National 07/17/14 cdc.gov: Media Release – Seven months after the mosquito-borne virus chikungunya was recognized in the Western Hemisphere, the first locally acquired case of the disease has surfaced in the continental United States. The case was reported today in Florida in a male who had not recently traveled outside the United States. The Centers for Disease Control and Prevention is working closely with the Florida Department of Health to investigate how the patient contracted the virus; CDC will also monitor for additional locally acquired U.S. cases in the coming weeks and months. Since 2006, the United States has averaged 28 imported cases of chikungunya (chik-un-GUHN-ya) per year in travelers returning from countries where the virus is common. To date this year, 243 travel-associated cases have been reported in 31 states and two territories. However, the newly reported case represents the first time that mosquitoes in the continental United States are thought to have spread the virus to a non-traveler.
Chikungunya virus is transmitted to people by two species of mosquitoes, Aedes aegypti and Aedes albopictus. Both species are found in the southeastern United States and limited parts of the southwest; Aedes albopictus is also found further north up the East Coast, through the Mid-Atlantic States and is also found in the lower Midwest. It is not known what course chikungunya will take now in the United States.
CDC officials believe chikungunya will behave like dengue virus in the United States, where imported cases have resulted in sporadic local transmission but have not caused widespread outbreaks. None of the more than 200 imported chikungunya cases between 2006 and 2013 have triggered a local outbreak. However, more chikungunya-infected travelers coming into the United States increases the likelihood that local chikungunya transmission will occur. Infection with chikungunya virus is rarely fatal, but the joint pain can often be severe and debilitating. This virus is not spread person to person. There is no vaccine and no specific treatment for infection, but research is underway in both areas. Patients recover in about a week, although long-term joint pain occurs in some people. – For complete rmedia release see http://www.cdc.gov/media/releases/2014/p0717-chikungunya.html
Caribbean Region 07/14/14 cidrap.umn.edu: by Lisa Schnirring – The number of chikungunya infections in an ongoing outbreak in the Caribbean region saw another steep rise last week, with the Dominican Republic again accounting for much of the new activity, along with Guadeloupe and Martinique, according to the latest update from the Pan American Health Organization (PAHO). The total number of suspected and confirmed cases rose to 355,617, an increase of 48,780 from the week before, according to PAHO’s Jul 11 update. Nearly 28,000 of the new cases were reported from the Dominican Republic, while new case numbers were not listed from neighboring Haiti, another outbreak hotspot. Other areas that contributed sizable parts of last week’s increase are Guadeloupe with 11,600 new cases and Martinique with 8,550, according to the PAHO report.
The European Centre for Disease Prevention and Control (ECDC) said in its communicable disease threat update today that most of the affected outbreak areas continue to report cases, “but the situation is particularly severe in the island of Hispaniola (Haiti and the Dominican Republic).” Elsewhere, the first locally acquired chikungunya cases have been detected in Trinidad and Tobago, according to a Jul 13 report from the Trinidad Express newspaper. James Hospedales, MD, executive director of the Caribbean Public Health Agency, said the outbreak appears to be spreading to one new country per week, according to the report. PAHO said the only US territory that saw a notable increase was Puerto Rico, which reported 177 more suspected or confirmed cases for a total of 405 so far. The number of deaths held steady at 21. – For complete article see http://www.cidrap.umn.edu/news-perspective/2014/07/chikungunya-outbreak-exceeds-355000-cases