IJCM_292A: Chikungunya Outbreak Investigation at Village Bolasa, Petlawat, Jhabua, Madhya Pradesh, India, September 2023

Abstract

Background: Chikungunya, a resurging vector-borne disease caused by chikungunya virus, remains a global health challenge. In 2023, globally 4.4 lakhs suspected cases and 365 fatalities were estimated; India accounting for 21% of the global burden. On 5 September 2023, suspected outbreak of chikungunya was reported at Bolasa village, Jhabua, Madhya Pradesh by local newspaper. Objective: We investigated to confirm the outbreak, describe the epidemiology and provide evidence-based recommendations. Methodology: We compared past three years Integrated Disease Surveillance System (IDSP) data to confirm the outbreak. We defined a suspect case as fever with arthralgia in a resident of Bolasa village, during 20 August-30 October 2023, searched cases by reviewing patients register from health-care-facilities and house-to-house in Bolasa village. Cases were interviewed using semi- structured questionnaire prepared by modifying WHO chikungunya toolbox and data analyzed using Microsoft-Excel. We conducted environmental survey at domestic and peri-domestic areas and serum samples collected for laboratory confirmation. Results: No chikungunya case was reported in the last three years. We identified 117 suspected cases (56% females) with median age of 40 years (range 27-52 years). Other than fever and arthralgia, the other symptoms included bodyache (78%) and headache (67%). Overall attack rate (AR) was 8%; highest AR in Tadvifaliya of 18% followed by Harijan and Patidar faliya with 12% each. Among the cases, 76% stored water in containers without cover, mosquito larvae were found in the containers in the house or nearby place of 60% cases. Of the 20 serum samples tested, nine were positive for chikungunya IgM-antibody. Conclusion: We detected a confirmed chikungunya outbreak in a rural setting with vector breeding sites identified in a community. Outbreak investigation led to vector control by eliminating breeding sites and community sensitization on water storage practices. We recommended early case reporting, periodic entomological surveys and source reduction.