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Mosquito virus cases soar by 432% in UK as holidaymakers return from Caribbean where major Chikungunya outbreak is spreading

Chikungunya Virus Alert

‘There is no vaccine to prevent Chikungunya’
Public health officials in the UK are grappling with a skyrocketing number of cases of a debilitating mosquito virus as British holidaymakers return from countries where an outbreak is rapidly spreading.
Nearly 200 British tourists have been diagnosed with Chikungunya in 2014 as the number of cases has quintupled in a little more than two months, according to figures released by Public Health England on Friday.
Of those, 162 have been associated with travel to the Caribbean and South and Central America, where health experts say the deadly outbreak is likely to get worse.
Public Health England has been made aware of 197 cases of Chikungunya in 2014 as holidaymakers are encouraged to cover their skin and wear mosquito repellent if they are travelling to the Caribbean to beat the winter blues.
The latest figures represent a 432 per cent increase from the last update on September 16, when just 37 cases had been reported in the UK.
The countries from which cases have been most frequently reported include Jamaica, Barbados and Grenada.
Dr Jane Jones, travel and migrant health expert at Public Health England, said: ‘Chikungunya is an unpleasant viral illness that can cause fever and joint pains which in some patients may persist for a prolonged period.
‘It is spread by mosquitos and is more usually found in parts of Asia and Africa but in recent years we have seen new areas of the world becoming affected, including the Caribbean and other parts of the Americas.’
Dr Dipti Patel, director of the National Travel Health Network and Centre, added: ‘There is no vaccine to prevent Chikungunya.
‘Anyone returning from affected areas with symptoms such as fever and joint pain should seek medical advice.’
The chikungunya virus, transmitted through infected mosquito bites, has spread to more than 30 Caribbean nations since it was first reported by the World Health Organisation in December 2013, when a case was discovered in St Martin, a French overseas territory.
With more than 700,000 suspected cases and approximately 120 deaths reported, experts are telling tourists to protect themselves if they are heading to the region for winter sun.
Earlier this month, the United States Centers for Disease Control and Prevention (CDC) reported more than 1,600 travellers returning to the US with Chikungunya as of November 4.
More cases are being reported every day on the island as victims arrive at hospitals or surgeries with Chikungunya symptoms, including fever, headaches, rashes and muscle and joint pain.
The worst of the outbreak in the Caribbean is occurring in the Dominican Republic, Guadeloupe, Haiti and Martinique, where more than 600,000 suspected cases have been reported.
Dr Tim Brooks, head of Public Health England’s rare and imported pathogens laboratory, said: ‘Chikungunya is now a common infection in travellers from the Caribbean, and is currently reported more frequently than dengue.
‘The Aedes mosquitoes which spread the disease are most active during daylight hours.
‘Particular vigilance with bite avoidance should be taken around dawn and dusk.
‘Doctors should consider Chikungunya in patients with a fever who return from the Caribbean, especially if they have symptoms of arthritis, and test them for the disease.’
Dr Laith Yakob, an infectious disease ecologist with the London School of Hygiene and Tropical Medicine, told MailOnline Travel earlier this month that people should speak to their GP or a travel doctor before their trip.
Once they arrive, they should keep their skin covered during the day, as mosquitoes are ‘day biters’, and regularly apply insect repellent containing DEET, he said.
And they should seek immediate medical attention at the onset of symptoms.
He said: ‘For most people within three to seven days they’ll have fever, then joint pain in the hands and wrists can persist for weeks or even months.
‘The joint pain can spread and can be quite debilitating.’
Patients are often left bedridden but they can recover within three to five days with proper treatment. 
Dr Yakob said the elderly are at particular risk of developing severe symptoms that can result in death.
Trials of an anti-viral drug in the US have had positive results, but there is currently no vaccine commercially available. 
A small number of cases result in death and up to 10 per cent of patients suffer from arthritis, chronic joint pain and fatigue.
Complications can include hepatitis, myocarditis (inflammation of the heart muscle), and neurological and ocular disorders.
Dr Yakob said the symptoms of Chikungunya and dengue fever, also spread by infected mosquitoes, are similar, so people who believe they are infected should seek a proper lab diagnosis.
The virus does not occur in the UK but Public Health England has been monitoring for signs of infected blood-suckers.
Despite the rise in cases involving tourists who visited the Americas, a majority of UK cases are associated with travel to South and South East Asia, NaTHNaC says.
In October, lab tests confirmed four people contracted the virus in Montpellier, France – prompting fears it could spread to the UK.

