Given the major Ebola outbreak in West Africa, some governments throughout the world seem to be teetering on hysteria. In some cities of the United States, for example, schools have put teachers on leave and barred children from West Africa to enroll unless they show a health certificate, and parents have pulled their children from school. These decisions have been made based on unfounded information and deserve a second look to prevent measures that could be excessive and counterproductive.
Without neglecting the attention that Ebola deserves, more pertinent consideration ought to be given to an infectious disease spreading throughout the Americas since it has been classified as an epidemic in some areas of the continent. This disease can cause significant complications and may even lead to death under certain circumstances.
What is this disease? We are talking about the Chikungunya virus, a name that comes from the Makonde language and which translates ‘to bend up’.
Chikungunya is transmitted through the bite of mosquitoes, Aedes aegypti and Aedes albopictu, the former also responsible for the transmission of Dengue fever. The virus is native to Africa and Southeast Asia, and produces a syndrome that resembles Dengue fever, featuring headache, muscle and joint pain, high fever (104°F), and in some occasions, a generalized rash. Occasionally, usually in elderly patients, it can lead to severe complications and death.
The incubation period takes 7 days on average, with symptoms that usually last a week. However, a considerable number of patients report the persistence of articular pain months after the onset of the initial symptoms. Currently, there is no specific treatment or vaccine against the Chikungunya virus, limiting the therapeutic options to ameliorate symptoms and preventing complications by taking painkillers and drinking an increased volume of liquids.
The virus is relatively new to the region. For decades, Chikungunya only appeared rarely in the Western Hemisphere, when travelers who acquired the infection abroad came back. Everything changed in December of 2013, when the first cases of native transmission —i.e., patients who acquired the disease locally— were reported in the Caribbean island of Saint Martin.
By August of 2014, 31 nations in the Western Hemisphere reported native transmission, including the United States, Panama, El Salvador, Costa Rica, Venezuela, Surinam, Guyana, and most of the countries in the Caribbean. By the first week of September, the Pan-American Health Organization (PAHO) reported 8,210 confirmed cases of native transmission, as well as 37 fatal cases —mainly in the Caribbean. If this trend continues, most countries in the Americas will have cases of native transmission in the oncoming months.
Organizations and health care professionals face some particular challenges regarding Chikungunya’s prevention, detection and treatment:
• Lack of Knowledge: Since this is a relatively new disease in the region, most health professionals are largely unaware of the illness and its symptoms, potentially leading to non-diagnosed or misdiagnosed cases.
• Diagnostic Challenges: Taken into account that the virus features similar symptoms with Dengue Fever, it is difficult to clinically distinguish between them. Although laboratory tests can differentiate between the 2 viruses, their costs are relatively high, especially, when taking into account that the areas in which Dengue Fever is endemic tend to be rural, and/or in need of health resources. Telling apart these two viruses is important given their follow-up and prognosis: Chikungunya virus tends to produce fewer rates of hemorrhagic complications and generates more long-term complications —chronic joint pain—than Dengue Fever.
• Expanded Transmission: Considering that one of Chikungunya’s vectors, the Aedes albopictu, is tolerant to cold temperatures, it is possible that the disease could spread to regions which have previously been free of tropical diseases.
The measures to prevent Chikugunya infection include similar practices to those preventing other diseases transmitted by mosquitoes, such as:
• Long-sleeved clothes
• Repellent
• Mosquito-nets, ideally sprayed with insecticide
In order to decrease mosquito proliferation, it is also ideal to:
• Avoid stagnant water in daily life activities since these are environments where larvae reproduce and grow
• Frequently change water in vases
• Dispose of old tires
• If the house has water tanks, place small fishes that feed on larvae
What measures are you taking to avoid the expansion of the Chikungunya virus? Are you going to inform your community about this new virus?