Chikungunya

October 1, 2014 — Leave a comment

….or expat arrogance. Have you ever noticed how life plays wonderful little ironies when least expected? Having spent many years in countries where malaria and dengue are prevalent, where chloroquine (Sunday Sunday medicine is what we called it) left it’s acidic taste once a week, where long-term use of doxycycline left an unpleasant gastric condition and where larium sent you loopy, malarone became, in Equatorial Guinea, the prophylactic drug of choice. My husband has had a number of bouts of malaria, and one of dengue – he did spend many weeks in the jungles of Papua New Guinea, but I have managed to avoid those most unpleasant of viruses.

When contemplating retirement and where best we would like to live, there were some definite ‘must haves and must not haves’ on our list; cheese, wine, tropical fruit and fresh milk and bread rank high on our essentials. No more anti-malarial drugs was equally high on the must-not haves. And so it is with some consternation and a great deal of irritation that I find, having avoided the demon mozzie for 56 years, I have been caught, and in the place we have chosen in time to retire – the Caribbean.

Chikungunya, is a word with which I have recently become intimately acquainted, and one which frankly I don’t wish to hear again. Coming from the Makonde language of modern-day Tanzania, chikungunya means ‘that which bends up’ and was first noted by those outside Africa in 1952 after an outbreak along the Makonde Plateau.

For me it started over two weeks ago with very sore hands, which I put down to over-zealous gardening. As I watched my fingers swell as the day progressed it occurred to me I should probably remove my rings, but I never did. Day two saw total body ache, which again I put down to the vicious removal of tan-tan and an invidious and invasive non-native creeper covered in small pink flowers that I have come to detest. Day three I started the arduous task of closing up the many shutters that protect our little piece of paradise from the vagaries of late-season weather systems crossing the Atlantic, as I readied for the trip back to Houston, along with Marley the cat. Wholly unable to finish the job as every bone and joint began to thrum with pain, I was fortunate to be able to call a friend, who graciously and kindly shut the house down.

Now I don’t know if you’ve flown with a cat, but I find the entire process stressful. I have become a dab hand at bribing Marley with cheese whiz infused with a sedative; though each time we go through the process I contemplate just giving it to myself. If he wasn’t so unhappy when not with us, bearing in mind we hand reared him from three days old, we would not put him or ourselves through it. However we do, and once we reach our destination he jumps from his cage and is perfectly content as I reach shakily for the Jim Beam. The thought of being ejected from the plane with Marley was the reason I did not succumb to tears but rather swallowed fistfuls of analgesics on the final leg of my journey.

Bent over and hobbling along the concourse at George Bush Intercontinental airport at midnight, pulling a cat cage and cursing the day I decided to become a writer and therefore become beholden to a computer, I finally made it to the sanctuary of my husband’s arms.

By 4 am it had become obvious I needed medical attention and so began a day of phials of blood coursing from my veins for testing, and morphine trickling in. I was hospitalised. Infectious-disease specialists’ tutted as my body refused to produce the expected rash, though every other symptom satisfied their desire for a sure diagnosis of chikungunya. The rash did appear the day after my release from hospital, covering my arms, legs, face and chest in a mottled hive of red bumps. Intermittent fever and headache vied for supremacy over my aching body. Apart from pain relief, keeping hydrated and rest there is no magic pill.

Arriving for the first time on the French island of St Martin late in 2013, then quickly leap-frogging around and across the Caribbean to Central and South America, chikungunya has infected more than a million people. In El Salvador, the AP report cases are up from 2,300 at the beginning of August to over 30,000 now. Health officials in Colombia predict 700,000 cases by early 2015. The US Virgin Islands declared the virus at epidemic proportions last week.

The usual common-sense preventative measures for mosquito controls – widespread fogging, removing standing water, avoiding the outdoors at dusk and dawn – appear relatively ineffective. The aedes aegypti mosquito much prefers to be indoors, snug under beds and in closets, and typically lays its eggs in clear, clean water. Liberally covering oneself with Deet, picaridin, oil of lemon eucalyptus or other products disliked by the little buggers, and generally following preventative guidelines seems the most effective deterrent. Larvaciding, killing the mosquito larvae through water treatment and which lasts about three months, is being undertaken in the USVI.

Fortunately chikungunya is rarely fatal but joint pain can apparently last for a couple of years. After nearly three weeks I find typing two pages is the limit for my hands, which as a writer is distressing but hopefully manageable, and I take solace from knowing I am now likely to be protected from future infections.

I have been severely jolted from my expat arrogance in believing that after many years of exposure I was immune to the mosquito. I have been chikungunyaed, and by God it is cripplingly painful.

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