Mingus
Well-known member
Published Date 02-APR-2006
Subject PRO/EDR> Chikungunya - China (Hong Kong) ex Mauritius: conf
CHIKUNGUNYA - CHINA (HONG KONG) EX MAURITIUS: CONFIRMED
*******************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>
Date: Fri, 31 Mar 2006 23:04:00 -0500 (EST)
From: Julian W Tang <jwtang49@hotmail.com>
You will be pleased to know that your recent postings of the chikungunya
outbreaks in Mauritius and Reunion helped us to diagnose our 1st-ever case
of chikungunya in Hong Kong SAR -- which was almost certainly imported from
Mauritius.
A 66 year old Chinese man was seen in the Prince of Wales Hospital (PWH)
Infectious Diseases clinic on 24 Mar 2006, after returning from a one-week
stay in Mauritius. He attended the clinic the same day he returned to Hong
Kong. He had already been ill with fever, headache, myalgia, arthralgia,
and a rash for 2 days. He had been visiting relatives in rural parts of
Mauritius (there is a large Chinese population there) and had been bitten
by mosquitoes. The differential diagnosis was dengue fever in the first
instance, but recent postings in ProMED-mail (see archive numbers:
20051231.3716, 20060121.0202, 20050519.1372) alerted us to the fact that he
may also have contracted chikungunya, so this test was also requested.
A sample taken from this clinic visit on day 2 of illness tested positive
for chikungunya by polymerase chain reaction (PCR) and confirmatory
sequencing at the Public Health Laboratory Centre (PHLC). Dengue PCR, IgG and IgM testing were negative at both the PWH and PHLC diagnostic
laboratories. This is the 1st case of chikungunya diagnosed in Hong Kong SAR.The clinical presentations of dengue (a flavivirus) and chikungunya (an
alphavirus) are very similar. The primary mosquito vector [_Aedes aegypti_]
for both these viruses can be found in Hong Kong SAR, where there have been
sporadic cases of dengue previously. In patients presenting with
dengue-like illness, with a compatible travel history, where all dengue
testing has proved negative, chikungunya may now be considered as a
possible alternative diagnosis.
Their incubation periods may be similar (dengue 4-7 days, chikungunya 2-4
days), and both can occasionally give rise to a more severe haemorrhagic
fever, though this is more common with dengue. With chikungunya, as with
dengue, the viraemia is short-lived, with the virus usually only being
detectable for only the first 48 hours with neutralising antibodies arising
by days 5-7.
Chikungunya is endemic in parts of Africa and South ast Asia, including
Vietnam, Thailand, Cambodia, and Burma (Myanmar). It is likely that some
cases in Hong Kong may have been missed, because until now, the
differential diagnosis of chikungunya may have not been considered.
Chikungunya means 'bending up' in Swahili. Interestingly, the word for
dengue also originates from the Swahili word 'dinga', meaning 'break-bone',
due to the severe muscle and joint [pains]. This original Swahili word has
been altered by the American Spanish usage (probably in South America) to
'dengue'.
--
Julian Wei-Tze Tang, MA, PhD, MRCP, MRCPath, FHKCPath
Assistant Professor,
Department of Microbiology,
The Chinese University of Hong Kong,
Prince of Wales Hospital, Shatin,
New Territories, Hong Kong SAR.
<jwtang49@hotmail.com>
[Dr. Julian Wei-Tze's informative feedback on the 1st imported case of CHIK
in Hong Kong is indeed greatly appreciated by ProMED-Mail. ProMED-Digest
presents reports on epidemic outbreaks of timely significance to all
communities, including public health authorities and ordinary subscribers.
The purposes of such postings are better management and understanding of
any infectious diseases, either newly emerging and/or re-emerging, by
responsible organizations as well as the population at large. In the
current situation, many imported cases of chikungunya have been reported
from a number of European countries (see also: 20060304.0695). ProMED has
followed chikungunya transmission closely.
For interactive maps of Hong Kong: please see:
<http://www.google.com/search?hl=en&q=hong+kong+map&btnG=Google+Search>. -
Mod.RY]
[Although the main vector of chikungunya virus, _Aedes aegypti_, was
previously reported in Hong Kong, it is currently reported to be absent.
