Tag Archive | chikungunya

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.

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.

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 strikes Costa Rica

Chikungunya Virus Alert

Health Vice Minister María Esther Anchía on Friday confirmed that a French tourist is officially the first patient to test positive for the Chikungunya virus in Costa Rica.

The woman, whose identity was not disclosed, visited Costa Rica from May 10-21. She first showed symptoms on May 27 in France.

After an alert from French health agencies, Costa Rica’s Health Ministry confirmed the case as the country’s first. The tourist traveled on a one-stop flight with ​​a stopover in Dallas, Anchía said.

“There are no records that the tourist visited another country with the reported virus before arriving in Costa Rica. But there is also a possibility that she was already incubating the virus when she entered the country,” the ministry’s director of health surveillance, María Ethel Trejos, said.

The woman traveled with her mother and visited San José, Tortuguero, La Fortuna, Monteverde and Quepos, Trejos added.

Last week, Health Ministry officials ruled out nine other suspected cases. Currently there are five more potential cases, all of people who traveled to the Dominican Republic recently.

Chikungunya is a virus transmitted by Aedes aegypti and Aedes albopictus mosquitoes, and it shares many of the same symptoms as dengue: high fever, headaches, muscle and joint pains, nausea and rashes. But symptoms are more aggressive than dengue and can persist for up to 10 months.

Health officials called on resident to take extreme preventive measures, including cleaning up trash and other items that collect stagnant water.

Chikungunya Virus Appears in Paraguay

Chikungunya Virus Alert

Paraguayan authorities reported on Monday the first case of Chikungunya virus in the country after a citizen got infected in the Dominican Republic.
An official communiqué by the country’s Health Ministry explained that a Paraguayan citizen returned to the country six days after he began to feel the symptoms, which included fever and pains in his joints, and he looked for specialized assistance.
The citizen’s attitude allowed health specialists to take measures and avoid the spread of the disease, reads the communiqué cited by PL news agency.
The person was clinically analyzed and doctors considered he did not run any risk of complication, so he did not need hospitalization. However, the Health Ministry alerted that the risk of a Chikungunya epidemic in Paraguay is high and called on travelers to take into account all precautions to lower such risk.
According to the Pan-American Health Organization, the number of suspected Chikungunya cases in the continent has increased to over 185 thousand, with 21 deaths, up to last June 20 since the virus was first detected in this part of the world in December 2013.
The organization says that imported cases of the virus have been detected in Panama, Cuba, Venezuela, Chile, Brazil, Costa Rica, Mexico, Peru and the United States and that a concentration of the virus exists in the Dominican Republic with nearly 90 thousand suspected cases.

New Virus Spikes in the Caribbean Islands

Chikungunya Virus Alert

The number of chikungunya cases in the Caribbean has more than tripled in a month.

As of this week, the region is reporting 4,576 confirmed and 165,990 suspected cases of the virus, for a total of 170,566, according to the Pan American Health Organization.

That’s up dramatically from the 55,992 confirmed and suspected cases the agency reported May 16.

In the U.S., the CDC is reporting that 80 chikungunya cases have been reported to ArboNET, the national surveillance system for arthropod-borne diseases, from U.S. states and territories.

Puerto Rico has the largest number of cases, with 23, all a result of local transmission. Travelers returning from the Caribbean imported the other 57 cases reported by the agency.

Florida has 34 of those cases and Virginia six, but no other state has more than three.

The total doesn’t include a case reported by Tennessee and two reported by Rhode Island.

The virus — pronounced chik-un-GUHN-ya — is carried by mosquitoes, mainly Aedes aegyptiand Aedes albopictus, which are widespread in the U.S.

Nevertheless, there is no indication yet of local transmission in the U.S., other than the cases in Puerto Rico. The virus is not a national notifiable disease but can be reported to ArboNET, although not all cases are.

Chikungunya is widespread in Asia and Africa, but until late last year, cases in the Americas were imported by travelers to those regions, rather than being homegrown infections.

