Key facts

Transmission: vector-borne (mosquito)

Mosquitoes that spread chikungunya usually bite during the daytime (early morning – late afternoon)
Other transmission modes exist but these rarely cause epidemics (for example during blood transfusion or vertical mother-child transmission)

Most vulnerable to severe consequences

Elderly
Newborns
People with other medical conditions (such as arthritis, high blood pressure, diabetes, heart disease, etc.)

Symptoms

Sudden onset of fever and chills
Joint pain (usually)
Headache (sometimes)
Body aches and generalized pain (sometimes)
Nausea (sometimes)
Light sensitivity (sometimes)
Rash (sometimes)

If an epidemic occurs

Prevention and control

Vector control and prevention
- Initiate elimination of mosquito breeding sites (for example, remove standing water and apply larvicides)
- Promote community clean-up campaigns to remove rubbish and cover water containers
- Prevent mosquito bites by advocating the use of:
  - Insect screens on windows and doors and
  - Personal protection (application of repellents, wearing long-sleeved clothes)
  - Bed nets for children and others who sleep during the day
Monitoring the community and identifying sick people
- Identify people in the community with suspected Chikungunya

Treatment and management

Rapidly detect and refer serious cases to health facilities
Refer all pregnant women with suspected infection to health facilities
Provide psychosocial support to the sick person and their family members

Social mobilization and health promotion

Find out the specific advice being given by health and other relevant authorities
Model following this advice and inform community members of current health practice advice
Offer support and encouragement to follow the advice
- Try to gain understanding about if and why health practice advice is not being followed
- With the advice of your supervisor and health authorities, work with communities to overcome barriers to following health advice and recommended practices
Identify if there are any community spaces where women give birth and engage with traditional birth attendants to share information about the disease transmission and prevention modes

Community-based assessment - questions

Make a map of the community.
Mark the following information on the map:
- How many people have fallen sick with chikungunya? Where? When?
- Who and where are the vulnerable people?
- Where are the local health facilities and services? (include traditional healers)
- Where do women give birth? (include traditional birth attendants)
Record the following information on the back of the map:
- When did people start to fall sick with chikungunya?
- How many people live in the affected community? How many are children under five years of age?
- Do people generally cover their water containers (inside and outside)? Who is responsible for the maintenance of containers for household drinking water and for vessels to do laundry; is it women or men?
- How common is it for people to live in houses with insect screens on windows and doors?
- How common is it for people who sleep during the daytime (for example, babies and small children) to sleep under bed nets?
- Are children badly affected by chikungunya? Are there other groups (specific ages, occupations, geographic areas, etc.) that are badly affected?
- What are the community’s habits, practices and beliefs regarding use of repellents, sprays, etc.?
- Have the authorities established a vector control programme?
- Is a social mobilization or health promotion programme in place?
- Which sources do people use/trust the most for information?
  - Are there rumours or misinformation about chikungunya? What are the rumours?
- Who spends more time in the household during the day (and is more exposed to the mosquito bite)? Women, or men, or both?

Volunteer actions

01. Community-based surveillance 02. Community mapping 03. Communicating with the community 04. Community referral to health facilities 05. Volunteer protection and safety 12. Managing fever 19. Psychosocial support 36. Vector and reservoir control 37. Mosquito nets / bed nets 38. Waste disposal and clean-up campaigns 43. Social mobilization and behaviour change