Clinical Updates
25 July 2011
Chikungunya virus activity – Global update
This update reports on current and recent chikungunya (CHIKV) outbreaks; it is not a comprehensive listing. Further information on confirmed and suspected CHIKV outbreaks can be accessed via the NaTHNaC Outbreak Surveillance Database.
A map of areas of risk for CHIKV is available from the World Health Organization.
Africa and the Middle East
Republic of Congo
The Republic of Congo has reported a CHIKV outbreak that has caused illness in thousands of people [1]. This is the first time that the Republic of Congo has reported CHIKV [2]. Since the end of May 2011, the capital city of Brazzaville, and Pointe Noire have been affected, and as of 1 July 2011, CHIKV has spread to the neighbouring Pool region [1]. As of 23 June 2011, the total number of reported cases in the country has reached 7,474 [2].
Yemen
Since the end of 2010, an outbreak of CHIKV has been reported in the western coastal province of Hodeidah with 1,000 cases and 75 deaths. This is the first time CHIKV has been identified in Yemen [3].
Islands of the Indian Ocean
Historically outbreaks of CHIKV have occurred in several islands of the Indian Ocean including the Comoros, Madagascar, Mayotte, Mauritius, Reunion and the Seychelles. In 2010, only Reunion reported cases of CHIKV [4].
In 2011, confirmed cases of CHIKV have been reported from Seychelles (one confirmed case) and Madagascar (five confirmed and 102 suspected cases) [5].
Asia and Western Pacific
New Caledonia
Following two imported cases from Indonesia in 2011, the diagnosis of the first indigenous case of CHIKV was confirmed on 3 March 2011 [6-7]. As of 7 July 2011, 33 cases of CHIKV have been reported. Of these, 29 cases were from Noumea, one case from Sarramea and three cases from Dumbéa [6-7].
Malaysia
As of 25 June 2011, a total of 17 cases have been reported, representing a decrease of 98% compared with the same period in 2010, when 684 cases were reported [8].
Singapore
As of 26 June 2011, two confirmed cases of CHIKV have been reported (one imported), compared with 26 cases in 2010 (20 imported) [9-10].
Thailand
As of week 28 in 2011, a total of 90 cases have been reported in 15 provinces of Thailand. To date, the most affected provinces are Southern Province, followed by Central Province, North Province and North-East Province [11].
India
As of 26 March 2011, seven states have reported 1,180 suspected cases of CHIKV. The state of West Bengal has reported most of the cases (504), followed by Tamil Nadu (328) and Maharashtra (154). The remaining cases were reported from Karnataka, Goa and Kerala. [12].
Europe
France
As of 15 July 2011, one case of CHIKV has been confirmed in Provence-Alpes-Côte d'Azur, an area of enhanced surveillance for the disease. The case occurred in a person from Brazzaville, Republic of Congo, who arrived in France and reported symptoms on 3 May 2011 [13].
In 2010, two indigenous cases of CHIKV and four imported cases of CHIKV occurred in the Var department [14].
Advice for travellers
CHIKV is a viral infection of humans and non-human primates transmitted by Aedes spp. mosquitoes. It is endemic in parts of sub-Saharan Africa, the islands of the Indian Ocean, and South and South East Asia. In symptomatic illness there is the sudden onset of fever, headache, myalgia and arthralgia. After 2 to 3 days a generalised maculopapular rash can develop. Most cases recover in 3 to 5 days, however, 5-10 percent of cases can have chronic joint pain, arthritis and fatigue. Treatment is supportive.
There is no vaccine to prevent CHIKV. Travellers to endemic areas can reduce their risk of infection by practising insect bite avoidance measures. Aedes spp. mosquitoes responsible for transmitting CHIKV, are most active during daylight hours. Particular vigilance with bite avoidance should be taken around dawn and dusk.
