Globally, there are a number of diseases for which no vaccine or cure have been found. They always create a lot of tension in the society as no one would like to be among the victims. Chikungunya is one of those diseases and, although it originated in Africa, it found its way into the United States. The epidemic has been reported in various countries around the world. It had been silent for almost 32 years but resurfaced later in 2005 when India witnessed an outbreak. The incubation period is between three to twelve days. The symptoms include skin rash, severe arthralgias, high fever and myalgias. Some patients may also have a crippling arthritis, bleeding and swelling of joints. The researcher aims at conducting a library study to explore the history of Chikungunya, its epidemiological data in America as well as the preventive measures considered by the Center for Disease Control in line with the Healthy People 2020 goals.
Keywords; Chikungunya, United States, transmission
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Caused by an arbovirus, Chikungunya fever is transmitted via infected female mosquitoes of genus Aedes. Since there is no vaccine available, the best strategy for preventing Chikungunya is community education and vector control by public health personnel (Alladi, Kiran Manohar & Kumar, 2010). The Chikungunya virus had been witnessed in other parts of the world such as Africa, Asia, and Europe by 2013, but it is not locally transmitted in the United States. The only reported cases of contracting the virus mostly involved the travelers who returned from the affected areas, while others were recorded on the American territories such as Puerto Rico and Virgin Islands (CDC, 2016). Prevention of the Chikungunya virus pursues the goals of Healthy People 2020. The program fosters public awareness, cleanliness and use of the technology to decrease the number of mosquitoes and, respectively, control the spread of the virus, which is transmitted through their bites (CDC, 2016). This paper demystifies the disease by presenting important data, ranging from history to epidemiology and control measures.
History of the Chikungunya Fever
Chikungunya fever, being an acute disease, is characterized with intense and mostly debilitating polyarthralgia. It is caused by a virus that is arthropod-borne, the Chikungunya virus (CHIKV,) that is transmitted to the human through an infected mosquito bite. It was not until 1950 that the Chikungunya virus was identified as a human pathogen in Africa, and since then, it has been recognized in many countries in Asia and Africa (Staples, Breiman & Powers , 2009). The disease later re-occurred in Kenya in 2004 and spread from there to other countries along the Indian Ocean. Stapels et al. (2009) further state that by 2007, the CHIKV had reached Europe, causing a Chikungunya fever outbreak in Italy. According to Weaver (2014), more cases of CHIKV, supposedly imported from India, were identified in Americas. Although it was previously considered a tropical disease, it has now mutated to be able to adapt and thrive during cold winters as little control is possible due to people`s global travel. Its spread in the Caribbean in 2013 was considered a bad news and a health risk for the local community with about 176 cases reported in the French Guiana, as there was no vaccine yet and the level of public awareness was low.
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The cases of the Chikungunya have been identified in other parts of the world including Asia, Africa, and Europe, but not in Americas. Between 2006 and 2013, about 28 people were annually reported to test positive for the Chikungunya and all of them were travelers, moving either in or out of the United States. The first local case of the Chikungunya virus was discovered towards the end of 2013 in the Caribbean territories. Since that time, around 1.7 million individual cases have been identified across 45 territories (CDC, 2016). It is further acknowledged that in the following year; 2014, there were 2811cases of Chikungunya reported in the United States, of which 12 were transmitted locally, specifically in Florida, while the others involved people in transit. In the same year, 4710 cases were reported in the American territories, of which 4659 cases in Virgin Islands, Puerto Rico, and American Samoa were identified as being transmitted locally, while 51 cases involved travelers returning from the affected areas. According to CDC (2016), the threat posed by the Chikungunya virus became more pronounced in 2015, with 679 positive tests from 44 U.S states, although none of these cases was confirmed to be local. All of them involved returnees from the areas affected by the the Chikungunya virus. 202 cases of locally transmitted virus were reported in the U.S territories of the Virgin Islands and Puerto Rico.
Application of the Levels of Prevention According to the CDC based on Healthy People 2020 Goals.
In line with one of the Healthy People 2020 goal, which is to promote healthy behaviors across all ages, the CDC( 2016) encourages all individuals to ensure that they take necessary measures to prevent mosquito bites. This will entail wearing long pants and shirts with long sleeves as well as sleeping under the mosquito net. It also states that both physical and social conducive environment could be achieved by ensuring that the area around our dwelling is well maintained in terms of cleanliness. Standing water, especially in containers like buckets and flower-cans, ought to be emptied and the bushes cleared in order to prevent mosquitoes from breeding. According to CDC (2016), general improvement of health involves the provision of education to the masses on how Chikungunya is transmitted and crucial steps to take in order to avoid this growing threat. This important knowledge of how to safeguard yourself against the virus will certainly improve the health of local communities. Such measures as sleeping under a mosquito net, clearing bushes and using window doors, aimed at preventing mosquito bites, may also improve the quality of life. If all these steps are taken, the risk of contracting Chikungunya will considerably decrease. (CDC, 2016).
In summary, it is evident that the Chikungunya virus originated from Africa and after many years found its way into the United States due to travelers from the infected areas. It is transmitted by female mosquitoes. The incidence of the disease is 1.7 million cases across 45 countries. The epidemiological data show that the virus has spread to most parts of America, hence prevention measures, recommended by the Center for Disease Control, have been timely implemented to curb this growing menace. According to the CDC, the control over mosquito populations, as well as preventing bites, are the best solution to the problem.