National Emergency Declared Due To Chikungunya Virus Outbreak In Jamaica

National Emergency Alert

Jamaica Prime Minister Portia Simpson Miller says the country is in a “national emergency” over the outbreak of the mosquito-borne Chikungunya virus in the country.
The virus, which is similar in symptoms to Dengue fever, often leads to fever and severe joint pain that can last from a few days to, in some cases, for years, though it is rarely fatal.
The disease has spread across the Caribbean region after initially appearing in St Martin in late 2013, but has hit Jamaica particularly hard.
“I want to stress that we are in a NATIONAL emergency,” Simpson Miller said at a briefing on Tuesday. “I have therefore, assumed a lead role in mobilizing the nation and national resources.”
She said she sympathized with those across Jamaica who had come down with the painful illness.
“I understand that some MPs even as we speak are out with the virus,” she said. “I want to commend MPs, Mayors and Councillors who have been active in encouraging your constituents to get involved in the only sustainable way to control and reduce the epidemic – which is, to destroy and reduce mosquito breeding sites.”
She said the government had called on about $4.5 million USD in state resources for national health emergency response, with the objective of reducing mosquito breeding sites by starting with the worst-affected areas.
“This is our country,” she said. “We all have a stake and a vested interest in protecting it and in keeping our people safe and healthy.”
There have been almost 800,000 suspected cases in the Caribbean region, with the majority in the Dominican Republic.

Chikungunya Virus is spreading across Jamaica at an alarming and scary rate

Chikungunya Virus Alert

Jamaica’s health minister said Sunday that the government is doing all it can to combat a newly arrived mosquito-borne virus that is increasingly disrupting life and cutting productivity on the Caribbean island.
In a national address carried on television and radio, Fenton Ferguson said the Chikungunya virus is spreading across Jamaica and “everyone is susceptible.”
“We are aware of the impact this is having on productivity and attendance at school and work and ask employers to be compassionate and assist their staff through this difficult period,” Ferguson said.
It’s a rarely fatal but typically very painful viral illness that has advanced rapidly through the Caribbean and parts of Latin America after local transmission started in the tiny French dependency of St. Martin late last year, likely introduced by an infected air traveler. Apparently hardest hit has been the Dominican Republic, with half the cases reported in the Americas.
In recent days, the mosquito-borne virus with no cure or vaccine has been increasingly sickening people in Jamaica, perhaps most severely in the southeastern parish of St. Thomas.
“Schools, business, churches, farms and entire communities in St. Thomas continue to report ever mounting cases of persons ill with chikungunya, some communities with over half the population affected,” said opposition official Delano Seiveright before the health minister’s speech.
Confirmed cases in Jamaica are few so far, but there are many signs that the real number of sickened people is far higher than the official tally. Laboratories have only been able to confirm a small portion of people who fall ill because many patients don’t bother seeking care so their cases go unrecorded. Some private doctors are also not reporting patients to the government, according to the health ministry.
Some Jamaicans are blasting the government for what they believe is a sluggish response to a public health threat they knew was on the way. Fenton asserts the government was prepared and is doing all it can to swat down the virus but the “expectation is for chikungunya cases to spike and then trend down” as more people become immune. People develop immunity after getting infected.

Chikungunya Virus is raging at epidemic levels across Latin America

Chikungunya Virus Alert

An excruciating mosquito-borne illness that arrived less than a year ago in the Americas is raging across the region, leaping from the Caribbean to the Central and South American mainland and infecting more than 1 million people. Some cases have already emerged in the United States.

While the disease, called Chikungunya, is usually not fatal, the epidemic has overwhelmed hospitals, cut economic productivity and caused its sufferers days of pain and misery. And the count of victims is soaring.

