Overview

This is a disease that is transmitted from mosquitoes to humans and affects many people in the world. Found in densely populated countries and continents, like Africa, Asia and the tropics of the Americas, this has severe symptoms. This viral disease is caused by the Chikungunya virus of the Togaviridae. First identified in the United Republic of Tanzania in 1952 and subsequently in other countries like Africa and Asia. Since 2004 the outbreak of CHIKV virus has become more widespread and caused partly due to the viral adaptations allowing the virus to be spread more easily by Aedes albopictus mosquitoes. The transmission has been noted to persist in countries where there is a large population, but interestingly, the transmission has been interrupted on islands where a high proportion of the population is infected and then immune.

Symptoms

The onset of the disease is usually in 4-8 days and after a bite of an infected mosquitoes, it is characterized by an abrupt onset of fever and then joint pain. This joint pain is severed and lasts for a few days but may prolong for months maybe even years. Other signs are joint swelling, muscle pains, headache, nausea, fatigue and rash. These symptoms also overlap with those of dengue and Zika virus and can be misdiagnosed. Most people fully recover from the infection and experience only mild and sometimes the infection even goes unrecognized. However, there have been cases of eye, heart, and neurological complications. The elderly and newborns are more susceptible to the infection and if they have any underlying conditions then they are likely to become severely ill increasing the risk of death.

Diagnosis and treatment

The diagnosis and treatment of the virus may be done by blood sampling and other tests like reverse transcriptase–polymerase chain reaction (RT–PCR). Other tests detect the activity of the antibodies. These can be detected in the first week after illness onset and can be detected for about 2 months. Many clinical measures can be taken to address fever and joint pain. But there is no specific anti-viral drug treatment for the virus.

Preventing Chikungunya

As this disease is caused by the bite of a mosquito, you must reduce the opportunities to let the mosquito breed. Mosquitoes bite during the day and night, and for people who live in risk areas like southeast Asia, Africa and tropical regions of America, many outbreaks happen each year. The best way to prevent it is to protect yourself from the mosquito's bite. You also must get vaccinated before travelling to any of these regions. Use insect repellent, and wear long-sleeved shirts and pants. You can also treat your clothes and gear with permethrin. As we all know, they tend to breed in humid places and places where they have access to water, so try to close the rooms that are air-conditioned with screens and windows. Use nets and mosquito repellents if you are sleeping outside. There are many different types of mosquito repellents like paper, liquid etc, and they are quite effective. If your job needs, you to be stationary for long hours or frequently go outside you must take the necessary precautions.

Breast cancer remains one of the most common and fatal cancers among women worldwide, and early detection is proven to play a crucial role in improving outcomes. While mammography remains the most effective screening tool, knowing when to start and how often to get screened can be confusing.

The changing medical guidelines, as with the new screening guidelines from the American College of Physicians (ACP), can also leave women confused about when to start mammograms and how often to repeat them. HealthandMe spoke to experts to understand the correct timing.

So, What Do The ACP Guidelines Say?

The new guidance statement developed by ACP's Clinical Guidelines Committee urged mammography screening once every two years in asymptomatic, average-risk adult females, instead of the annual recommendation.

The ACP guidelines further state that all average-risk females ages 50 to 74 must undergo biennial mammography. It added that women aged 75 years or older with asymptomatic and average-risk can also discuss stopping routine screening with their doctor.

In sharp contrast, the United States Preventive Services Task Force (USPSTF) urges starting annual screening at age 40 to save lives.

What You Should Follow

“Some cancer societies like the American Cancer Society say biennial, while NCCN says annually. We prefer annually starting at age 40 till the woman is in good health, as biennial screening may delay early diagnosis in some cases,” Dr. Ashwani Kumar Sharma, Vice Chairman - Manipal Comprehensive Cancer Centre and Onco Robotic Surgeries, Manipal Hospitals, Gurugram, told HealthandMe.

NCCN, or the National Comprehensive Cancer Network, is an alliance of 34 cancer centers in the US.

Dr. Sharma added that a practical and balanced approach would be to do biennial mammography from 40 to 50 years of age and annual mammography after 50 years of age for maximum benefit.

What Are Mammograms?

A mammogram is a low-dose X-ray that captures detailed images of breast tissue, capable of identifying cancers before any physical symptoms appear.

In women with a BRCA1 or BRCA2 gene mutation who are referred to as "high risk" or with a history of radiation to the chest between ages 10 and 30, screening may start as early as age 30 and include annual breast MRIs alongside mammograms.