However, another potential vector, _Aedes albopictus_, does occur in Hong
Kong. This day-biting mosquito breeds in domestic containers such as water
storage pots, discarded tin cans but also in tree holes. Although
transmission is possible in Hong Kong it would depend on whether breeding
sites -- and thus adult mosquitoes -- were near infected people. - Mod.MS]
[see also:
Chikungunya - Indian Ocean update (11): islands, India 20060330.0961
Chikungunya - Indian Ocean update (10): Reunion seq. 20060323.0896
Chikungunya - Indian Ocean update (09) 20060320.0864
Chikungunya - Indian Ocean update (08) 20060316.0819
Chikungunya - Indian Ocean update (07): Madagascar conf. RFI 20060307.0734
Chikungunya - Indian Ocean update (06) 20060304.0699
Chikungunya - Indian Ocean update (05): spread to Europe 20060304.0695
Chikungunya - Indian Ocean update (04): vector 20060302.0664
Chikungunya - Indian Ocean update (03): spread to France 20060225.0619
Chikungunya - Indian Ocean update (02): Reunion 20060224.0609
Chikungunya - India (AP): susp. 20060220.0551
Chikungunya virus vaccine 20060219.0544
Chikungunya - Indian Ocean update 20060218.0525
Chikungunya - Mauritius and Reunion Island (10): Mauritius 20060216.0509
Chikungunya - Mauritius and Reunion Island (09): Reunion 20060214.0491
Chikungunya - Mauritius and Reunion Island (08): Reunion 20060205.0378
Chikungunya - Mauritius and Reunion Island (07): Reunion 20060204.0358
Chikungunya - Madagascar: susp., RFI 20060202.0340
Chikungunya - Mauritius and Reunion Island (06): Reunion 20060203.0343
Chikungunya - Mauritius and Reunion Island (05): Reunion 20060131.0306
Chikungunya - Mauritius and Reunion Island (04): Reunion 20060127.0254
Chikungunya - Mauritius and Reunion Island (03): Reunion 20060124.0230
Chikungunya - Mauritius and Reunion Island (02): Reunion 20060121.0202
Chikungunya - Mauritius and Reunion Island: Reunion 20060102.0007
2005
----
Chikungunya - Mauritius and Reunion Island (04): Reunion 20051231.3716
Chikungunya - Mayotte, Reunion, Comoros 20050913.2707
Chikungunya - Indonesia (Tangerang) 20050717.2059
Chikungunya - Mauritius and Reunion Island (03) 20050624.1770
Deaths at sea - France (Reunion Island): RFI 20050622.1759
Chikungunya - Mauritius and Reunion Island (2) 20050520.1384
Chikungunya - Mauritius and Reunion Island 20050519.1372
Chikungunya - Indonesia (West Lombok) 20050422.1121
Chikungunya - Comoros (Ngazidja) 20050405.0986]
.............................ry/pg
Subject PRO/EDR> Chikungunya - China (Hong Kong) ex Mauritius: conf
CHIKUNGUNYA - CHINA (HONG KONG) EX MAURITIUS: CONFIRMED
*******************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>
Date: Fri, 31 Mar 2006 23:04:00 -0500 (EST)
From: Julian W Tang <jwtang49@hotmail.com>
You will be pleased to know that your recent postings of the chikungunya
outbreaks in Mauritius and Reunion helped us to diagnose our 1st-ever case
of chikungunya in Hong Kong SAR -- which was almost certainly imported from
Mauritius.
A 66 year old Chinese man was seen in the Prince of Wales Hospital (PWH)
Infectious Diseases clinic on 24 Mar 2006, after returning from a one-week
stay in Mauritius. He attended the clinic the same day he returned to Hong
Kong. He had already been ill with fever, headache, myalgia, arthralgia,
and a rash for 2 days. He had been visiting relatives in rural parts of
Mauritius (there is a large Chinese population there) and had been bitten
by mosquitoes. The differential diagnosis was dengue fever in the first
instance, but recent postings in ProMED-mail (see archive numbers:
20051231.3716, 20060121.0202, 20050519.1372) alerted us to the fact that he
may also have contracted chikungunya, so this test was also requested.
A sample taken from this clinic visit on day 2 of illness tested positive
for chikungunya by polymerase chain reaction (PCR) and confirmatory
sequencing at the Public Health Laboratory Centre (PHLC). Dengue PCR, IgG and IgM testing were negative at both the PWH and PHLC diagnostic
laboratories. This is the 1st case of chikungunya diagnosed in Hong Kong SAR.The clinical presentations of dengue (a flavivirus) and chikungunya (an
alphavirus) are very similar. The primary mosquito vector [_Aedes aegypti_]
for both these viruses can be found in Hong Kong SAR, where there have been
sporadic cases of dengue previously. In patients presenting with
dengue-like illness, with a compatible travel history, where all dengue
testing has proved negative, chikungunya may now be considered as a
possible alternative diagnosis.
Their incubation periods may be similar (dengue 4-7 days, chikungunya 2-4
days), and both can occasionally give rise to a more severe haemorrhagic
fever, though this is more common with dengue. With chikungunya, as with
dengue, the viraemia is short-lived, with the virus usually only being
detectable for only the first 48 hours with neutralising antibodies arising
by days 5-7.
