Dengue and chikungunya infections in travelers

Chen, Lin H.; Wilson, Mary

doi:10.1097/qco.0b013e32833c1d16

Cited by 133 publications

(86 citation statements)

References 46 publications

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“…The clinical symptoms reported among those with recent evidence of CHIKV infection included rash, joint pain, headaches, and myalgias-all consistent with illness previously reported in the literature. 15,16 Few individuals in our cohort required medical care in the DR beyond alerting organization A on-call staff. According to organization A's protocol, on-call health-care providers in the United States monitor the health status of ill volunteers and staff remotely and advise in-country supervisory staff on treatment recommendations, as well as whether participants should have additional medical attention while in-country or medically evacuated to the United States.…”

Section: Discussionmentioning

confidence: 99%

Chikungunya and Dengue Virus Infections Among United States Community Service Volunteers Returning from the Dominican Republic, 2014

Millman

Esposito

Biggs

et al. 2016

The American Society of Tropical Medicine and Hygiene

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Abstract. Chikungunya spread throughout the Dominican Republic (DR) after the first identified laboratoryconfirmed cases were reported in April 2014. In June 2014, a U.S.-based service organization operating in the DR reported chikungunya-like illnesses among several staff. We assessed the incidence of chikungunya virus (CHIKV) and dengue virus (DENV) infection and illnesses and evaluated adherence to mosquito avoidance measures among volunteers/staff deployed in the DR who returned to the United States during July-August 2014. Investigation participants completed a questionnaire that collected information on demographics, medical history, self-reported illnesses, and mosquito exposures and avoidance behaviors and provided serum for CHIKV and DENV diagnostic testing by reverse transcription polymerase chain reaction and IgM enzyme-linked immunosorbent assay. Of 102 participants, 42 (41%) had evidence of recent CHIKV infection and two (2%) had evidence of recent DENV infection. Of the 41 participants with evidence of recent CHIKV infection only, 39 (95%) reported fever, 37 (90%) reported rash, and 37 (90%) reported joint pain during their assignment. All attended the organization's health trainings, and 89 (87%) sought a pretravel health consultation. Most (∼95%) used insect repellent; however, only 30% applied it multiple times daily and < 5% stayed in housing with window/door screens. In sum, CHIKV infections were common among these volunteers during the 2014 chikungunya epidemic in the DR. Despite high levels of preparation, reported adherence to mosquito avoidance measures were inconsistent. Clinicians should discuss chikungunya with travelers visiting areas with ongoing CHIKV outbreaks and should consider chikungunya when diagnosing febrile illnesses in travelers returning from affected areas.

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Section: Discussionmentioning

confidence: 99%

Chikungunya and Dengue Virus Infections Among United States Community Service Volunteers Returning from the Dominican Republic, 2014

Millman

Esposito

Biggs

et al. 2016

The American Society of Tropical Medicine and Hygiene

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“…In chikungunya virus-infected patients, treatment with nonsteroidal anti-inflammatory drugs and corticosteroids may be considered when these patients have severe and disabling joint involvement, which can last for extended periods. 16 In contrast, Zika virus infections are, for the most part, self-limiting and without significant sequelae. 5,6 The significant advantage of a positive molecular test result is that the result is definitive, and thus precludes follow-up samples to monitor for serologic conversions and multiple evaluations.…”

mentioning

confidence: 99%

First Case of Zika Virus Infection in a Returning Canadian Traveler

Fonseca¹,

Meatherall²,

Zarra³

et al. 2014

The American Society of Tropical Medicine and Hygiene

215

178

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A woman who recently traveled to Thailand came to a local emergency department with a fever and papular rash. She was tested for measles, malaria, and dengue. Positive finding for IgM antibody against dengue and a failure to seroconvert for IgG against dengue for multiple blood samples suggested an alternate flavivirus etiology. Amplification of a conserved region of the non-structural protein 5 gene of the genus Flavivirus yielded a polymerase chain reaction product with a matching sequence of 99% identity with Zika virus. A urine sample and a nasopharygeal swab specimen obtained for the measles investigation were also positive for this virus by reverse transcription polymerase chain reaction. Subsequently, the urine sample yielded a Zika virus isolate in cell culture. This case report describes a number of novel clinical and laboratory findings, the first documentation of this virus in Canada, and the second documentation from this region in Thailand.

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“…IgM is produced after 5-7 days, with the highest levels of IgM being detected following a primary infection, and becoming undetectable 30-90 days after a primary infection. After a primary infection, IgG appearing in the blood indicates an old infection 21 .…”

Section: Discussionmentioning

confidence: 99%