Avoiding Chikungunya and Other Mosquitoborne Illnesses
A pediatrician returned home to Minnesota recently after providing voluntary medical service in Haiti. She arrived with “crushing joint pain” from chikungunya (pronounced: \chik-en-gun-ye), a viral infection spread by mosquitoes. The exotic-sounding disease can cause high fever in addition to joint and muscle pain. These symptoms are similar to those of dengue, another mosquitoborne illness that currently threatens the popular FIFA World Cup™ games in Brazil.
Chikungunya is spread by Aedes mosquitoes, which are found throughout much of the world.
According to the Centers for Disease Control and Prevention (CDC), chikungunya is rarely deadly and most people feel better within a week, but for some, joint pain may persist for months. The Minnesota pediatrician declared to the Minneapolis Star Tribune: “I’ve broken a bone. I’ve had other medical issues. I don’t think I’ve ever been in so much pain.”
“That which bends up”
The term “chikungunya” comes from the African Kimakonde language, meaning “that which bends up,” a reference to the stooped appearance of those suffering with joint pain brought on by the virus. Mosquitoes become infected with the virus after biting someone with chikungunya; they then spread the virus when they bite others. CDC notes that people at risk for the most severe symptoms include newborns infected around the time of birth, older adults and people with medical conditions such as high blood pressure, diabetes or heart disease. If you develop symptoms of chikungunya, seek medical attention and be sure to tell your doctor if you have traveled recently.
A Spreading Infection
The World Health Organization reports outbreaks of chikungunya have occurred in Africa, Asia, India and Europe. The virus appeared in the Caribbean region late in 2013; since then, over 100,000 cases have been recorded. CDC is monitoring the spread of chikungunya, which so far has not been transmitted locally on the US mainland. According to a CNN interview with a CDC expert, however, based on a current major outbreak in the Caribbean, “it’s just a matter of time before it starts to spread within the United States.”
Tips for Avoiding Chikungunya1 and Other Mosquitoborne Illnesses
There are no vaccines available to avoid mosquitoborne chikungunya, dengue and West Nile Virus. Control depends upon a multi-barrier approach to mosquito exposure:
- Physical Barriers: Use air conditioning or window/door screens to keep mosquitoes out of indoor areas. Keep screens in good repair. If you are not able to protect yourself from mosquitoes inside your home or hotel, sleep under a mosquito bed net.
- Chemical Barriers: Use insect repellent2 before going to tropical (e.g., the Caribbean region) or wooded areas near water. Be sure outdoor swimming pools and hot tubs are properly chlorinated. If you use both sunscreen and insect repellent, CDC recommends applying sunscreen first, followed by insect repellent.3
- Habitat Protection: Remove standing water where it may collect in depressions, buckets, flower pots and other open containers. These are choice locations for mosquito breeding. If standing water cannot be easily drained, treat with chlorine bleach.
- Clothing: Wear long sleeves and long pants outdoors when possible. Aedes mosquitoes—transmitters of chikungunya and dengue viruses—are most active during daylight hours. According to a CDC Fact Sheet, many of the mosquitoes that transmit West Nile Virus are active from dusk to dawn.
- Transmission to Others: Finally, if you are sick with a mosquitoborne illness, avoiding mosquitoes and their bites will help prevent spreading the virus to others.
A Word to the Traveler: CDC’s interactive Travelers’ Health website can help you stay healthy while away from home.
Ralph Morris, MD, MPH, is a Physician and Preventive Medicine and Public Health official living in Bemidji, MN.
1 Based on CDC “Protect Yourself from Mosquito Bites” and the World Health Organization “Chikungunya”.
2 According to CDC, repellents containing DEET, picaridin, IR3535, and oil of lemon eucalyptus and para-menthane-diol products provide long lasting protection against mosquitoes.
3 Always follow label instructions when using insect repellent or sunscreen.