Chikungunya Virus Concern Growing For The Whole Of USA

Chikungunya Virus Alert

Clinicians should be alerted to the possible spread of chikungunya virus in the United States, according to a commentary published online September 23 in the Annals of Internal Medicine.
“Clinicians should advise patients to use antivector measures when traveling to regions with chikungunya transmission,” write Davidson Hamer, MD, professor of global health at the Boston University School of Public Health and School of Medicine in Massachusetts, and Lin Chen, MD, from the Division of Infectious Disease at Mount Auburn Hospital in Cambridge, Massachusetts. “Clinicians should consider chikungunya in the differential diagnosis of febrile travellers with arthralgia and rash after visiting regions with chikungunya transmission, including the Caribbean and Central and South America.”
Chikungunya causes high fevers, rash, and incapacitating joint pains. Most symptoms clear up within 7 to 10 days, although they have persisted for months or years in some people. Severe disease and complications such as meningoencephalitis and death are rare.
Symptoms overlap with dengue virus, and coinfection can occur. Severity and persistence of joint pains help make the differential diagnosis, according to the authors. Clinicians can also use polymerase chain reaction, immunoglobulin M, and immunoglobulin G tests for differentiation..
No licensed treatments or vaccines exist; thus, treatment is supportive using anti-inflammatory agents. In addition, Dr. Hamer and Dr. Chen note that public health efforts should focus on identifying infected travelers and interrupting the transmission cycle, using antivector methods such as insect repellents and drainage of mosquito breeding sites.
Chikungunya means “that which bends up” or “to be contorted” in the Kimakonde language and was first described in the 1950s in Tanzania. It subsequently spread globally, with outbreaks in West Africa, the Indian Ocean, India, and Southeast Asia. Imported cases to France and Italy by travelers from India have also been reported.
In 2013, chikungunya emerged in the Caribbean, where it quickly spread to almost every island, with many cases found in the Dominican Republic and Haiti. In 2014, travelers introduced the virus to Central and South America, where it rapidly became endemic. As of September 5, 2014, the Pan American Health Organization had confirmed 8210 cases and 37 deaths resulting from chikungunya. The continental United States has had 751 reported cases of chikungunya, with local transmission in southern Florida.
Several strains of chikungunya virus exist. The current epidemic is caused by the Asian strain, spread most efficiently by the Aedes aegypti mosquito (which also spreads dengue and yellow fever) and less efficiently by the Aedes albopictus mosquito. Because A albopictus occurs farther north, there is a possibility the virus could spread more widely.
Firm Foothold in the United States Debatable
“I do not think that chikungunya will become established in the northern hemisphere. I think it will closely follow the pattern of dengue virus,” Robert Lanciotti, PhD, chief of the Diagnostic and Reference Laboratory in the Arbovirus Diseases Branch at the Centers for Disease Control and Prevention, Fort Collins, Colorado, commented to Medscape Medical News. “With only a few exceptions in recent history, we have only isolated imported cases [in the United States,] and dengue is not endemic.”
Opinions differ, however. In addition to Florida, the Texas–Mexico border could become a hotbed of chikungunya transmission, Scott Weaver, PhD, director of the Institute for Human Infections and Immunity and scientific director of the Galveston National Laboratory at the University of Texas at Galveston told Medscape Medical News. In that location, dengue has a “pretty regular” transmission pattern that “you might consider that endemic,” he said. And chikungunya could follow a similar pattern.
Americans, who may be most familiar with West Nile, should be aware of Chikungunya’s different transmission pattern, according to Dr. Weaver. A aegypti mosquitoes bite during the day, like to stay inside houses, and have closer associations with humans than West Nile vectors.
“The most important way to protect yourself from chikungunya is to keep mosquitoes out of your house. Here in the US, the main reason we don’t think we’re going to see major outbreaks is because people air condition their houses, or at least have screens that keep mosquitoes out,” Dr. Weaver explained. He added that draining areas of standing water is also important because that is where the mosquito larvae live.
Several chikungunya vaccines are under development. Dr. Weaver’s group is partnered with Takeda Pharma and is working on a live attenuated vaccine that has shown promise in nonhuman primates, he said. Another vaccine recently went into human trials in Europe and uses a measles virus vector. Still another, a non–live replicating vaccine developed by the National Institutes of Health, was “fairly immunogenic” in phase 1 human clinical trials. That vaccine was licensed to Merck but currently has no commercial partner after being dropped by Merck a few months ago, according to Dr. Weaver.
“Scientifically it’s not particularly difficult to develop a chikungunya vaccine, but the financial side of the equation is much harder to work out,” he revealed, “If a vaccine can make it to the market before chikungunya reaches some of the major Latin American cities, it can have a huge public health impact.”
Dr. Hamer reports receiving a grant from the International Society of Travel Medicine. Dr. Chen reports receiving personal fees from Shoreland, Inc; Elsevier Publishing; Springer Publishing; and GlaxoSmithKline. Dr. Weaver reports having a patent for a method of attenuating alpha viruses that could be used in a chikungunya virus vaccine under development. Dr. Lanciotti has disclosed no relevant financial relationships.