References
1. Relief Web. The International Federation of Red Cross and Red Crescent Societies, Republic of Congo: Chikungunya outbreak in Brazzaville, Pointe Noire and Pool, 29 June 2011. [Accessed 25 July 2011]. Available at: http://reliefweb.int/sites/reliefweb.int/files/resources/Full_
2. The Integrated Regional Information Network (IRIN), Congo: Chikungunya spreads to Pool region, 1 July 2011. [Accessed 25 July 2011]. Available at: http://www.irinnews.org/report.aspx?reportid=93112
3. EpiSouth. Weekly Epi Bulletin 155. 10 March 2011. [Accessed 21 July 2011]. Available at: http://www.episouth.org/cgi-bin/searchbull?TEMP=_2&QUART=20111
4. Institut de Veille Sanitaire. Chikungunya à la Réunion [in French], 6 May 2011. [Accessed 25 July 2011]. Available at: http://www.invs.sante.fr/regions/reunion_mayotte/pe_rm_chik
5. Institut de Veille Sanitaire. Circulation active dans le sud ouest océan Indien. [in French]. 15 April 2011. [Accessed 25 July 2011]. Available at: http://www.invs.sante.fr/regions/reunion_mayotte/pe_rm_chik
6. Government of New Caledonia, The Department of Health and Social Affairs. [in French]. 6 July 2011. [Accessed 25 July 2011]. Available at: http://www.dass.gouv.nc/portal/page/portal/dass/sante/themes
7. Government of New Caledonia, Communique De Presse. Deux Nouveaux Cas de chikungunya Autochtone aujourd'hui (7 CAS au total). [in French]. 21 March 2011. http://www.gouv.nc/portal/pls/portal/docs/1/14962003.PDF
8. Ministry of Health of Malaysia. Dengue and chikungunya in Malaysia for epidemiological week 25, 2011 [in Malay] [Accessed 25 July 2011]. Available at: http://www.moh.gov.my/press_releases/190
9. Ministry of Health, Singapore. Weekly Infectious Disease Bulletin. Epidemiological week 26, 2011 [Accessed 25 July 2011]. Available at: http://www.moh.gov.sg/mohcorp/uploadedFiles/Statistics/
Infectious_Diseases_Bulletin/2011/2011_week_26.pdf
10. Ministry of Health, Singapore. Weekly Infectious Disease Bulletin. Epidemiological week 52, 2010 [Accessed 25 July 2011]. Available at: http://www.moh.gov.sg/mohcorp/uploadedFiles/Statistics/
Infectious_Diseases_Bulletin/2010/2010_week_52.pdf
11. Bureau of Epidemiology, Department of Disease Control Ministry of Public Health of Thailand. 20 July 2011 [in Thai] [Accessed 25 July 2011]. Available at: http://www.boe.moph.go.th/boedb/surdata/disease.php?ds=84
12. Government of India. National Vector Borne Disease Control Programme. State-wise clinically suspected chikungunya cases in the country. 26 March 2011. [Accessed 25 July 2011]. Available at: http://nvbdcp.gov.in/Doc/Chikungunya-CD-march2011.pdf
13. Institut de Veille Sanitaire. Surveillance épidémiologique en Paca et en Corse. Point épidémiologique au 15 juillet 2011. [In French], 15 July 2011. [Accessed 25 July 2011]. Available at: http://www.invs.sante.fr/fr/Publications-et-outils/Points-epidemiologiques/Tous-les-numeros/Sud/2011/Surveillance-epidemiologique-en-Paca-et-en-Corse.-Point-epidemiologique-au-15-juillet-2011
14. Institut de Veille Sanitaire. Dispositif de surveillance du chikungunya et de la dengue. 24 May 2011. [In French]. 15 April 2011. [Accessed 25 July 2011]. Available at: http://www.invs.sante.fr/fr/Regions-et-territoires/L-InVS-dans-votre-region/Provence-Alpes-Cote-d-Azur-et-Corse/Programmes-de-la-Cire/Dispositif-de-surveillance-du-chikungunya-et-de-la-dengue
Links
HPA: Chikungunya in England, Wales and Northern Ireland
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