Reunion Island Chikungunya
Outbreak Now 40,000 Cases
From Patricia Doyle, PhD
This appears to be a serious Chikungunya outbreak. Has the patogen mutated? This outbreak, which is seriously underestimated, appears to have complications of myelo-meningo-encephalitis. There is an unidentified illness in Angola which has symptoms quite similar to the symptoms we are seeing in Reunion Island.
Has this illness spread beyond Reunion? Chikungunya is transmitted by the bite of an infected mosquito. The numbers of cases are high for a mosquito borne virus.
More information on the current virus sequence would be needed to determine if the virus has mutated to a more deadly form.
Patricia Doyle
From Lionel Suzon
I'm a doctor at the southern end of Reunion Island. First of all, almost everybody here, especially doctors, agree that the epidemic is underestimated. According to an unofficial estimate by the "Conseil Departemental de l'Ordre des Medecins", there would be almost 40 000 cases.
2 weeks ago, I was personally seeing about 5 new cases of chikungunya fever each day, whereas there were officially about 100 new cases a week for the entire island. The epidemic began 11 months ago and was focused in a limited number of areas. During the last week, the epidemic has become explosive and out of control, but I was on holiday, so I didn't notice it personally. On Monday, when I'll be back to work, I'm afraid the number of new cases will be much higher.
This disease is usually considered a benign one, and this is also my clinical impression, even if some patients suffer arthralgias or stiffness for months. But some unexpected complications have occurred here: several cases of myelo-meningo-encephalitis have been reported, some in neonates, with a strong suspicion of maternal-foetal transmission. Some wonder if we will see the first-ever fatal case of chikungunya.
Fear, as fever, is now spreading in the population. Unfortunately, communication is mainly controlled by local press and politicians. I would personally prefer a recognised expert.
ProMed Mail
Dr. Suzon's report is greatly appreciated by ProMED-mail. Chikungunya is characterized by a brief febrile episode, persistent arthralgia in some cases, but not by mortality. It is thus rather different from dengue infection. The latter can develop into dengue haemorrhagic fever and shock syndrome, which tends to be fatal. In the wake of the current widespread epidemic of chikungunya, local health professionals worry that some fatalities may result from complications without timely and effective public health measures. - Mod.RY
"Chikungunya is a rare viral infection transmitted by the bite of an infected mosquito. It is characterized by a rash, fever, and severe joint pain (arthralgias) that usually lasts for three to seven days. Because of its effect on the joints, Chikungunya has been classified among the Arthritic Viruses. It primarily occurs in tropical areas of the world."
--Patricia Doyle
Patricia A. Doyle, DVM, PhD- Bus Admin, Tropical Agricultural Economics
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