Mammograms: What Do India’s Guidelines Say?

Breast cancer in India is usually diagnosed at an advanced stage due to poor health awareness. But of late, there has been an increase in awareness, and more and more women are reporting in their earlier stages with a breast lump.

“Sometimes even this is too late. Breast cancer screening would help us diagnose this disease at an even earlier stage to help increase the chances of a cure from this deadly but treatable disease with the help of simple tests,” Dr Abhijit Kotabagi, Senior Consultant, Department of Surgical Oncology, Yatharth Hospital, Noida, told HealthandMe.

“I would endorse screening and women’s health awareness in our Indian population for women above 40 years after discussion of the pros and cons of screening with a clinician,” he added.

The Indian Council of Medical Research (ICMR) and other health organizations recommend the following guidelines:

1. Women Aged 30-40 Years

• Clinical Breast Examination (CBE) every 1-3 years by a doctor.
• Self-Breast Examination (SBE) every month to check for lumps or changes.

2. Women Aged 40-50 Years

• Annual Clinical Breast Examination (CBE).
• Mammogram (X-ray of the breast) every 2 years if advised by a doctor.

3. Women Above 50 Years

• Mammogram every 2 years (or as recommended by a doctor).
• Continue monthly self-exams and yearly clinical exams.

India is in the peak of summer, with heatwave conditions affecting several parts of the country. The India Meteorological Department (IMD) has predicted that these extreme heat conditions will continue over the next few days, especially across North and Central India.

According to IMD's latest bulletin, heat wave conditions are likely in isolated pockets of Bihar, Haryana-Chandigarh-Delhi, Punjab, East Rajasthan, Vidarbha, Chhattisgarh, and Jharkhand.

The IMD has also forecast a yellow alert for heatwave conditions at isolated places in Delhi from today, with maximum temperatures expected to climb between 41 °C and 44 °C through April 24. The state government has issued guidelines for all schools, focusing on hydration and safety measures.

As temperatures rise, health experts highlighted the disproportionate burden of heat on women and the related physical, social, and financial effects. Studies show women often have higher heat-related mortality rates and suffer from increased fatigue, dehydration, and reproductive health issues.

Women typically face higher risks during heatwaves than men due to

• physiological factors (higher body fat, lower sweat rate),
• hormonal changes (menopause, pregnancy),
• social roles.

How Heatwaves Affect Women Differently

Heat stress is known to interfere with the endocrine system, which disrupts hormonal balance. This means that severe heat can cause delay or interrupt menstrual cycles, causing heavier or more painful periods, and, in severe cases, absence of menstruation. Women with conditions like PCOS or endometriosis face compounded stress.

"Many women report feeling unusually tired, irritable, or drained during heat waves, and hormones can play a role," Dr. Tripti Raheja, Director - Obstetrics & Gynecology at the CK Birla Hospital (R), Delhi, told HealthandMe.

Women are more likely to feel this during certain hormonal phases, such as menstruation, PMS, pregnancy, perimenopause, or menopause.

“Women’s core temperatures rise after ovulation. That, combined with a higher surface area-to-mass ratio, means they absorb heat more quickly,” Mike Tipton, professor and leading expert in applied physiology at the University of Portsmouth, was quoted as saying to Thisdaylive.com.

Women in perimenopause or menopause may experience hot flashes, night sweats, and sleep disturbances, making heat waves exhausting.

Also read:Heatwave Hassles: What Body Odour Could Say About Your Health

Iron deficiency or heavy bleeding can also lower energy levels, and extreme heat may worsen weakness.

Pregnant women naturally have higher metabolic demands, so dehydration and fatigue can set in faster.

Without sufficient hydration, blood flow to the placenta might be reduced, potentially harming the baby. Heat exhaustion in pregnancy can cause early labor or stillbirth. Thyroid disorders and PCOS can also contribute to fatigue and reduced overall energy levels, Dr. Raheja said.

"Long exposure to high temperatures can disrupt the balance between hormones such as estrogen, progesterone, and thyroid hormones, which regulate energy, mood, and metabolism," Dr. Sakshi Goel, Senior Consultant Obstetrics & Gynecology at Rainbow Children's Hospital, Delhi, told HealthandMe.

Dehydration further worsens this by affecting circulation and temperature control, leading to exhaustion, headaches, and dizziness.

