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Chikungunya Spreads -
US, Taiwan, And Sri Lanka

A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases

By Fernando Quintero
Rocky Mountain News
11-25-6

At least 2 Coloradans returned home recently from Asia and East Africa with chikungunya, an infectious disease transmitted by mosquitoes.
 
According to the national Centers for Disease Control and Prevention's website, the disease can cause fever, headache, nausea, joint pain and other symptoms. No deaths related to the infection have been documented [True in the USA; mortality has been reported in the Indian Ocean and India epidemics. - Mod.TY]
 
Chikungunya is among several types of mosquitoborne diseases that people can contract when they travel abroad, said John Pape, an epidemiologist with the Colorado Department of Public Health and Environment. "Each year, we get reports of dengue, malaria, and other diseases from travelers," Pape said. "There is no outbreak of these diseases locally, and it's not mosquito season. So there's really no danger to the general public."
 
But Eileen Farnon, a medical epidemiologist with the CDC, said the disease is nonetheless a concern because mosquitoes may still be prevalent in other parts of the country. She said at least 28 cases have been confirmed nationwide [USA] in 2006.
 
In India and islands of the Indian Ocean, an outbreak of chikungunya has afflicted more than 1.4 million people since March 2005.
 
http://www.rockymountainnews.com/drmn/local/article/0,1299,DRMN_15_5161636,00.html
 
 
(This report cites some additional cases imported into the USA that were reported by the CDC. The risk of introduction of chikungunya virus into the western hemisphere, including the USA, is real. Both vectors, _Aedes aegypti_ and _Ae. albopictus_, are present and even abundant in some areas. In the USA, _Ae. albopictus_ is distributed in the southern to central tier of states and Hawaii, and _Ae. aegypti_ is present from the south eastern states southward through the neotropics. [From answers.com, a definition of 'neotropics': The biogeographic region of the New World that stretches southward from the Tropic of Cancer and includes southern Mexico, Central and South America, and the West Indies. - CopyEd.PG)
 
 
First Chikungunya Fever Case In Taiwan
By Angelica Oung
Taipei Times
11-24-6
 
The country has reported its first ever case of Chikungunya fever, a Center for Disease Control (CDC) official said yesterday.
 
A 13-year-old Taiwanese student was detected with a high fever at Taiwan Taoyuan International Airport on Nov. 20 upon his return from Singapore where he studies.
 
At the time, he said he was suffering from fever and fatigue and after examining a blood sample from the boy, the CDC announced that he had contracted Chikungunya fever.
 
"This disease is very similar to Dengue fever, but less likely to be fatal" said Chou Jih-haw (©P§ÓE), the CDC deputy director-general.
 
Chikungunya fever patients suffer substantial joint pain in addition to Dengue fever-like symptoms such as fever, headaches and muscular aches, Chou said.
 
"When the patient entered Taiwan, heat-registering cameras at the airport indicated that he had a fever" said Chou, "We were able to conduct a blood test on the spot."
 
If the virus is still in its incubating phase, it is impossible to detect carriers at the airport, said Chou.
 
Like Dengue-fever sufferers who are stopped at the airport, the Chikungunya sufferer was allowed to enter Taiwan with no restrictions on movement.
 
However, the sufferer and his family will be medically monitored and the environs of his home sprayed for mosquitos to prevent the potential spread of the disease.
 
"So far, none of his family have come down with the disease," said Chou, "We think the risk of the disease spreading and taking root in Taiwan is small."
 
However, Chou has asked that doctors be on the lookout for apparent Dengue cases that could be Chikungunya Fever.
 
Tseng Shu-hui (´¿"Q´f), deputy director of the CDC's fifth division, said 94 Dengue fever suffers are known to have entered Taiwan this year.
 
Of the 94, two thirds were stopped at the airport after being identified by heat-registering camera technology and the rest were tracked down following alerts from medical professionals.
 
http://www.taipeitimes.com/News/taiwan/archives/2006/11/25/2003337792
 
 
 
Sri Lanka Confirms Chikungunya Viral Fever Epidemic
 
COLOMBO (Reuters) -- Sri Lanka has confirmed an epidemic of the mosquito-borne Chikungunya viral fever, a top health official said on Saturday. Doctors suspect it has infected 5,000 people in the island's far north.
 
Dr. Nihal Abeysinghe, director of the state Epidemiology Department, said pockets of the fever had been detected in Sri Lanka's northwest, south and east, but could not say how many cases had been reported.
 
"We have got some samples down to Colombo and we handed them over to five different laboratories. All five have reported it as Chikungunya," Abeysinghe said. "You could say it is (an epidemic)."
 
"We have confirmed there is an outbreak going on in Kalmunai, Mannar, Batticaloa, Puttalam and some parts of Colombo city," he added. "It is in densely populated pockets."
 
Abeysinghe said he believed up to 60 percent of reported fever cases were due to Chikungunya.
 
"There are several different fevers. Not all fevers reported are Chikungunya," he said, but added that bird flu was "very, very unlikely because there are no respiratory symptoms, no cough or cold or anything like that".
 
However laboratories had yet to confirm whether an outbreak of viral fever in the northern Jaffna peninsula, cut off from the rest of the country for months amid renewed civil war between the state and Tamil Tiger rebels, was Chikungunya as suspected.
 
DENGUE TOO
 
The outbreak comes as Sri Lanka also grapples with a sharp increase in dengue fever cases as monsoon rains create breeding conditions for mosquitoes which carry the diseases.
 
Symptoms of Chikungunya include high fever, joint and muscular pain, severe headaches, body aches and a rash similar to that seen in dengue patients. While the disease is painful, the U.S. Centers for Disease Control and Prevention (CDC) says no deaths from Chikungunya have been documented in scientific literature.
 
Dr. A. Ketheeswaran, director of provincial health services for the Jaffna peninsula, suspects the viral fever spreading in the far north is Chikungunya.
 
"In Jaffna, this viral fever which has the symptoms of Chikungunya is spreading very fast. I find that more than 5,000 people have been infected," Ketheeswaran said.
 
Cut off behind rebel lines, Jaffna residents are living on rations shipped in by sea from the south, and medicines and food are in short supply. Residents said doctors had recommended paracetamol as a fever preventive, but most shops had run out.
 
Abeysinghe said it was very unlikely that Chikungunya caused the death on the peninsula of a Tamil woman suffering from viral fever on Friday.
 
"It is very unlikely to be (due to Chikungunya). There may be a lot of other disease conditions associated with these people who are reported to have died due to Chikungunya," he said.
 
Chikungunya, Swahili for "that which bends up", was first isolated in the blood of a febrile patient in Tanzania in 1953, the CDC said.
 
 
Patricia A. Doyle DVM, PhD
Bus Admin, Tropical Agricultural Economics
Univ of West Indies
 
Please visit my "Emerging Diseases" message board at:
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http://drpdoyle.tripod.com/
Zhan le Devlesa tai sastimasa
Go with God and in Good Health
 


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