First imported cases of Chikungunya virus detected in Michigan

Message Details
Date Sent: 06/26/2014 10:07 AM EDT
Sender: Michigan Health Alert Network
Subject: First imported cases of Chikungunya virus detected in Michigan

Message:
Two Michigan residents have tested positive for Chikungunya virus (CHIKV). The patients, from Wexford and Midland Counties, experienced fever and severe joint pain following recent travel in the Caribbean, where there is an ongoing outbreak of CHIKV disease. CHIKV is not currently found in the United States or Michigan, but it is expected that visitors to an outbreak area could become infected.

CHIKV is transmitted through the bites of certain types of daytime biting mosquitoes. Humans are the primary source of the virus for mosquitoes during disease epidemics. CHIKV is not transmitted person-to-person. There is no vaccine available to protect against CHIKV infection. When traveling in areas where human cases are occurring, CHIKV infection can be prevented by using the following steps:

• Use air conditioning or window/door screens to keep mosquitoes outside. 
• If you are not able to protect yourself from mosquitoes inside your home or hotel, sleep under a mosquito bed net.
• Help reduce the number of mosquitoes outside your home or hotel room by emptying standing water from containers such as flowerpots or buckets.
• When weather permits, wear long-sleeved shirts and long pants.
  
• Use insect repellents, following the label directions
  
• Repellents containing DEET, picaridin, IR3535, and oil of lemon eucalyptus provide long lasting protection.
• If you use both sunscreen and insect repellent, apply the sunscreen first and then the repellent.
• Treat clothing with permethrin or purchase permethrin-treated clothing.
  

Most people infected with CHIKV will experience some symptoms, beginning 3-7 days after being bitten by an infected mosquito. The most common symptoms are fever and severe joint pain, but other symptoms may include headaches, muscle pain, joint swelling, or rash. While the disease is usually not fatal, the symptoms can be severe and disabling. Most people feel better within a week, but for some, joint pain may persist for months.

The symptoms of CHIKV are similar to Dengue virus, another disease spread by mosquitoes that is present in the Caribbean and other CHIKV endemic countries. If you develop any of these symptoms and have recently traveled, tell your healthcare provider. Physicians who suspect CHIKV or Dengue in their patients can contact the MDCH to facilitate testing for these diseases through the Centers for Disease Control and Prevention. Focus Diagnostics also offers testing for CHIKV.

There is no specific treatment for CHIKV beyond supportive care. Patients should
rest, drink plenty of fluids and take non-steroidal anti-inflammatory medicines to
relieve fever and pain.

The mosquitoes that transmit CHIKV are not native to Michigan, but many states in the U.S. do harbor species of mosquitoes capable of transmitting CHIKV. During the first week of infection, CHIKV can be found in the blood and passed from an infected person to a mosquito through bites. An infected mosquito can then transmit the virus to other people. If a patient is suspected to be ill with CHIKV, it is important to advise them to avoid mosquito bites during the first week of illness, when they may be viremic.

For additional information, visit the CDC's CHIKV website
at http://www.cdc.gov/chikungunya/.