Jamaica Urged To Brace For Full Impact Of Chikungunya Virus

Chikungunya Virus Alert

A strong warning is coming from the head of the Caribbean Public Health Agency (CARPHA), based in Trinidad and Tobago, to the rest of the region, including Jamaica, to brace for the “full impact” of the Chikungunya virus even as concerns mount locally about the spread of the mosquito-borne disease.
As the number of cases in Jamaica climbs steadily, medical practitioner and former president of the Jamaica Medical Doctors Association Dr Shane Alexis said Jamaica should take the warning from CARPHA seriously.
In a Gleaner interview, Dr Alexis suggested that efforts to prevent the rapid spread of Chikungunya should include widespread community involvement. “I certainly would encourage schools, churches and other community groups to do Labour Day-type activities, such as bushing and clearing areas, especially where a lot of people meet at any one time.”
He stressed that efforts to contain the spread of the virus should not only be confined to doctors, nurses and the Ministry of Health, but should be expanded to teachers, journalists, public-sector workers, labourers and every Jamaican that can play his/her part in this critical drive.
Executive Director of CARPHA Dr James Hospedales told the Caribbean Media Corporation that with a population of 17 million people, the region is still in the early stages of the virus. He said the “full bloom of Chikungunya virus is yet to come”.
According to the CARPHA head, in six months, the virus has spread to all the islands “and we can expect further increases in levels of cases based on what has happened elsewhere in the world where, in some countries, you find a 30 per cent attack rate of the entire population within a year or so.”
Dr Alexis said that while each country in the Caribbean has had a different experience in relation to the spread of the virus, Jamaica has been fortunate to have recorded a low number, to date. He is urging the country to be vigilant, especially from a grass-root standpoint.
Chikungunya is a viral disease carried mainly by the Aedes Aegypti mosquito and causes a dengue-like sickness.
Symptoms include a sudden high fever, severe pain in the wrists, ankles or knuckles, muscle pain, headache, nausea, and rash. Joint pain and stiffness are more common with chikungunya than with dengue.
Visit health centres first
Dr Alexis is advising persons with symptoms of the virus to contact the primary health-care facilities before visiting hospitals. “We don’t want to overwhelm our health sector any further. We want to direct them to the right place – the health centres – and then they will determine at that level whether they should be referred further or they can be managed there.”
Last week, the Ministry of Health urged the administrators of schools across the country to take urgent steps to remove mosquito breeding sites at their institutions.
Yesterday, The Gleaner visited two institutions, one in St Andrew and the other in Portmore, St Catherine, and found areas of concern that could be conducive to mosquito breeding.
However, Principal of the Pembroke Hall High School Daniel Morgan said steps have been made by the school to maintain a clean environment to prevent mosquito breeding.
He said the Ministry of Health has visited the school on a number of occasions to carry out fogging. Despite this, students at the institution told The Gleaner yesterday that they have had to battle pesky mosquitoes daily while in class.
Morgan suggested that the breeding of mosquitoes could be taking place in proximity to the institution.

Puerto Rico declares epidemic as Chikungunya Virus continues to spread unabated

Chikungunya Virus Alert

The Puerto Rican government declared on July 17 that the mosquito-transmitted disease chikungunya has reached epidemic proportions. Puerto Rico is only the latest country to fall prey to the disease, which has been sweeping the Caribbean since its arrival in late 2013.
According to the Pan American Health Organization, a total of 354,000 cases are suspected or confirmed across the Caribbean as a July 11.
“We’re seeing an epidemic ripping through a naive population, with a very large number of cases in the Dominican Republic and elsewhere,” said Peter Hotez of Baylor College of Medicine. “There is every reason to believe we could see similar epidemics along the US Gulf Coast maybe later this summer or starting next year.”

Virus causes severe pain

Chikungunya, first identified in Africa in 1953, is characterized by symptoms similar to those of dengue fever, another mosquito-borne illness.
“As with dengue fever, there is a high fever,” said emergency room doctor Dominic Martinello of Anna Jaques Hospital in Newburyport, Mass. “There will be a high fever of up to 104 degrees. There will be pretty significant joint pain and possibly a rash. There may be nausea and vomiting, but rarely would a patient die.
“The incubation period is about one to 12 days. The person may have the fever for one or two days. The joint pain, while it can be severe, can last for five to seven days and then the person should recover.”
Chikungunya first arrived in Puerto Rico in late May, and more than 200 cases have been confirmed mostly in or around the capital.

