitos, to be more exact, the tiger mosquito. This is a black-white striped mosquito (zebra mosquito might have been a better name…), that is known from spreaded a lot of (miserable) viruses. CHIKV is spread by a tiger mosquito that bites an infected person, or at least someone who has the virus in his blood, and then bites a healthy person.

Until the end of 2013 it was known that CHIKV caused outbreaks and problems in areas in Africa and South-East Asia. But the end of that year CHIKV was introduced in Mid-America (the Caribean). Probably this was caused by someone with the virus in his blood, travelling from Asia to this continent. Presumably, that person was bitten by a mosquito and so the outbreak started.

Fortunately, the amount of people that dies from a CHIKV infection is not that big. In general the people get better by time. However, the extreme pains can, in some cases, last until 12 months after infection. Of course this can have big consequences for the local economy. During the kick-off in Suriname, I asked the children in the class who have had CHIKV in the last year. Almost 75 percent raised their hand! This shows how easy and fast a virus can spread in a population when the circumstances are good.

Suriname put a lot of effort in ways to eradicate the CHIKV outbreak by education, mosquito control and early testing. This last part is very interesting because it shows how viruses spread. How can you stop the outbreak? Actually it is quite simple. You have to make sure the infected persons won’t get bitten by mosquitos so they can not spread the virus and the amount of new infected people will go down. Many interesting ways to do this are thought about already. For example, placing everyone who is infected under a mosquito net or give them a substance in their blood which is toxic for the mosquitos when they bite them. Thereby the virus can not spread anymore and the outbreak will come to an end finally.

Chikungunya poster in Suriname

The education in Suriname is organized very well and professional. I think it had a high Viruskenner value. Until far in the jungle posters and flyers were spread with explantions about the spread of CHIKV and how you can prevent having mosquitos around your living place and prevent getting bitten at all. The posters were very clear and attractive to read, which is not per definition in all education campaigns worldwide. (In the image above an example of one of the posters.)  You were attracted by bright colours, funny cartoons and clear texts.

Some infections are difficult to prevent and unfortunately Suriname did not succeed to prevent letting CHIKV come to their country after hearing from outbreaks in surrounding countries.  However, how they react on the outbreak and the knowledge about CHIKV of the people now can be complimented!