THE SPREAD AND SPREAD OF CHIKUNGUNYA: MOSQUITO JUST GOT DEADLIER. FACTS BEYOUND THE HEADLINES. In 2014 an outbreak of Chikungunya has spread across the Americas The mosquito-borne virus causes debilitating symptoms such as joint pain More than 1 million people have been infected and 155 have died There is no treatment or vaccine, making prevention the main strategy for control Vital Signs is a monthly program bringing viewers health stories from around the world. Its name means bending over in pain. It has no treatment or vaccine. Its symptoms resemble Dengue fever. And it has infected more than 1 million people -- 155 of them fatally -- since spreading to the Americas one year ago. The mosquito-borne Chikungunya virus has long been diagnosed in travelers returning from countries in Asia and Africa, where the disease is widespread. But in December 2013, the first people infected by mosquitoes local to the region were reported on the Caribbean island of Saint Martin. This was the first outbreak of the debilitating disease in the Western hemisphere, health officials said. All countries in Central America have now reported local transmission of Chikungunya [pronounced chik-un-GOON-ya], and the United States had 11 confirmed cases of local infection this year as of December 12, all in the state of Florida. There also have been 1,900 imported cases across the U.S. in returning travelers. It wasnt until 2013 that unfortunately a traveler resulted in local transmission of Chikungunya, said Erin Staples of the U.S. Centers for Disease Control (CDC), referring to the people infected in Saint Martin. Those infected carry the virus in their bloodstream; it can then be picked up by mosquitoes as they bite, making them carriers. The virus has since spread rapidly and shows no signs of leaving, as ecological conditions are perfect for the disease to flourish. We knew it would spread, said Staples, a medical epidemiologist. The big question perplexing officials: Why now? Two mosquito species primed to the temperatures of Central and South America carry Chikungunya. The species -- Aedes aegypti and Aedes albopictus -- also carry the virus behind Dengue fever. Given the level of Dengue in the region, we knew there could be the same levels of Chikungunya, Staples said. Both diseases can cause joint pain and inflammation, headaches, rashes and fever, and can lead to death in rare cases. But this tropical disease with an exotic name (which originates from the African Makonde dialect) causes more intense joint pain and inflammation. For some people the pain can last for months or years, resulting in additional psychological strain. The lack of immunity among people living in the Americas provided a blank canvas for Chikungunya to spread throughout the population this year. As of December 12, more than 1.03 million people have been infected, in addition to the 155 who died, according to the Pan-American Health Organisation (PAHO). Almost all of the fatalities occurred in the Caribbean island countries of Guadaloupe and Martinique. Where we saw the biggest jump was after it reached the Spanish-speaking countries in the region, said Staples, referring to the weakened infrastructures and health systems of countries such as the Dominican Republic, which has reported more than 520,000 cases -- more than half of the overall outbreak and 5% of the island countrys population. As South American countries approach their summer, numbers are expected to rise there as the mosquitoes flourish in the heat. Brazil, Peru, Paraguay are coming into their summer months and reporting their first local transmission, Staples said. Already, more than 2,000 people have been infected in Brazil. Is there cause for concern? Because infection with Chikungunya is rarely fatal, the issue of most concern to officials is the burden on health services and the impact of the debilitating symptoms on the economy. The high number of cases can overload health services, says Dr. Pilar Ramon-Pardo, regional adviser for PAHO, the regional office of the World Health Organization. Until recently, monitoring for Chikungunya was not part of routine surveillance in the region. Clinicians have to be ready to diagnose, she said About 20% to 30% of cases are expected to become chronic, with symptoms such as arthritis and other rheumatic manifestations leading to physical disabilities, Ramon-Pardo said. Further long-term effects are psychological as people become more depressed and tired. All of this can result in missed work and lower school attendance, she said, hurting local economies. Is it here to stay? The warm climate of the region offers potential for Chikungunya levels to be maintained for years to come, just like Dengue fever. But areas of most concern are the tropics.
Posted on: Wed, 31 Dec 2014 10:06:24 +0000
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