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Chikungunya common among US volunteers in Dominican Republic
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Infection with chikungunya was common among a group of United States volunteers working in the Dominican Republic during a large outbreak there, according to recent findings presented at the CDC’s Annual Epidemic Intelligence Service Conference.
“In late 2013, local transmission of chikungunya virus, a mosquito-borne disease, was reported for the first time in the Americas in the Caribbean region,” CDC researcher Alexander Millman, MD, told Infectious Disease News. “In August 2014, nearly half of the service volunteers who worked with an organization in the Dominican Republic during the summer months tested positive for chikungunya virus infection.”
Since the first laboratory-confirmed cases were reported from the Dominican Republic in April 2014, chikungunya virus has spread quickly in that country. In June 2014, a U.S.-based volunteer service organization working there reported illness consistent with chikungunya among several staff. Researchers sought to determine the incidence of chikungunya and dengue virus infection, and subsequent illness, among volunteers and staff dispatched on 4- to 8-week assignments to the country and to assess adherence with recommended mosquito bite-avoidance measures.
Alexander Millman
The researchers recruited 102 volunteers and staff (76%, female; median age, 17 years) returning to the U.S. in July and August. Participants completed questionnaires pertaining to mosquito exposures, avoidance measures and episodes of febrile illness. Participants also provided blood samples to be tested for both diseases. All participants attended the volunteer organization’s health training, and 87% pursued medical consultation before traveling.
The researchers found that 94% of volunteers reported insect repellent use — although only one-third reported applying it multiple times daily — and the use of bed nets. However, fewer than 5% of volunteers stayed in residences with window/door screens. In total, 45% of volunteers had evidence of recent infection with chikungunya virus only; 1% had evidence of recent infection with dengue virus only; and 1% had evidence of recent infection with chikungunya and dengue virus. Of the 46 participants infected with chikungunya virus only, 39 reported at least one febrile illness, while 37 also reported rash and joint pain.
Both of the dengue virus-infected participants reported at least one febrile illness; one volunteer reported rash, and one reported joint pain. Of the 59 total febrile illnesses reported by the respondents, 71% occurred in participants with evidence of recent chikungunya or dengue virus infection.
“Chikungunya virus infections were common among these volunteers,” the researchers wrote. “Clinicians should discuss chikungunya with travelers visiting areas with ongoing chikungunya virus outbreaks and should consider chikungunya when diagnosing febrile illnesses in travelers returning from those areas.” – by Jen Byrne
Reference:
Millman A, et al. Chikungunya and Dengue Virus Infections Among United States Community Volunteers Returning from the Dominican Republic, 2014. Presented at: Annual Epidemic Intelligence Service Conference; April 20-23, 2015; Atlanta.
Disclosure: Millman reports no relevant financial disclosures.