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Outbreak Notice
Update: Chikungunya Fever and International Travel
This information is current as of today, September 12, 2007 at 00:40
Updated: September 11, 2007
Chikungunya fever is a viral disease spread to people by the bite of infected mosquitoes, including the Aedes aegypti and Ae. albopictus species. Symptoms can include sudden onset of fever, chills, headache, nausea, vomiting, joint pain with or without swelling, low back pain, and rash. The symptoms are very similar to those of dengue, but, unlike dengue, there is not usually any hemorrhagic (bleeding) or shock syndrome form. This disease almost always resolves on its own and is rarely fatal.
Italian Health authorities have recently reported cases of chikungunya fever in the province of Ravenna, Emilia-Romagna, in northeast Italy. See the In the News: Chikungunya Fever in Italy travel notice for more details. Local transmission has been confirmed. This represents the first time that local transmission of chikungunya virus through mosquitoes has been detected in Europe. Therefore, travelers to the province of Ravenna, Emilia-Romagna, should take steps to avoid mosquito bites (see advice below) and be aware of the symptoms of chikungunya fever.
Other countries that have experienced recent outbreaks of chikungunya include India, Sri Lanka, and the Indian Ocean Islands of Mayotte, Mauritius, R?union (territory of France), and the Seychelles. Travelers to all tropical and subtropical areas of the world are reminded to take precautions to avoid mosquito bites.
Prevention Measures
There are no preventive medications or FDA-approved vaccines for chikungunya fever, but travelers can take steps to reduce their risk of being bitten by infected mosquitoes.
Treatment
No specific drug treatment against chikungunya fever is available; thus, care is focused on treating the symptoms of chikungunya fever; bed rest, fluids, and mild pain medications such as ibuprofen, naproxen, or acetaminophen (paracetamol) may relieve symptoms of fever and aching, provided that there are no medical reasons not to use these medications. Because aspirin can increase the risk of bleeding and possibly increase the risk for Reye's syndrome, it should be avoided during the acute stages of the illness. Few cases are severe enough to warrant hospitalization. All persons with chikungunya fever should be protected against additional mosquito bites to reduce the risk of further transmission of the virus.
For more information about chikungunya fever, see the Chikungunya Fever Fact Sheet.
For more information on protection from mosquitoes, including repellents, see "Protection against Mosquitoes and Other Arthropods" in CDC Health Information for International Travel 2008.
Other Mosquito-related Diseases
International travelers may also be at risk of other diseases from the bites of infected mosquitoes, such as dengue, malaria, Japanese encephalitis, yellow fever, and others.
In addition to the mosquito bite prevention measures listed above, medications are available for prevention of malaria that can greatly reduce the risk of infection (Information for the Public: Prescription Drugs for Malaria). Vaccines are available to prevent yellow fever (See Yellow Fever Vaccination Clinics registry) and Japanese encephalitis.:tiphat: http://wwwn.cdc.gov/travel/contentChikungunyaIndia.aspx
Update: Chikungunya Fever and International Travel
This information is current as of today, September 12, 2007 at 00:40
Updated: September 11, 2007
Chikungunya fever is a viral disease spread to people by the bite of infected mosquitoes, including the Aedes aegypti and Ae. albopictus species. Symptoms can include sudden onset of fever, chills, headache, nausea, vomiting, joint pain with or without swelling, low back pain, and rash. The symptoms are very similar to those of dengue, but, unlike dengue, there is not usually any hemorrhagic (bleeding) or shock syndrome form. This disease almost always resolves on its own and is rarely fatal.
Italian Health authorities have recently reported cases of chikungunya fever in the province of Ravenna, Emilia-Romagna, in northeast Italy. See the In the News: Chikungunya Fever in Italy travel notice for more details. Local transmission has been confirmed. This represents the first time that local transmission of chikungunya virus through mosquitoes has been detected in Europe. Therefore, travelers to the province of Ravenna, Emilia-Romagna, should take steps to avoid mosquito bites (see advice below) and be aware of the symptoms of chikungunya fever.
Other countries that have experienced recent outbreaks of chikungunya include India, Sri Lanka, and the Indian Ocean Islands of Mayotte, Mauritius, R?union (territory of France), and the Seychelles. Travelers to all tropical and subtropical areas of the world are reminded to take precautions to avoid mosquito bites.
Prevention Measures
There are no preventive medications or FDA-approved vaccines for chikungunya fever, but travelers can take steps to reduce their risk of being bitten by infected mosquitoes.
- Use insect repellent on exposed skin surfaces when outdoors, particularly during the day.
- Repellents containing 30% to 50% DEET (N,N-diethyl-m-toluamide) are recommended for adults. Lower concentrations of DEET offer shorter-term protection and require more frequent reapplication.
- Repellents containing picaridin are available in the United States in formulations of up to 15% concentration, which require frequent reapplication. Repellents with higher concentrations of picaridin may be available in some regions outside the United States.
- For additional information regarding the use of repellent on infants and children, please see the ?Insect and Other Arthropod Protection? in Traveling Safely with Infants and Children and the ?Children? section of CDC?s Frequently Asked Questions about Repellent Use.
- Wear long-sleeved shirts and long pants when outdoors.
- Clothing may also be sprayed with repellent containing permethrin or another EPA-registered repellent for greater protection. (Remember: don't use permethrin on skin.)
- Where possible, stay in hotels or resorts that are well screened or air conditioned and take measures to reduce the mosquito population.
- Reduce Aedes breeding sites by emptying standing water that may have collected in containers (e.g., uncovered barrels, flower vases, or cisterns) and either overturning the vessels or covering the opening.
- If illness develops, for the first week of illness, avoid mosquito bites to avoid spreading the infection to local mosquitoes which could then transmit it to other people.
Treatment
No specific drug treatment against chikungunya fever is available; thus, care is focused on treating the symptoms of chikungunya fever; bed rest, fluids, and mild pain medications such as ibuprofen, naproxen, or acetaminophen (paracetamol) may relieve symptoms of fever and aching, provided that there are no medical reasons not to use these medications. Because aspirin can increase the risk of bleeding and possibly increase the risk for Reye's syndrome, it should be avoided during the acute stages of the illness. Few cases are severe enough to warrant hospitalization. All persons with chikungunya fever should be protected against additional mosquito bites to reduce the risk of further transmission of the virus.
For more information about chikungunya fever, see the Chikungunya Fever Fact Sheet.
For more information on protection from mosquitoes, including repellents, see "Protection against Mosquitoes and Other Arthropods" in CDC Health Information for International Travel 2008.
Other Mosquito-related Diseases
International travelers may also be at risk of other diseases from the bites of infected mosquitoes, such as dengue, malaria, Japanese encephalitis, yellow fever, and others.
In addition to the mosquito bite prevention measures listed above, medications are available for prevention of malaria that can greatly reduce the risk of infection (Information for the Public: Prescription Drugs for Malaria). Vaccines are available to prevent yellow fever (See Yellow Fever Vaccination Clinics registry) and Japanese encephalitis.:tiphat: http://wwwn.cdc.gov/travel/contentChikungunyaIndia.aspx