Gert van der Hoek
In Memoriam - Editor, Senior Moderator
ECDC
Chikungunya outbreak in Caribbean region - 25 June 2014
RAPID RISK ASSESSMENT
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
Chikungunya outbreak in Caribbean region - 25 June 2014
RAPID RISK ASSESSMENT
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