6 June Posted: As of May 30, 2014, 103,018 suspected and 4406 laboratory-confirmed chikungunya cases had been reported from Anguilla, Antigua and Barbuda, British Virgin Islands, Dominica, Dominican Republic, French Guiana, Guadeloupe, Guyana, Haiti, Martinique, Puerto Rico, Saint Barthelemy, Saint Kitts and Nevis, Saint Lucia, Saint Martin, Saint Vincent and the Grenadines, and Sint Maarten. The CDC defines a suspected case as a patient with acute onset of fever higher then 101°F (>38°C) and severe arthralgia or arthritis not explained by other medical conditions who lives in or has traveled to epidemic or endemic areas within 2 weeks before symptom onset. A confirmed case also requires laboratory evidence of recent chikungunya virus infection (viral isolation, reverse transcription–polymerase chain reaction, immunoglobulin M antibodies, or at least a 4-fold increase in virus-specific neutralizing antibody titers). With the recent outbreaks in the Caribbean and the Pacific, the number of chikungunya cases among travelers visiting or returning to the United States from affected areas will likely increase, the authors write. These imported cases could result in local spread of the virus in other parts of the United States. Recommendations for Clinicians: Clinicians should consider chikungunya virus infection in patients with acute onset of fever and polyarthralgia, particularly if they have recently returned from areas with known virus transmission. The CDC, 3 state health departments (California, Florida, and New York) and 1 commercial laboratory (Focus Diagnostics/Quest Diagnostics) currently perform chikungunya virus diagnostic testing. Because no specific treatment, vaccine, or preventive drug is currently available for chikungunya virus infection, treatment is palliative, including rest, fluids, analgesics, and antipyretics. To prevent further transmission, infected persons should be protected from mosquito exposure during the first week of illness. The best way to prevent chikungunya virus infection is to avoid mosquito bites by indoor use of air conditioning or screens and outdoor use of insect repellents, long sleeves, and pants. Clinicians should report chikungunya cases to their state or local health department, which should in turn report confirmed chikungunya virus infections to CDC through ArboNET, a national passive surveillance system for arthropod-borne diseases. CDC and the Council of State and Territorial Epidemiologists urge health departments to perform surveillance for chikungunya cases in returning travelers and be aware of the risk for possible local transmission in areas where Aedes species mosquitoes are currently active, the report authors conclude.
Posted on: Fri, 06 Jun 2014 23:23:52 +0000
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