Mosquito-borne illness from Caribbean shows up in NC for first time

jprice@newsobserver.comJune 12, 2014 

— A Forsyth County resident who recently returned from the Caribbean has been diagnosed with the state’s first case of chikungunya, a painful illness transmitted by mosquitoes, according to state public health officials.

County and state health experts are spreading information about the illness in part to try to head off any chance that the disease gets a foothold in the local mosquito population. It can be spread via Asian tiger mosquitoes that are common here in the warm months and are aggressive daytime biters.

The illness has infected millions of people in the tropics, but travelers have also triggered some locally transmitted cases in Italy and France. Dozens of cases have been reported in the United States among returning travelers, but so far there have been no reported instances of the disease being acquired in North Carolina or the continental United States.

Symptoms typically start three to seven days after a bite by an infected mosquito and can include the sudden onset of fever and severe, often disabling, joint pains in the hands and feet. Many patients feel better within a week, but joint pain, insomnia and headaches may persist for months.

Some people may be infected but show no symptoms, though most do. Newborns exposed during delivery, adults over 65 and people with chronic medical conditions are at greater risk for severe bouts.

There is no treatment that fights the virus. Typically, doctors will treat symptoms with rest, fluids, and pain and fever relief drugs, and keep patients indoors under mosquito nets while they are infectious.

Chikungunya was first found in East Africa, India, the Indian Ocean and the Western Pacific regions. It apparently spread to the Caribbean this winter via travelers and so far has infected more than 130,000 people there.

It would be difficult to quantify the likelihood of an outbreak here, said Dr. Carl Williams, the state public health veterinarian at the N.C. Department of Health and Human Services.

For one thing, a mosquito who bit an infected traveler wouldn’t automatically take in enough of the virus to host it. Also, the window in which someone is infectious is relatively small, lasting only from about two days before symptoms begin to five days after they start.

If there was an outbreak, though, it would likely be relatively modest, in part because of the lifestyle here. Screens on windows, air-conditioned buildings sealed to mosquitoes and people spending less time outdoors would make it harder for the disease to spread in North Carolina than in the Caribbean, Williams said.

“The potential does exist for it to establish local transmission here, but I think the likelihood of us seeing hundreds of thousands of cases as they do elsewhere is low,” he said.

State health officials, though, are advising people who travel to countries where the illness exists to take precautions to avoid getting bitten by mosquitoes and to immediately consult with a doctor if they develop fever within two weeks of their return home.

Taking the steps to dodge mosquitoes – such as using repellent with DEET and applying pyrethrin to clothing – also are a good idea here anyway. Mosquitoes in North Carolina may not have been shown to carry chikungunya yet, they do spread potentially deadly West Nile and La Crosse viruses, Williams said. And the same precautions are effective in warding off ticks, which carry other diseases.

Price: 919-829-4526

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