Home' Trinidad and Tobago Guardian : February 1st 2015 Contents 12 UWI TODAY – SUNDAY 1ST FEBRUARY, 2015
“I remember stepping off the bed and thinking, oh this
pain in my feet was probably because of the skipping
I did the night before; but as the day progressed my
knees started to hurt, my lower back, and then my wrists,
at which point I realized it was not the skipping, but
This was on September 12, 2014, the day that transformed
Sherry’s life, and one she will never forget.
“ The following day when I went to work, simply using my
fingers at the cash register was so painful and then I lost
a rash all over my body, no itchiness. I felt as if my bones
had turned to jelly.”
The fever came, as did the itchiness: a persistent tingling,
especially on the palm of her left hand. “It was always red
and felt as it if it was on fire and painful,” she says.
It is now the middle of January, just over four months
since the first appearance of the virus appeared and she
is describing what it has meant for her.
Every day, she says, every single day there has been pain,
“sometimes worse than others, especially my knees and
feet, wrists.” Her feet have been swollen, her hands and
fingers too, and there have been days when her eyes have
felt like they would fall out.
It has improved a little but the pains are still there, though
not as intense; and it has not been a straight line towards
what she hopes will be a full recovery.
“For example on Old Year’s day when I was on my feet all
day, everything was all swollen, legs, feet, eyes, nose, lips
hands, wrists, everything.”
She’s noticed that whenever she’s had a particularly
strenuous day, and she has been on her feet a lot, the pain
is more intense and the swellings return. She also had a
particularly frightening episode of lightheadedness, more
intense and unsettling than anything she had ever had
before, making her feel not only that she was going to
faint, but that she was having a stroke or something like
that. (I’d had a similar experience and had discovered at
least three others who had as well.) Her blood pressure
had also been fluctuating quite frequently.
Sherry is 44, an energetic mother of three daughters
ages 22, 18 and 14, who divides her time between her
duties as a manager at the pharmacy her family owns,
housekeeping and managing her children’s demands.
She is fairly fit she says, because of all the running around
Today, she is at a doctor’s office, seeking some relief from
the unbearable pains in her feet, the alopecia she has
discovered in her head and traces of blood in her urine. I
have asked to be present.
The doctor asks a lot of questions, takes her vitals and
begins prodding and poking at the pain sites.
“ Where does it hurt the most?”
Is the pain worse on mornings before you get out of
She says she feels stiff and arthritic and it takes a while
before she can warm up. She tells him that more lately
her hands and fingers feel like they are losing sensation,
as if her blood circulation has stopped and her hands feel
cold, heavy and dead.
He began tossing around the words ‘carpal tunnel’ (carpal
tunnel syndrome is associated with numbness, tingling,
weakness and other problems in your hand because of
pressure on the median nerve in your wrist), suggesting
that surgery could easily fix that.
It turns out his specialty is orthopedics, and although
he says that for the past few months he has been seeing
more than a hundred patients every month presenting
similar symptoms, he insists that this is carpal tunnel
It raises the question I promptly ask. Several people
are complaining of similar feelings and sensations, if it
is related to the virus, won’t it clear once the virus has
gone? There seems to be no answer to this; at least, none
Many doctors are predicting chronic arthritis and
rheumatoid arthritis and reactive arthritis that may be
corrosive and erosive and may trigger other conditions.
Some say that it will all pass over time. What kind of time?
The answers vary widely. It might be days, weeks, months
or years. Although older people seem more likely to feel
more prolonged effects, it is not yet clear what determines
In the meantime, the doctor is treating the alopecia areata
(hair loss) with a steroid injection, and then he will do
something similar to her foot, though this is a very painful
procedure. Three days later, the site of the injections is a
purple patch, but the pain has eased, she says.
He shows her some exercises to do repeatedly during the
day, mostly stretches, and recommends that she rests a
lot more than she does.
An hour has passed and the visit has ended. The bill is
Is it the Chikungunya virus? He will not say it is, he will
not say it isn’t. He does not believe that all the cases that
share the symptoms are Chikungunya. There are viruses
presenting with similar symptoms, he says. It could be
any one of them.
Another unconfirmed case.
changed my life
By Vaneisa Baksh
The Chikungunya Effect
UWI TODAY SPECIAL REPORT
SUNDAY 1ST FEBRUARY, 2015 – UWI TODAY 13
David Bratt is well known, not just as a paediatrician, but
as a columnist and author. It was one of his columns which
made me realize that the effects of the Chikungunya virus
might be much more prolonged than I had thought, and
that there was even the possibility that it might lead to
chronic conditions, especially of an arthritic nature.
He had begun keeping notes on his experiences with
ChikV, and I asked him if he would share it. Three months
into it, he had this to say.
skeletal pains and a rash. Every morning I get up stiffish
and achy. I limp around for the first five to ten minutes
(it depends) because of pain in my right heel. Some
weeks ago it was my left heel. After about half an hour,
the stiffness goes but the heel pain persists throughout
the day, without the limp. Getting up from the desk after
sitting for more than 15 to 20 minutes is still an occasional
problem because of tightness in the lower back, which
eases with stretching or movement. No other joints
not gone away but there is no itching,” he reports.
It is a marked improvement from what he had first written
of his ChikV experience in his weekly column, when he
had noted that he got up many times in the night and felt
sudden waves of exhaustion during the course of the day,
making him feel that all he wanted to do was lie down.
