Week #5 – Chikunyunga Virus comes to America

If you have given blood at your local Red Cross lately, you may have been asked whether you had recently traveled outside the U.S., particularly to the Caribbean Islands and Mexico. The reason is that thousands of U.S. citizens are arriving home with an unwanted souvenir: a mosquito-borne virus known as Chikungunya ( (chih-kihn-GOON'-yuh or chik-en-gun-ye). It leaves the infected person suffering from severe, often disabling joint pain, fever, rash and a host of other problems.  Few U.S. doctors have ever seen a case and many are stumped by the symptoms. More than 2,300 U.S. travelers to the Caribbean and parts of Latin America, South America and Mexico have caught the virus since last May. (“Mosquito virus sickening more travelers to the Caribbean,” 2015).

Chikungunya (CHIKV) is a mosquito-borne viral disease first described during an outbreak in southern Tanzania in 1952. It is an RNA virus that belongs to the alphavirus genus of the family Togaviridae. The name ‘chikungunya’ derives from a word in the Kimakonde language, meaning "to become contorted" and describes the stooped appearance of sufferers with joint pain (arthralgia).  As of January 2015, over 1,135,000 suspected cases of chikungunya have been recorded in the Caribbean islands, Latin American countries and USA. 176 deaths have also been attributed to this disease during the same period. Canada, Mexico and USA have also recorded imported cases (“WHO | Chikungunya,” n.d.). Beginning in 2014, cases were identified in travelers returning from the Caribbean. As of January 13, 2015, a total of 2,344 chikungunya virus disease cases have been reported to ArboNET from U.S. states for 2014. Eleven locally-transmitted cases have been reported from Florida (“United States Geographic Distribution | Chikungunya virus | CDC,” n.d.). 

CHIKV has been responsible for significant human morbidity for (probably) several hundred years; yet in spite of its prevalence, CHIKV epidemiology and mechanisms of virulence and pathogenesis are poorly understood. The 2005–2007 epidemic of CHIKV disease, like the West Nile virus (WNV) epidemics in North America that began in 1999, has served as a reminder that laboratory and field research combined with epidemiological preparedness are essential for timely and appropriate public health response and control measures.(Powers & Logue, 2007)  

Although arthropods (creatures with segmented bodies and jointed limbs – think crabs, spiders and the like) are the most numerous phylum on Earth, and thousands of arthropod species are venomous, they inflict relatively few serious bites and stings on humans. Far more serious are the effects on humans of diseases carried by blood-sucking insects (“Arthropod,” 2015). Mosquitoes, ticks and bed bugs fall into this category and overpopulation of them is known to cause serious epidemics of illness.

 

Now that this disease is beginning to show up in the United States, all of us must be aware of the danger a simple mosquito bite can have. We must be sure to check our surroundings for standing water, a breeding ground for mosquitoes and be vigilant in removing sources for breeding. And it would behoove us to wear clothing that protects our skin from attach as well as using a quality insect repellant. As Arts in Medicine practitioners we can add to the campaign to educate the population about the dangers of this disease as well as how to help control the population growth of mosquitoes. The virus is transmitted from human to human by the bites of infected female mosquitoes. Most commonly, the mosquitoes involved are Aedes aegypti and Aedes albopictus, two species which can also transmit other mosquito-borne viruses, including dengue. These mosquitoes can be found biting throughout daylight hours, though there may be peaks of activity in the early morning and late afternoon. Both species are found biting outdoors, but Ae. aegypti will also readily feed indoors. Other types of mosquitoes present us with other viruses such as Dengue Fever, Yellow Fever, Malaria and Filariasis, to name just a few, we would be wise to eradicate them altogether. 

Because there is no known cure for chikunyunga, and while people do eventually get well, many have lingering joint pain for months, or even years afterwards. For this portion of the population, we can help them cope with their pain by providing activities that take their minds off their pain, such as painting, playing or listening to music.

Arthropod. (2015, February 6). In Wikipedia, the free encyclopedia. Retrieved from http://en.wikipedia.org/w/index.php?title=Arthropod&oldid=645760101

Mosquito virus sickening more travelers to the Caribbean. (2015, February 6). [Text.Article]. Retrieved February 6, 2015, from http://www.foxnews.com/health/2015/02/06/mosquito-virus-sickening-more-travelers-to-caribbean/

Powers, A. M., & Logue, C. H. (2007). Changing patterns of chikungunya virus: re-emergence of a zoonotic arbovirus. Journal of General Virology, 88(9), 2363–2377. doi:10.1099/vir.0.82858-0

United States Geographic Distribution | Chikungunya virus | CDC. (n.d.). Retrieved February 6, 2015, from http://www.cdc.gov/chikungunya/geo/united-states.html

WHO | Chikungunya. (n.d.). Retrieved February 6, 2015, from http://www.who.int/mediacentre/factsheets/fs327/en/