Disease has already reached mainland U.S.

Cases of Chikungunya have already been reported in the mainland United States as well. Just a week after the Puerto Rico announcement, Florida health officials announced two confirmed cases of people who had contracted the disease from local mosquitoes. This marks the first evidence of the disease becoming endemic to the mainland.
“There is definitely a lot of discussion about this and we are watching,” said Beth Daly, chief of infectious disease surveillance at the New Hampshire Department of Health and Human Services. “There have actually been 497 cases of this virus in the U.S., but that includes the territories like Puerto Rico. We have seen 300 cases in 30 states, but with the exception of the two Florida cases, all have been in returning travelers.”
It remains to be seen whether Chikungunya will be able to establish itself on the US mainland over the long term. According to Dr. Joseph Gross of River Valley Infectious Disease Specialists, three factors are required for a mosquito-borne virus to colonize a new area: the virus itself, a high enough population for the disease to spread and the correct species of mosquito. In the case of Chikungunya, the mosquitoes must be of the species Aedes aegypti or Aedes albopictus. While both species can be found in the southeastern United States and parts of the Southwest, only A. albopictus is found throughout the mid-Atlantic states and the lower Midwest.
“It will be interesting to see what happens,” Dr. Gross said. “We have seen this before, with West Nile virus and with dengue fever. Dengue did not take a hold in the country, but West Nile did. It may be climate related, but there are other factors that could make the difference as well.”
There is no cure for Chikungunya, and no treatment other than painkillers for symptomatic relief. The best way to avoid contracting it, health experts say, is to prevent mosquito bites by wearing long pants, long sleeves and insect repellent. For natural, nontoxic ways to repel bugs, check into using garlic and essential oils.

Chikungunya virus targets 20 New Jersey residents, USA

Chikungunya Virus Alert

Twenty New Jersey residents have tested positive for the chikungunya virus, according to the state Health Department.

The mosquito-borne virus has spread through the Caribbean, and the first two cases in the U.S. were reported last week in Florida.

Health officials say the virus is not contagious from person to person, is typically not life threatening and will likely resolve on its own.

If a person tests positive for chikungunya and is then bitten by a mosquito, that mosquito may later spread the infection by biting another person.

Infection with chikungunya virus is rarely fatal, but the joint pain can often be severe and debilitating. Other symptoms include high fever, headache, muscle pain, back pain and rash.

Symptoms appear on average three to seven days after being bitten by an infected mosquito, the health department says. Most patients feel better after a few days or weeks, however, some people may develop long-term effects. Complications are more common in infants younger than a year old; those older than 65; and people with chronic conditions such as diabetes and hypertension.

The state Health Department says the residents who came down with chikungunya had returned to New Jersey from the Caribbean. Chikungunya causes a high fever and severe pain in the joints.

Chikungunya virus has mutated; many countries be on your guard

Chikungunya Virus Alert

Chikungunya virus has mutated; many countries be on your guard

New mosquito born Chikungunya virus invades Ohio, USA

Chikungunya Virus Alert

Common Ohio mosquitos are now spreading a serious virus with a very exotic sounding name.

By now, most of Ohio have heard about the West Nile virus but since July 4 there have been about 50 cases in the United States of a disease called chikungunya.

Two of those people were diagnosed in Ohio and infectious disease experts say that the mosquito that carries the disease is in the Tri-State.

Symptoms of the disease include fever and joint pain, headaches, muscle pain, joint swelling or rash and start three to 7 days after a bite.

And there is no cure once the virus strikes, just a need for patience, plenty of rest, fluids and ibuprofen.

Dr. Carl Fitchenbaum a professor of clinical medicine at the University of Cincinnati’s medical school says as always people should make efforts to protect themselves.

He suggests avoiding times at dawn and dusk when mosquitoes are most active, wear long sleeves or mosquito repellant.

And even if the disease isn’t in the area yet, being prepared will prevent discomfort, as Lucy England knows. Her four-year-old son was bit multiple times days ago.

“We were at my mom’s house,” England said. “She lives in Mount Healthy and she he was out around dusk and he got about six bites on each leg and woke me up in the middle of the night crying because these bug bites itched so badly.”