Moreover, sleep disturbances from hot nights can impair melatonin production and disrupt overall hormonal rhythms. This leads to poor recovery and low energy the next day.

How Women Can Protect Their Health From Heatwaves

Read: Excessive Energy Drinks Damaging Young Adults’ Livers, Experts Warn

Understanding how heat affects hormonal health lets women take steps to manage fatigue and maintain overall well-being during extreme weather.

To cope better, the experts suggested prioritizing hydration and including ORS when needed.

Dr. Goel noted that even mild fluid loss can hurt circulation and lower the body’s ability to regulate temperature. This can lead to exhaustion, headaches, and dizziness. Other preventive measures include:

• Avoiding long sun exposure during peak hours.
• Eating lighter, balanced meals and avoid stepping out during peak afternoon heat.
• Wearing breathable clothing and ensure adequate sleep in a cool environment.
• Gentle movements, such as walking or stretching, can improve circulation and mood.
• If fatigue is severe, persistent, or associated with dizziness, palpitations, irregular periods, or excessive weakness, it is important to seek medical evaluation rather than dismissing it as just the weather.

In this hot summer period, with rising temperatures, those working outdoors are among the groups most susceptible to developing health problems, especially those related to kidney health. Construction workers, delivery workers, traffic officers, farmers, and sanitation workers all work for long periods outdoors in the sun, which adds continual strain on their bodies. While heat exhaustion and dehydration have been discussed frequently, a less visible but very significant concern is the increasing risk of kidney damage.

In an interview with Health and Me, Dr Anupam Roy, Additional Director – Nephrology and Kidney Transplant, Aakash Healthcare Multi-Speciality Hospital, Dwarka, spoke about the silent impact of the heatwave on outdoor workers.

With continued exposure to heat, there is increased sweating, which results in the insensible loss of a considerable amount of fluid and electrolytes from the body. If this is not matched by adequate fluid replacement, dehydration will set in. Dehydration reduces the amount of blood circulating throughout the body’s systems; therefore, the amount of blood flowing to vital organs, including the kidneys, will be diminished. As a result, the ability to filter waste from the body and maintain an adequate fluid balance is impaired. Reduced circulation to the kidneys will eventually impair their function altogether, thus leading to a greater likelihood of the worker developing an acute kidney injury (AKI).

How does a heatwave affect the kidneys?

There is a continuum of challenges that arise when kidney damage occurs as a result of internal heat stress due to poor hydration. The earliest signs are usually fatigue, dizziness, muscle weakness and/or cramps, or reduced urine production. Many people mistakenly believe these symptoms are due to their duties in hot conditions, or they dismiss them as something that will go away with time. By the time they begin to recognise an increase in the severity of their symptoms (for example, a lack of strength or confusion), significant damage to the kidneys may have already developed. Because of this delay in recognising kidney damage, the ability to treat and manage the condition becomes much more difficult.

Chronic dehydration

Chronic dehydration and heat stress also have additional long-term effects on the kidneys. Research has shown that prolonged exposure to heat is linked to a higher incidence of kidney stones and urinary infections in those frequently exposed to high temperatures. Both individuals with traditional risk factors for kidney disease (for example, diabetes or hypertension) and those without such risk factors can develop chronic kidney disease. Many agricultural and manual labour workers have been shown to develop this condition in hot climates.

Working and living conditions can further exacerbate the risk of developing chronic kidney disease due to dehydration and heat-related illness. Limited or no access to clean drinking water, a lack of restroom or food breaks, and the expectation to maintain high productivity can reduce workers’ ability to hydrate themselves appropriately. Additionally, many workers may resort to medications such as pain relievers due to discomfort. When such medications are consumed alongside dehydration, they can aggravate kidney damage.

How to protect your kidneys amid a heatwave?

To help prevent heat-related damage to the kidneys, awareness and practical measures are essential. Staying hydrated at all times is the most important step, and workers should drink sufficient water even when not thirsty. Employers and agencies must ensure that all employees have easy access to safe drinking water on-site, along with regular breaks to rest in shaded or cool areas. Furthermore, workers should wear lightweight, breathable clothing and have access to shade, hats, and sunscreen to reduce exposure to extreme heat.

Several simple steps can help protect this workforce from the hidden effects of extreme heat. These include avoiding work during the hottest parts of the day, rotating job responsibilities, providing education about the signs of heat-related illnesses, and conducting regular health assessments to monitor kidney health so that any issues are detected early.