UK outbreak of chikungunya linked to Caribbean
Public health officials in the UK are grappling with a skyrocketing number of cases of a debilitating mosquito virus as British holidaymakers return from countries where an outbreak is rapidly spreading.
Nearly 200 British tourists have been diagnosed with chikungunya in 2014 as the number of cases has quintupled in a little more than two months, according to figures released by Public Health England on Friday.
Of those, 162 have been associated with travel to the Caribbean and South and Central America, where health experts say the deadly outbreak is likely to get worse.
Public Health England has been made aware of 197 cases of chikungunya in 2014 as holidaymakers are encouraged to cover their skin and wear mosquito repellent if they are travelling to the Caribbean to beat the winter blues.
The latest figures represent a 432 per cent increase from the last update on September 16, when just 37 cases had been reported in the UK.
The countries from which cases have been most frequently reported include Jamaica, Barbados and Grenada.
Dr Jane Jones, travel and migrant health expert at Public Health England, said: ‘Chikungunya is an unpleasant viral illness that can cause fever and joint pains which in some patients may persist for a prolonged period.
“It is spread by mosquitos and is more usually found in parts of Asia and Africa but in recent years we have seen new areas of the world becoming affected, including the Caribbean and other parts of the Americas.”
Dr Dipti Patel, director of the National Travel Health Network and Centre, added: ‘There is no vaccine to prevent chikungunya.
“Anyone returning from affected areas with symptoms such as fever and joint pain should seek medical advice.’
The chikungunya virus, transmitted through infected mosquito bites, has spread to more than 30 Caribbean nations since it was first reported by the World Health Organisation in December 2013, when a case was discovered in St Martin, a French overseas territory.
With more than 700,000 suspected cases and approximately 120 deaths reported, experts are telling tourists to protect themselves if they are heading to the region for winter sun.
Earlier this month, the United States Centers for Disease Control and Prevention (CDC) reported more than 1,600 travellers returning to the US with chikungunya as of November 4.
More cases are being reported every day on the island as victims arrive at hospitals or surgeries with chikungunya symptoms, including fever, headaches, rashes and muscle and joint pain.
The worst of the outbreak in the Caribbean is occurring in the Dominican Republic, Guadeloupe, Haiti and Martinique, where more than 600,000 suspected cases have been reported.
Dr Tim Brooks, head of Public Health England’s rare and imported pathogens laboratory, said: “Chikungunya is now a common infection in travellers from the Caribbean, and is currently reported more frequently than dengue.
‘The Aedes mosquitoes which spread the disease are most active during daylight hours.
“Particular vigilance with bite avoidance should be taken around dawn and dusk.
“Doctors should consider chikungunya in patients with a fever who return from the Caribbean, especially if they have symptoms of arthritis, and test them for the disease.’
Dr Laith Yakob, an infectious disease ecologist with the London School of Hygiene and Tropical Medicine, told MailOnline Travel earlier this month that people should speak to their GP or a travel doctor before their trip.
Once they arrive, they should keep their skin covered during the day, as mosquitoes are ‘day biters’, and regularly apply insect repellent containing DEET, he said.
And they should seek immediate medical attention at the onset of symptoms.
He said: “For most people within three to seven days they’ll have fever, then joint pain in the hands and wrists can persist for weeks or even months.
“The joint pain can spread and can be quite debilitating.”
Normally, the majority of UK cases are associated with travel to South and South East Asia, say experts
Patients are often left bedridden but they can recover within three to five days with proper treatment.
Dr Yakob said the elderly are at particular risk of developing severe symptoms that can result in death.
Trials of an anti-viral drug in the US have had positive results, but there is currently no vaccine commercially available.
A small number of cases result in death and up to 10 per cent of patients suffer from arthritis, chronic joint pain and fatigue.
Complications can include hepatitis, myocarditis (inflammation of the heart muscle), and neurological and ocular disorders.
Dr Yakob said the symptoms of chikungunya and dengue fever, also spread by infected mosquitoes, are similar, so people who believe they are infected should seek a proper lab diagnosis.
The virus does not occur in the UK but Public Health England has been monitoring for signs of infected blood-suckers.
Despite the rise in cases involving tourists who visited the Americas, a majority of UK cases are associated with travel to South and South East Asia, NaTHNaC says.
In October, lab tests confirmed four people contracted the virus in Montpellier, France – prompting fears it could spread to the UK. (DailyMail)