Aileen M. Marty, M.D.
Director, FIU Health Travel Medicine Program

The Florida Department of Health says two South Florida women are among three cases of Chikungunya fever reported in Florida. The women, from Miami-Dade and Broward Counties, and a third woman from Hillsborough County had recently traveled to the Caribbean where they acquired the infection. Chikungunya is a viral infection primarily spread by two mosquitoes, Aedes aegypti and Aedes albopictus, both already present in Florida. These mosquitoes can acquire the virus when they bite an infected person within the first week of their illness, then the mosquito can pass on the disease when they bite another human. This process could introduce Chikungunya virus to Florida. It was a similar kind of event, involving the same two species of mosquito that introduced dengue to Florida in 2009.

Travelers Beware
The Caribbean Public Health Agency (CARPHA) reports cases of Chikungunya have been confirmed in Anguilla, Antigua and Barbuda, Aruba, British Virgin Islands, Dominica, Dominican Republic, French Guiana, Guadeloupe, Haiti, Martinique, St. Barthelemy, St. Kitts and Nevis, St. Lucia, St. Vincent and the Grenadines, Saint Maarten and St. Martin.

Before you travel, visit the FIU Health travel medicine clinic (305-FIU-DOCS) for information on how to stay healthy. If you get sick on your trip, visit us when you get back, so we can evaluate and treat any health-related problem.

Prevention: Drain and Cover

Aedes mosquitoes are day biters and can lay eggs in very small water containers.

To decrease the mosquitoes in your area: Drain water from garbage cans, house gutters, pool covers, coolers, toys, flower pots or any other containers where sprinkler or rain water has collected and discard any items that may collect water. Clean birdbaths and pet water bowls twice a week.

To protect yourself from infected mosquitoes: If you must be outside when mosquitoes are active, cover up. Wear shoes, socks, long pants, and long sleeves. Use mosquito  repellents with DEET, picaridin, oil of lemon eucalyptus, and IR3535. Sleep under mosquito nets/curtains.

Chikungunya Symptoms

People bitten by infected mosquitoes usually begin to feel sick 3 to 7 days later, but some get sick after only 2 days or as much as a week after the bite, and about a quarter of people infected never feel sick. Infected people who are not sick can still transmit the virus to mosquitoes. Chikungunya most often causes severe illness in babies, people over 65-years of age, and people with underlying health conditions.

The sickness includes a high fever (>102° F), back pain, terrible pain and some swelling of the joints (especially in hands and feet), bad muscle pain, and after 2 to 5 days people develop a rash (red flat patches that may contain small raised spots).  These symptoms usually last 3-10 days. In addition to those problems, some people also have headache, sensitivity of eyes to light, general sense of ill feeling and body ache, nausea, vomiting, insomnia, and redness around the eyes. Men may develop tiny ulcers in the genital area. The rash can cause skin discoloration on the face and elsewhere. Although less common, the virus can produce damage to the brain, eyes, heart, kidney and other organs.

Treatment

We can treat the symptoms of the disease, but there is no specific treatment that targets this virus. Fortunately, most people get well with time, though the muscle and joint pain may last several months, especially among the elderly.  Currently there is no vaccine. 

May 20, 2014