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ECDC Assessment - Chikungunya outbreak in Caribbean region - 25 June 2014

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  • ECDC Assessment - Chikungunya outbreak in Caribbean region - 25 June 2014

    ECDC

    Chikungunya outbreak in Caribbean region - 25 June 2014

    RAPID RISK ASSESSMENT

    Autochthonous transmission of chikungunya in Caribbean islands and its extension to America: what is the risk for
    the EU?

    Main conclusions and options for action

    ? This is the first documented autochthonous transmission of chikungunya virus in the Americas. The
    outbreak started on the Caribbean island of Saint Martin in early December 2013 and expanded through
    the Caribbean during the first half of 2014. Recently, suspected autochthonous cases have been
    reported from Central America (Costa Rica and El Salvador), raising concern about virus spread in
    continental America where Aedes aegypti is endemic.

    ? Exposure to infected mosquitoes is the principal risk for infection in currently affected areas. Prevention
    of chikungunya among travellers and local residents is essentially based on personal protection against
    mosquito bites and vector control; these are the same as the preventive measures to be taken against
    dengue.

    ? With the present holiday season in Europe, high vigilance must be maintained regarding imported cases
    of chikungunya and dengue in the EU, including awareness among clinicians and travel clinics, notably
    in those EU areas where competent vectors are present.

    ? The risk for onward transmission in Europe is linked to importation of virus by viraemic patients in areas
    with competent vectors (Aedes albopictus on mainland Europe and Aedes aegypti in Madeira).
    Autochthonous transmission from an imported viraemic chikungunya case during the summer season in
    the EU is possible. Madeira is particularly vulnerable due to the presence of Aedes aegypti and
    favourable climatic conditions.

    ? Travellers returning from outbreak areas should seek medical care if presenting with chikungunya
    compatible symptoms and apply personal protection measures to avoid mosquito bites. Such measures
    will reduce the risk of viral introduction in the European mosquito population and furthermore limit the
    establishment of a local cycle of transmission during the summer season.

    ? Preparedness regarding chikungunya in the EU includes strengthened surveillance systems and rapid
    notification of cases; review of contingency plans for mosquito-borne outbreaks; education and
    collaboration of the general public in the control of mosquito breeding sites; strengthened vector
    surveillance systems and rapid implementation of vector control measures around each case.

    ? EU blood safety authorities need to be vigilant regarding the epidemiological situation in the Americas in
    line with measures taken for West Nile virus infection.


    Full document
    ?Addressing chronic disease is an issue of human rights ? that must be our call to arms"
    Richard Horton, Editor-in-Chief The Lancet

    ~~~~ Twitter:@GertvanderHoek ~~~ GertvanderHoek@gmail.com ~~~
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