Written by Linda Yau, M.D., F.A.C.P.
December 21, 2014
Are you headed to warmer weather for the holiday break? In addition to bringing sunscreen and your bathing suit, do not forget to pack mosquito repellant if you are venturing to the Caribbean islands. One year ago, the first cases of Chikungunya, a viral illness that causes severe joint pains and fever, were detected in the Americas, in St. Martin, USVI. Since then, the virus has been detected in virtually all the Caribbean islands. Thankfully, unlike Ebola virus, this virus rarely causes death. The symptoms can be quite uncomfortable, so prevention of mosquito bites is key to not getting sick.
The name “Chikungunya” comes from the Makonde language which is spoken in Tanzania and Mozambique and means “that which bends up”, referring to the crippling arthritis symptoms caused by the virus. It was first discovered in 1953 in Tanzania and there have been outbreaks over time in Africa, Asia and South America periodically. Many travelers have not heard of it until it hit the Americas late last year though. The virus is transmitted by two types of mosquitos that bite humans both during the day and at night.
The time period between the mosquito bite and the onset of symptoms is generally 3-7 days. The first symptoms are usually an acute fever and severe joint pains. Headache, muscle aches, rash, nausea and vomiting may also occur. Often it is difficult to tell the difference between Chikungunya and Dengue fever, which is another illness transmitted by the same mosquitos, but that can cause death. Blood tests can be run to determine the difference between Dengue fever and Chikungunya virus. While waiting for the results, patients should not take aspirin or non steroidal anti-inflammatory medicines, as that can exacerbate bleeding which can occur in Dengue fever.
What can you do to avoid this illness? Since there is no treatment or vaccine for Chikungunya, preventing mosquito bites is the wisest course of action. Buy DEET containing mosquito repellants such as Off!, Cutter, Sawyer and apply any time you will be outside. If you do not like DEET, you can use products containing Picardin, Oil of Lemon, IR3535 and PMD. Apply sunscreen first and then the bug repellant. Wear long sleeves, long pants and hat when outside. Try to only sleep in air conditioned rooms or rooms with screens. You should use a mosquito net if sleeping exposed to the outdoors. Often it is helpful to buy permethrin treated clothes which will also repel mosquitos.
If you develop fever, joint pains, muscle pains and nausea or vomiting after travel to a place with Chikungunya, see your physician and tell them about the travel. You can use acetaminophen (Tylenol) to treat symptoms. Avoid using aspirin or ibuprofen until you are sure you do not have Dengue fever. As with other viruses, increase your resting and sleep time and drink plenty of fluids. Avoid further mosquito bites so that there is less chance of transmitting the disease to others.
So if you are one of the lucky vacationers to the Caribbean this year, don’t forget to pack your mosquito repellant and beware of bites!
References: http://emergency.cdc.gov/HAN/han00358.asp
Tags: chikungunya, mosquito bites, travel