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Chikungunya

Mosquitoes are extremely annoying and can cause painful bites and welts. If you’ve ever had a camping trip spoiled by mosquito bites or have been kept awake at night by the irritating drone of a mosquito in your hotel room or bedroom, you already know that mosquitoes can be a nuisance.

Many people also know that these insects can carry diseases. While West Nile virus and malaria get a lot of attention, fewer Americans have heard of Chikungunya. According to experts, more Americans may soon be hearing about this virus, which has traveled to the Caribbean, Jamaica, Florida and other parts of the Americas.

     

    What is Chikungunya?

    Chikungunya is a virus that affects people and is transmitted by mosquito bites. Specifically, the virus is usually spread through Aedes aegypti and Aedes albopictus mosquitoes. These two types of mosquitoes are very common throughout the world, especially in warmer locations such as Asia, Africa, parts of Central and South America as well as the Southern areas of the United States. Both Aedes aegypti and Aedes albopictus mosquitoes are notable because they have white stripes and markings on their legs and bodies.

    How to Pronounce Chikungunya

    Chikungunya is pronounced chik-en-GOON-ye. The word comes from the Makonde language of Africa. In that language, Chikungunya means “bent over in pain” or “bent up,” indicating how much patients suffer with this painful virus.

     

    Is Chikungunya Contagious

    Yes, the virus is contagious. It is spread through mosquito bites. During the first week that someone is infected, the virus is found in their blood. If during that week the infected person is bitten by a mosquito, the mosquito can then pass the virus to other people it bites.

    There are two main ways that the virus enters an area:

    • Local transmission. This occurs when mosquitos in a region bite infected patients and then transmit the virus to others who have not been exposed to the virus before. In 2014, the CDC reported the first local transmission cases of the virus in the U.S. Virgin Islands, Florida, and Costa Rica.
    • Imported cases. These occur when someone travels to an area with an outbreak and becomes infected, and then returns home while still ill. About 28 people a year in the United States have been infected in this way between 2006 and 2013, according to the CDC. In 2014, however, this number increased sharply and between May 2014 and January 2015, over 2,300 travelers returned to the United States with the virus.

    Local transmission cases can obviously be dangerous because they prove there are infected mosquitoes in an area, which can create the possibility of an outbreak. However, imported cases can also be dangerous because a patient can be bitten by a mosquito at home, allowing the infected mosquito to transmit the virus, paving the way for local transmission. A local population may not have any resistance to the virus because they have not been exposed to it before, so they may be more vulnerable. This can create the basis for an outbreak.

    As the virus travels to new countries and territories, there is also a risk of transmission since doctors may not identify the virus. A patient who travels to a foreign country and returns with a fever or who becomes one of the first patients to get the virus through local transmission might stump local doctors, who have not seen the virus before. That patient may have a difficult time getting the right medical help and might not get important information about preventing the spread of the virus.

    In theory, the virus can be spread through blood transfusions, although there are no known cases of this type of transmission happening. There is also a small risk that the virus can be spread from a mother to her child during childbirth, although this is also rare. The virus cannot be shared through human saliva, kissing, breastfeeding, sharing food, or generally through human contact. Almost all cases involving the virus come from mosquito bites.

    Where Is Chikungunya Found?

    A Chikungunya outbreak can technically occur in any country with mosquitoes. In the past, outbreaks have occurred in Europe, the Indian Ocean, Asia, Africa, and the Pacific Ocean. In 2013, however, cases of the virus were found in the Caribbean, leaving some experts worried that the virus could eventually spread to other areas. Since 2013, reports of the virus have been found in territories all across the Americas. By May 2015, more than 1.4 million cases had been reported.

    One concern is that the mosquitoes that carry and transmit the virus live in many parts of the United States, meaning that outbreaks of Chikungunya could potentially happen in Florida and other parts of the South. Chikungunya can also pose a risk in Costa Rica, Mexico, and other warm areas of the Americas where mosquitoes can be found.

    According to the Costa Rica Health Ministry, as of January 2015, 106 people in that region had been infected with the virus, with 70 of those cases occurring through local transmission. By late 2014, eleven local transmission cases of the virus were reported in Florida. In Puerto Rico, more than 10,000 people had been affected by the virus. Also in late 2014, Jamaica declared a state of emergency after more than 800,000 suspected cases of the virus were reported in the Caribbean.

    It’s important to note that rates of infection may eventually become higher as the disease spreads. The numbers may already be higher because not all patients experience strong symptoms that require a visit to the doctor. Some may assume they have the flu and not realize they had the virus when they get better a week later.

    Anywhere travelers go, they can bring the virus with them. There’s a risk that the virus will be imported to new areas by infected travelers, where it can become an outbreak. Where there is an outbreak, it can affect 38% to 63% of the local population.

    One of the risks in the United States and other territories is that some regions provide fertile ground for the virus. Warm climates where Aedes aegypti and Aedes albopictus mosquitoes can live can easily become areas of outbreaks. A traveler may return with the virus from another destination and get bitten by local Aedes aegypti and Aedes albopictus mosquitoes, only to have those insects spread the virus. Many U.S. states have Aedes aegypti and Aedes albopictus mosquitoes, including parts of Texas and part of the South.

     

    Symptoms of Chikungunya Virus

    Chikungunya symptoms can vary from person to person, but can include:

    • Fever
    • Severe joint pain
    • Rash
    • Significant swelling of the joints
    • Muscle pain
    • Headache

    Symptoms usually show up within 3 days or a week of being bitten. In most cases, patients will recover in a week from the symptoms, although recovery times can last months or even years in some cases.

