The number of chikungunya patients is rising at a time when Bangladesh has already been struggling with a surge in dengue cases, creating a serious public health concern — particularly in Dhaka.
Although many people are visiting doctors with chikungunya symptoms, the diagnosis of the disease remains limited due to the absence of advanced diagnostic facilities and the high cost of available tests.
Officials at the Directorate General of Health Services admitted that no public hospital currently has PCR or RT-PCR laboratories for chikungunya detection, though two public health institutes possess the technologies.
Chikungunya is a mosquito-borne viral disease transmitted by Aedes aegypti and Aedes albopictus, the same mosquitoes responsible for spreading dengue.
The illness typically appears three to seven days after the infection and is marked by sudden high fever and severe joint pain.
DGHS Hospital Services Management line director Dr Md Zainal Abedin Tito said that chikungunya was not considered a public health emergency to the government because of its low fatality risk.
‘Chikungunya is not our priority as there have been no reported deaths. The diagnostic test is very costly and can’t be made widely available,’ he told ¶¶Òõ¾«Æ·.
However, survivors of the chikungunya virus said that although the disease is rarely fatal, it has left them suffering immensely, with persistent joint pain and fatigue disrupting their normal life.
Despite these limitations, DGHS data show confirmed cases are steadily increasing.
Two cases were reported in March, three each in April and May, 18 in June, 64 in July, 104 in August, and 100 in the first 25 days of September.
Specialists, however, believe that the actual number of patients is far higher than reported or estimated.
Most suspected cases remain undiagnosed, with doctors relying on symptomatic treatment.
‘From our clinical experience, we continue to offer chikungunya treatment without waiting for costly PCR confirmation,’ said Professor Rafiqul Islam of Shaheed Suhrawardy Medical College Hospital, noting that rapid tests also frequently show false negatives.
One of the hallmark symptoms, he explained, is intense joint pain in wrists, ankles, hands, and feet.
Tests remain largely inaccessible.
A chikungunya PCR test costs up to Tk7,000 in private facilities and Tk3,300 in the few public centres offering it.
The rapid testing of dengue varies from Tk 250 to Tk700.
Currently, only the National Institute of Laboratory Medicine and Referral Centre provides tests for the public, while the Institute of Epidemiology, Disease Control and Research conducts limited number of tests for research purposes.
Public health experts suspect that the low detection rate may also be linked to sensitivity issues with testing kits or possible viral mutations.
Dr Nur Mohammad, a medicine specialist at the Labaid Specialized Hospital in the capital, said that of the total patients with fever he visits are found 10–15 per cent chikungunya positive in rapid testing.
The rest of the patients, he said, who are with same symptoms but are negative in test reports are given symptomatic treatment without advance diagnosis to confirm them.
The treatment is almost the same and many patients cannot afford the high cost of the treatment, he said.
According to him, victims often suffer debilitating joint pain for at least eight weeks, with many requiring regular painkillers to cope with what he described as the ‘intolerable pain’.
One such patient, Ariful Islam, a banker from Aftabanagar, was diagnosed negative on a rapid test in August despite having classic symptoms. ‘I still can’t walk normally. The pain is unbearable,’ he told ¶¶Òõ¾«Æ·.
Experts emphasise that mosquito control remains the only effective preventive method in this record.
‘Chikungunya spreads through the same Aedes mosquito as dengue. Controlling the vector is the only effective remedy, but authorities are not giving necessary attention to that,’ said Dr Golam Sharower, head of entomology at the National Institute of Preventive and Social Medicine.
Bangladesh previously witnessed a major chikungunya outbreak in 2017, when government data confirmed 984 laboratory cases and more than 13,176 clinically diagnosed patients across 17 districts, with Dhaka the worst affected.
