243 travel-related cases of Chikungunya have been reported in the US this year. Our neighbors in the Caribbean and Central America have witnessed an explosion of over 355,000 cases and 21 deaths since the virus was introduced to the region in December of last year.
As of yesterday, the first two cases of home-grown Chikungunya were announced by the CDC. The two patients live 70 miles apart in Southern Florida, neither had traveled recently. The virus causes headache, joint pain, rash and fever. It is similar to dengue fever but with a much smaller mortality rate. Recovery is painful and can take weeks. There is no cure only rest and pain relief for symptoms.
What physicians should look for
A Navy physician inside Sermo talked about the disease last night.
“Because many infections have similar presentations, they are very challenging to diagnose. It is always important to ask about travel in anyone with a fever, what activities they engaged in while on travel (swimming in fresh water, eating local foods, etc.), what vaccinations and prophylactic medications, i.e. doxy or Malarone for malaria they did or did not take. Knowing what diseases are endemic to that area of travel is paramount. There are many great resources you can refer to, such as the CDC and Travex websites.”
According to the CDC, as of July 15th, 73 people in Florida were diagnosed with Chikungunya. The disease spreads by a mosquito biting an infected person and then biting a second uninfected person. The best line of defense is insect repellent.
“CDC officials believe there will be sporadic local transmission but not a widespread outbreak.
“None of the more than 200 imported chikungunya cases between 2006 and 2013 have triggered a local outbreak. However, more chikungunya-infected travelers coming into the U.S. increases the likelihood that local chikungunya transmission will occur,” said officials.
Two different mosquito species carry the virus, the Aedes aegytpi and A albopictus. They reside in the southeastern part of the US, up the East Coast through the Mid-Atlantic, the lower part of the Midwest, and parts of the Southwest.
Puerto Rico declares epidemic
While the US mainland is just beginning to see local cases, the virus is firmly established in Puerto Rico which has just declared an epidemic to free up resources to help combat the problem.
So far over 200 cases have been reported as of June 25th. Officials are urging people to drain standing water, cover skin with clothing and repellent and make sure doors and windows have proper screens.
As a physician, have you seen a case of Chikungunya yet? What do you think about the disease’s spread since its arrival in the Caribbean in December? Will you change your screening process for suspicious cases?
We will be discusses this and more inside Sermo, our physician community. If you’re an M.D. or D.O., please join us.
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