Now, his note ends,“Energy level is good. No need to rest
in the afternoon.”
Dr Bratt seems to be past the worst of it.
I can identify with almost everything he describes, except
for the rash which I have not had, though I still have fairly
regular bouts of a kind of prickly itchiness in my palms
and soles, particularly at nights.
I have had “unconfirmed” Chikungunya (that is, two
negative blood tests, though there has been a clinical
diagnosis), since the middle of October 2014, and
although the joint pains have subsided considerably in
terms of severity, they persist, and the exhaustion sets
in suddenly and overwhelmingly often. That might be
exacerbated by the fact that I entered 2015 with dengue
(for the third time), and I might be extra tired because of
the double whammy.
I’ve had swollen fingers, which are still pudgy, painful and
given to regularly feeling as if the circulation has gone
awry. I’ve had swollen feet and ankles; dreadful pains in
my shoulders, elbows and knees, and I’ve had a generally
arthritic kind of buzz going on all the time.
Several people have told me they’ve shared these
experiences. The most similarities come from those of
about 45 years and over who are really having a hard time
with the joint pains.
It seems that the ChikV is not quite so malingering or
severe in younger people, and they are coming out of
it relatively unscathed, with very mild after effects. One
out of him within days, but now, months later, he finds
himself experiencing pains in his knees and elbows when
Dr Bratt said he had not seen ChikV in anyone under age
six, “perhaps three from six to twelve and about 30 to 40
boy, recovered in a fortnight, he says he occasionally gets
a pain in one knee.”
And that seems to be the common youth story: occasional
twinges in the joints, intermittent bouts of itchiness, a
little numbness in the digits here and there.
But for older folk, it has been far more invasive. Many of
the people I know over 60, have found the joint pains to be
so debilitating that they have been driven by frustration
and depression to seek corticosteroid injections on the
sites. (These are not cheap; around $200 a pop.)
I’ve spoken with maybe 30 to 40 people of various ages
who have been carrying these symptoms, and their
complaints are very similar, but the intensity and duration
vary quite arbitrarily.
where the long term effect of Chikunguyna is going to
make itself felt, particularly in the workplaces. I asked a
psychiatrist if there had been any cases being presented
and he said there were none as far as he was aware, but
he agreed that the prolonged and incapacitating features
of ChikV would cause people to get depressed.
Dr James Hospedales, Executive Director of the Caribbean
Public Health Agency, told me that the National Insurance
system in Jamaica has been under pressure because of the
extra demands caused by ChikV. The head of the Private
Sector Organisation of Jamaica had reported that a survey
of their members (81 companies) showed they were
feeling the impact of employees taking up to four days off
work weekly due to the virus. Its CEO, Dennis Chung, said
in October 2014 that feedback from members indicated
that some places reported 60% of staff affected.
Jamaicans have been very vocal about the impact of
ChikV on their lives. And true to the Caribbean penchant
for finding humour in even the direst of times, there have
been several comedic skits and songs conceding the
might of ChikV and its mosquito agent.
“You could have a dozen M-16 / Mi only fraida chikungunya
/ Mi no care you a which bad man / Neither which garrison
you come from / You coulda spar wid a million don / Mi only
fraida chicken gunman!” is one gem from Beenie Man
and the Astronauts, and there are at least half a dozen
on the subject.
It is the raw Jamaican coping mechanism at work and the
volume alone tells you how deeply ChikV has etched itself
into public consciousness. Michael Abrahams’ version of
Every Breath I Take (Since Me Get ChikV) is a funny but apt
description of ChikV sufferation.
I have not yet heard any calypsos on the subject, but I am
sure ChikV is going to be a significant factor in Trinidad
and Tobago’s Carnival 2015. It only stands to reason.
If, as Dr Hospedales warns, the region has been virgin
suggests that a large number of potential masqueraders
and feters might have been hijacked by ChikV pains.
Principal Medical Officer, Dr Clive Tilluckdharry, did not
think it was going to create a significant absence in
the festivities, reminding me that a large proportion of
participants are visitors. But the tourism figures are bound
to be affected because there are many advisories posted
for visitors to the Caribbean urging protective measures
against mosquitoes (and other villains).
With all the concern about whether Carnival should
have been allowed in the context of Ebola, it would be
something, wouldn’t it, if the show was allowed to go on,
but everyone is too brukk up to play a mas?
I can feel it in my bones
By Vaneisa Baksh
published in 2013, from the La Reunion outbreak of
age 15) with clinical and laboratory confirmed ChikV,
attack! 43% had a continuous type of pain. 32% had an
intermittent type of pain.”
The truth is, by the time you’ve spent months trying to
cope with that persistent pain, the memory of the first few
days of the excruciating “brukk up” feeling pales pretty
much in the way labour pains do.
of us have the luxury of caregivers or people who can
relieve the routine demands on our minds and bodies
for prolonged periods.
And this is where I think Chikungunya is going to make
its biggest impact.
Persistent pain with no clear trajectory that says well, okay
for two or three days now, there has been some relief so
bring your spirits down. You have good days that make
you optimistic and then wham, the pain and exhaustion
hit again and you feel there’s been no progress. This is
The Chikungunya Effect
UWITODAY SPECIAL REPORT
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