Chikungunya pandemic reaches Europe
Chikungunya is a virus disease transmitted by Aedes mosquitoes. The virus was first isolated in 1953 in Tanzania. Chikungunya virus is a member of the genus Alphavirus in the family Togaviridae. The disease typically consists of an acute illness characterised by fever, rash, and incapacitating arthralgia. The word chikungunya, used for both the virus and the disease, means “to walk bent over” in some African languages, and refers to the effect of the joint pains that characterise this dengue-like infection.
Now the virus appears to have become established in Europe. The Ministry of Health in Italy has confirmed about 160 cases of chikungunya in the Ravenna region in northern Italy. Serological testing and PCR confirmed the diagnosis of chikungunya fever. In addition, the virus was detected by PCR in Aedes albopictus mosquitos, which is considered to be the most likely vector for this outbreak.
The index case for this outbreak is believed to be a person coming from an affected area in the Indian subcontinent who arrived in Italy on 21 Jun 2007 and developed symptoms two days later. In the majority of the Italian patients, the disease was mild and self-limiting. Preliminary data show that fever lasted for a few days in most patients and a macular rash (red spots) appeared in more than 50% of cases; however, arthralgia (joint pain) was intense and often persistent even after the abatement of fever. Only one death occurred, in an 83-year-old man with severe underlying conditions.
Aedes albopictus (often referred to as the “tiger mosquito”) is known to be present in areas of several European countries, including Albania, Italy, France, Belgium, Montenegro, Switzerland, Greece, Spain, Croatia, the Netherlands, Slovenia, and Bosnia and Herzegovina. The European Centre for Disease Prevention and Control (ECDC) is currently working with the health authorities in Italy, the European Commission and partners in all Member States to ensure an adequate response at EU level. Epidemiology and entomology experts were consulted in order to best estimate the risk for European citizens visiting areas where chikungunya virus is transmitted. Recommendations to visitors to areas with chikungunya transmission are:
- Use of anti-mosquito devices and wearing long sleeves, especially during the hours of highest mosquito activity;
- Mosquito repellent based on a 30% DEET concentration is recommended; Before using repellents, pregnant women and children under the age of 12 years should consult a physician or pharmacist. For newborn children under three months, repellents are not recommended; instead, insecticide-treated bed nets and protective clothing should be used;
- Pregnant women, immuno-deprived people and people suffering from a severe chronic illness should consult their physicians prior to the travel in order to assess their risk and get recommendations on personal preventive measures.
Related:
- Changing patterns of chikungunya virus
- Chikungunya, an epidemic arbovirosis
- Gabon reports outbreak of Chikungunya virus
