Public Health Authorities Began Preparing for Chikungunya Years Ago
This week is Mosquito Control Awareness Week, so it’s a good time to look at how the Pan American Health Organization and the U.S. Centers for Disease Control and Prevention took a proactive approach to the coming threat of chikungunya virus.
In December, 2013, the first case of “local” chikungunya transmission in the western hemisphere was recorded on the island of St. Martin. Before that, travelers to countries where the virus was established sometimes returned home with infections, but this was the first time that a person who had not traveled had been infected.
American health authorities began noticing increasing numbers of infections among travelers starting around 2006. Between 1995 and 2005, there were only three cases of laboratory-confirmed or probable cases of chikungunya among travelers returning to the U.S. However, between 2006 and 2010, this number jumped to 106 cases.
This drastic increase prompted the Pan American Health Organization and the U.S. Centers for Disease Control and Prevention to meet in Lima, Peru, in July, 2010, to discuss the potential threat of this virus and to examine measures that might be taken to mitigate it.
Their meeting resulted in a document called Preparedness and Response for Chikungunya Virus Introduction in the Americas, which was designed to increase awareness about chikungunya, to lay out the best possible strategies to prevent its importation, and to provide guidance on how to control it if introduced. The document tells how to detect an outbreak of the disease, how to conduct pertinent epidemiological investigations, and how to prevent or mitigate the spread of the disease.
The foresightedness and the importance of that meeting in 2010 and the document they produced has now been proven, as health experts expect chikungunya to become established in North America — it’s not a matter of if, but of when.
Some important points made in the document are:
* It is incredibly painful. The name chikungunya derives from a word in Makonde, the language spoken by an ethnic group in southeast Tanzania and northern Mozambique. It roughly means “that which bends,” describing the stooped appearance of persons suffering from it.
* There is no specific treatment for chikungunya infection, nor any commercially available vaccine to prevent it. Pending the development of a new vaccine, the only effective means of prevention are to protect individuals against mosquito bites.
* It is mainly spread by the yellowfever mosquito (Aedes aegypti) and by the Asian tiger mosquito (Aedes albopictus), both of which are present in North America.
* After a mosquito bites an infected person, it is then able to transmit the virus to another person after about ten days.
* Symptoms — which may include fever, joint pain, headaches, back pain, myalgias, nausea, vomiting, polyarthritis, rashes, and
conjunctivitis — typically occur three to seven days after a person has been bit.
* Although painful and debilitating, it is very rarely fatal.
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