Consider Chikungunya in Patients Who Have Traveled Internationally

The TMA Committee on Infectious Diseases encourages you to consider chikungunya virus infection for patients who have traveled to areas with known outbreaks and who present with illness consistent with this mosquito-borne disease.

Patients with this infection most commonly present with acute fever and severe joint pain, which is often bilateral and can be debilitating. Petechial rash can occur. The incubation period is typically three to seven days. There is no specific treatment or vaccine. Those at higher risk for more severe disease include neonates exposed intrapartum, older adults, and those with underlying medical conditions, including hypertension, diabetes, and cardiovascular disease.

You are encouraged to report suspected cases to the Texas Department of State Health Services (DSHS). For more information, contact Nicole Evert in the DSHS Zoonosis Control Branch at (512) 776-2890. Diagnostic testing is available.

Chikungunya has shown rapid global spread in the past decade, causing outbreaks in the Indian Ocean region, India, Southeast Asia, and Europe. In December 2013, local transmission of chikungunya was reported for the first time in the Americas — in the Caribbean. Over the past five months, more than 24,000 cases have been reported in this ongoing outbreak in the Caribbean islands.

Although chikungunya is not currently found in the United States, the Centers for Disease Control and Prevention (CDC) warns the virus may continue to spread to new areas in the Americas; the mosquitoes that transmit the virus are found in parts of the United States, including Texas. 

The CDC website has more information on the virus. 

Action, May 16, 2014