Chikungunya is endemic in parts of Africa and South ast Asia, including
Vietnam, Thailand, Cambodia, and Burma (Myanmar). It is likely that some
cases in Hong Kong may have been missed, because until now, the
differential diagnosis of chikungunya may have not been considered.
Chikungunya means 'bending up' in Swahili. Interestingly, the word for
dengue also originates from the Swahili word 'dinga', meaning 'break-bone',
due to the severe muscle and joint [pains]. This original Swahili word has
been altered by the American Spanish usage (probably in South America) to
'dengue'.
--
Julian Wei-Tze Tang, MA, PhD, MRCP, MRCPath, FHKCPath
Assistant Professor,
Department of Microbiology,
The Chinese University of Hong Kong,
Prince of Wales Hospital, Shatin,
New Territories, Hong Kong SAR.
<jwtang49@hotmail.com>
[Dr. Julian Wei-Tze's informative feedback on the 1st imported case of CHIK
in Hong Kong is indeed greatly appreciated by ProMED-Mail. ProMED-Digest
presents reports on epidemic outbreaks of timely significance to all
communities, including public health authorities and ordinary subscribers.
The purposes of such postings are better management and understanding of
any infectious diseases, either newly emerging and/or re-emerging, by
responsible organizations as well as the population at large. In the
current situation, many imported cases of chikungunya have been reported
from a number of European countries (see also: 20060304.0695). ProMED has
followed chikungunya transmission closely.
For interactive maps of Hong Kong: please see:
<http://www.google.com/search?hl=en&q=hong+kong+map&btnG=Google+Search>. -
Mod.RY]
[Although the main vector of chikungunya virus, _Aedes aegypti_, was
previously reported in Hong Kong, it is currently reported to be absent.
However, another potential vector, _Aedes albopictus_, does occur in Hong
Kong. This day-biting mosquito breeds in domestic containers such as water
storage pots, discarded tin cans but also in tree holes. Although
transmission is possible in Hong Kong it would depend on whether breeding
sites -- and thus adult mosquitoes -- were near infected people. - Mod.MS]
[see also:
Chikungunya - Indian Ocean update (11): islands, India 20060330.0961
Chikungunya - Indian Ocean update (10): Reunion seq. 20060323.0896
Chikungunya - Indian Ocean update (09) 20060320.0864
Chikungunya - Indian Ocean update (08) 20060316.0819
Chikungunya - Indian Ocean update (07): Madagascar conf. RFI 20060307.0734
Chikungunya - Indian Ocean update (06) 20060304.0699
Chikungunya - Indian Ocean update (05): spread to Europe 20060304.0695
Chikungunya - Indian Ocean update (04): vector 20060302.0664
Chikungunya - Indian Ocean update (03): spread to France 20060225.0619
Chikungunya - Indian Ocean update (02): Reunion 20060224.0609
Chikungunya - India (AP): susp. 20060220.0551
Chikungunya virus vaccine 20060219.0544
Chikungunya - Indian Ocean update 20060218.0525
Chikungunya - Mauritius and Reunion Island (10): Mauritius 20060216.0509
Chikungunya - Mauritius and Reunion Island (09): Reunion 20060214.0491
Chikungunya - Mauritius and Reunion Island (08): Reunion 20060205.0378
Chikungunya - Mauritius and Reunion Island (07): Reunion 20060204.0358
Chikungunya - Madagascar: susp., RFI 20060202.0340
Chikungunya - Mauritius and Reunion Island (06): Reunion 20060203.0343
Chikungunya - Mauritius and Reunion Island (05): Reunion 20060131.0306
Chikungunya - Mauritius and Reunion Island (04): Reunion 20060127.0254
Chikungunya - Mauritius and Reunion Island (03): Reunion 20060124.0230
Chikungunya - Mauritius and Reunion Island (02): Reunion 20060121.0202
Chikungunya - Mauritius and Reunion Island: Reunion 20060102.0007
2005
----
Chikungunya - Mauritius and Reunion Island (04): Reunion 20051231.3716
Chikungunya - Mayotte, Reunion, Comoros 20050913.2707
Chikungunya - Indonesia (Tangerang) 20050717.2059
Chikungunya - Mauritius and Reunion Island (03) 20050624.1770
Deaths at sea - France (Reunion Island): RFI 20050622.1759
Chikungunya - Mauritius and Reunion Island (2) 20050520.1384
Chikungunya - Mauritius and Reunion Island 20050519.1372
Chikungunya - Indonesia (West Lombok) 20050422.1121
Chikungunya - Comoros (Ngazidja) 20050405.0986]
.............................ry/pg