MESSAGE FROM THE UNITED STATES EMBASSY TO U.S.A. CITIZENS RESIDING IN NICARAGUA In case you have not seen it yet... Occurrence of Chikungunya and Prevention Tips -- November 25, 2014 This message is to inform U.S. citizens of a recent wave of new chikungunya cases in Managua and provide some guidance for preventing the disease. The Nicaraguan Ministry of Health (MINSA) has reported that there have been 1,097 laboratory-confirmed cases of chikungunya since July 2014, the vast majority occurring in Managua. About two weeks ago, they began to notice an increasing number of infections diagnosed each day throughout the city. At its apparent peak last week, 100 new infections were diagnosed each day. New diagnoses have dropped to under 40 per day this week, producing the hope that the epidemic is being brought under control through MINSA’s intensive mosquito-spraying program. MINSA has been spraying cypermethrin in the neighborhoods on a weekly basis and instructing residents to drain standing water pools. Cypermethrin is an EPA-approved pesticide that is used in the U.S. Although it is relatively safe to humans in small doses, we recommend that you remain indoors, with windows closed, and keep your pets indoors with you while your neighborhood is being sprayed. Chikungunya (“chik-en-gun-ye”) is a self-limiting disease caused by a virus and transmitted by the bite of an infected Aedes aegypti or Aedes albopictus mosquito. These are the same mosquitoes that transmit dengue fever and yellow fever. The female Aedes mosquito requires a blood meal for her eggs to develop. She has an almost imperceptible bite and will often bite several people to complete a single blood meal. She is a sneaky feeder and seems to prefer biting heels and elbows. Although she can feed any time of the day or night, she has increased biting activity two hours after sunrise and several hours before sunset. In order to transmit chikungunya or dengue fever, she must first bite someone suffering from the infection and then survive the incubation period. Since the Aedes mosquito flies only about 100 meters in its lifetime, a mosquito that is exposed to a large number of transient people is more likely to be a carrier of the infection (e.g., grocery stores, malls, churches, schools, and markets). Chikungunya was first described during an outbreak in southern Tanzania in 1952. Outbreaks have since occurred in Africa, Asia and the Indian subcontinent. In late 2013, the virus was found on the Caribbean island of St. Martin and has since spread throughout the Caribbean and Central America. Chikungunya is believed to come from a Kimakonde word which means “that which bends up” and describes the stooped appearance of sufferers with joint pain. The symptoms of chikungunya are: Abrupt onset of fever/chills to 40 C (104 F). The fever usually lasts 2 – 10 days. Severe joint and tendon pain, usually in the small joints of the hands, wrists, feet and ankles. In a small number of people, joint aches and stiffness can last for months. Headache Muscle pain Joint redness and swelling Nausea and vomiting Abdominal pain Flushed skin, followed by a pink-red rash when the fever breaks Sore throat Red eyes and sensitivity to light Diagnosis is confirmed by a blood test. In Nicaragua, only MINSA laboratories are performing the test. However, most hospital and private laboratories are willing and able to draw the blood sample, forward it to MINSA for testing and then report the results to the patient. There is currently no vaccine to protect against infection and no effective treatment. It is a self-limiting infection with an extremely low fatality rate. Chikungunya-related deaths usually result from complications of pre-existing conditions. Treatment is aimed at relieving the symptoms. This includes oral fluids, bed rest, and acetaminophen (Tylenol) for pain. Chikungunya can be prevented, however. Decreasing the mosquito population around your residence is important. Since larvae develop in clean water, empty all water-filled containers or puddles in the yard that can support mosquito breeding. If you cant empty water, add a little chlorine (bleach) or Abate/Temphos to kill the larvae. Keep your screen doors closed and make sure your window screens are in reasonably good shape. Most importantly, wear clothing that minimizes skin exposure to the day-biting mosquitoes and apply repellants like DEET and Picaridin, especially when visiting areas where people congregate like grocery stores, churches, schools and malls.
Posted on: Wed, 26 Nov 2014 00:55:25 +0000
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