    If you think you may have the virus, speak to a doctor who can offer a Chikungunya diagnosis as well as medical treatment. Although there’s currently no known medication to treat the condition, doctors can help monitor the patient and can help treat symptoms. In addition, you may be asked to take steps to avoid transmitting the virus.

    If you have been bitten by a mosquito and experience fever or any serious symptoms, it’s important to check with a doctor, even if you are not sure whether you have been exposed. A doctor can run blood tests to evaluate whether you have been affected and can offer advice and help if you have.

    Is Chikungunya Fatal?

    The virus is not considered fatal and it does go away in most cases. In fact, someone who has been infected once is usually protected from later infections. If you have had the virus and are bitten by a mosquito carrying the virus again months later, you’re unlikely to catch the virus again.

    Although it’s not usually fatal, Chikungunya can sometimes lead to very painful and even debilitating symptoms. Some patients experience incapacitating joint pain and swelling for months or even years after infection. In some cases, the pain and swelling can be serious enough to become a disability.

    Infants and the elderly are more vulnerable to this virus. If the virus affects a vulnerable person or someone with additional medical problems – such as hypertension or heart disease, for example – Chikungunya can cause serious complications that could potentially be life-threatening. Infants can also succumb to the virus because their smaller systems may not be able to handle it easily.

     

    Treatment for Chikungunya

    Most healthy adults do not require a hospital stay with this virus. However, the pain is significant enough that patients may need to rest at home in bed for a week, or even a few weeks. Doctors may prescribe paracetamol, ibuprofen, naproxen, or acetaminophen for the pain and fever. In addition, patients need to drink plenty of fluids because the high fever can lead to dehydration. Patients are often told to sleep under a mosquito net or to take other precautions to help prevent mosquito bites that could transmit the virus to others.

    Patients should be watched carefully. The intense pain and the high fever can lead to weakness, dehydration and potentially other complications – especially in patients with underlying conditions. The elderly and individuals with serious conditions other than the virus may need to be admitted to the hospital if they develop difficulty breathing or other complications due to the pain and high fever of the virus.

    Chikungunya Prevention and Treatment

    Preventing Chikungunya starts with avoiding mosquito bites. You can reduce your chances of mosquito bites in a few ways:

    • Use insect repellant during mosquito season if you’re going to be outside. There are plenty of insect repellants on the market, including products that contain DEET, para-menthane-diol products, picaridin, IR3535, and oil of lemon eucalyptus. All can be effective, but make sure you read and follow the instructions on the bottle carefully and re-apply as needed.
    • Use window screens and air conditioning to keep mosquitoes out of your home or hotel room. You can also buy mosquito nets to place over your windows and beds to offer additional protection.
    • Wear long pants and long-sleeved clothing where possible. Covering up more skin makes you less of a target because mosquitoes may not be able to get to your skin as easily.
    • Read about Chikungunya travel advisories before traveling. When traveling, be sure you understand whether you need to take additional precautions. You can check the CDC website for more information about where the virus can be found, as well as for updates about outbreaks. If you’ll be traveling somewhere where the virus is present, use extra precautions to avoid mosquito bites. For example, check that your hotel room has window screens and air conditioning and bring a mosquito net as well as mosquito repellant.
    • If you’ll be sitting outside, use mosquito coils, sprays, repellants, citronella candles, and mosquito traps. Do not rely on only insect repellant if you plan to spend considerable time outdoors. Use several methods to prevent mosquitoes from getting near.
    • Use extra caution during daytime activities. The Aedes aegypti and Aedes albopictus mosquitoes, the two types of mosquitoes most often responsible for spreading the virus, are most active during the day.

    Is There a Chikungunya Vaccine?

    Currently, there is no known vaccine for the virus and no treatment or medication for the condition. However, it’s still important to visit a doctor if you think you may have the symptoms. A medical professional can offer treatment for some of the symptoms of the condition.

    Preventing Disease by Battling Mosquitos

    One of the most effective ways to prevent Chikungunya is to reduce the number of mosquitoes and insect bites that can occur. There are a few ways to do this:

    • Empty out standing water. Standing pools of water, such as shallow pools of water, puddles and buckets of water can all be breeding grounds for mosquitoes. If water accumulates in flower pots or any containers, dump out the water rather than let it sit.
    • Evaluate the water near your home. Do you have bird baths, a reflecting pool or other water near your home? Running water in fountains is not a problem, and neither is pool water (thanks to the chemicals that keep your pool clean). If you have bird baths, water dishes or a rain barrel, however, consider keeping the containers covered with a fine wire mesh or replacing the water frequently.
    • Use mosquito traps. The cornerstone of Chikungunya prevention is to reduce the number of mosquitoes and mosquito bites. One way to do this is with mosquito traps. Each trap may work differently. Mosquito Magnet® traps, for example, work by generating carbon dioxide (CO2) from propane and then releasing moisture, heat and CO2 to attract mosquitoes, so they can be sucked into a vacuum. They are designed to mimic human breath that female mosquitoes are attracted to. Once mosquitos enter the traps, they are killed, preventing them from reproducing or biting. Unlike sprays and insect repellants, traps can work in a variety of environments and can work continuously.

    Chikungunya is a serious virus that can affect you for days or even months. The pain you may face with this virus is intense, and if you have a serious condition, Chikungunya may even be life-threatening. To protect yourself and your loved ones, stay alert to outbreaks and take steps to prevent mosquito bites.