That changed in December, when the World Health Organization reported that an investigation into possible dengue fever in St. Martin turned up two confirmed, four probable, and 20 suspected cases of chikungunya.

The patients had not traveled, suggesting they had been infected locally.

The PAHO defines a suspected case as a patient with acute fever greater than 38°C, severe arthralgia or arthritis that isn’t explained by other conditions, and who lives in or has recently visited an epidemic or endemic area.

Cases are said to be confirmed if there is also a positive lab test for the virus using any of several methods, the agency said.

In its most recent report, the agency said the French- and Spanish-speaking islands in the Caribbean had 163,072 suspected cases and 4,129 confirmed cases.

The English- and Dutch-speaking islands had 2,918 suspected cases and 447 confirmed.

There have been 14 deaths, all in the French- and Spanish-speaking islands.

The CDC is recommending that travelers to the Caribbean protect themselves from mosquito bites.

Incurable chikungunya virus spreads in US, at least 6 states affected

Chikungunya Virus Alert

US health officials are on high alert as a mosquito-borne virus that yet has no cure has struck six of the US states. The virus called chikungunya causes severe joint pain which can last for years.

The latest case of the virus has been confirmed by Tennessee officials as the resident of Madison County, has been tested positive for the virus. The officials, however, added that there was no transmission to other residents in the state.

“It will be more difficult for the virus to establish itself here,” Dr. William Schaffner, an infectious disease specialist at Vanderbilt University Medical Center in Nashville, Tennessee told Tech Times.

Rhode Island authorities also confirmed two cases of the mosquito-borne virus. They involve travelers who returned from the Dominican Republic on May 17 and May 29, said state officials, adding that authorities are currently investigating several other suspicious cases of the virus.

Florida has been the worst hit by the virus, with at least 25 cases reported in the state, according to the US Centers for Disease Control and Prevention.

The Florida Department of Health released a set of guidelines in order to avoid becoming infected and spreading the virus.

A scientist examines tiger mosquitos (AFP Photo / Pascal Guyot)
A scientist examines tiger mosquitos

The cases of the virus, transmitted to humans through mosquitoes, have also been confirmed in North Carolina, Nebraska and Indiana.

On Wednesday, the virus affected two residents from the US Virgin Islands, according to local authorities.

“The first case has been confirmed as locally acquired; the second case is an imported case with the patient recent travel history outside of the Territory,” said the Department of Health in the US Virgin Islands in a press release.

Florida officials advised residents “to wear long sleeves and long pants when possible,” and “use mosquito-proof screens on windows and doors.”

A resident of San Cristobal, southeast of Santo Domingo with symptoms of chikungunya fever awaits to be treated in the emergency sector of the Juan Pablo Pina Hospital. (AFP Photo / Erika Santelices)
A resident of San Cristobal, southeast of Santo Domingo with symptoms of chikungunya fever awaits to be treated in the emergency sector of the Juan Pablo Pina Hospital

Symptoms of the malaria-like illness include fever, headache, chills, sensitivity to light, and rash, vomiting and severe joint pain, according to World Health Organization (WHO). Occasional cases of eye, neurological and heart complications have been reported, as well as gastrointestinal complaints, it adds. They usually begin three to seven days after infection occurs. The consequences include a long period of joint pains which may persist for years in some cases. Though the virus rarely leads to death, the problem is that there is currently no vaccine available. The treatment only aims at improving the symptoms.

According to WHO, Chikungunya was first described during an outbreak in southern Tanzania in 1952, eastern Africa, and since then has been detected in nearly 40 countries in Asia, Africa, Europe and also in the Americas.

The Pan American Health Organization says that about 165,000 cases have been either suspected or confirmed in the Caribbean since it was first documented in 2013-2014 with 14 death cases. Most of the cases have been detected in Dominican Republic, Guadalupe, Martinique and Haiti.