Chikungunya Fever in Emilia Romagna, Italy
An outbreak of Chikungunya fever, a viral infection carried by mosquitoes, has been reported in the small town of Castiglione di Cervia (Emilia Romagna, Italy). Cases first appeared in mid July 2007, and a significant number of people have now been affected.
Chikungunya fever is commonly found in East Africa, Southeast Asia and in the Indian sub-continent. A large outbreak was reported in Réunion and countries of the Indian Ocean Basin in 2006 (http://www.hpsc.ie/hpsc/A-Z/Vectorborne/ChikungunyaFever/News/MainBody,2053,en.html).
Illness generally follows 4-7 days after the bite of an infected mosquito and presents with sudden onset of fever with joint and muscle pain (that can at times be very severe) with headache and conjunctivitis. The joints of the wrists, ankles, hands and feet are most commonly affected. Rashes on the chest and abdomen are common and in the large outbreak in Réunion and countries of the Indian Ocean Basin in 2006, almost a quarter of patients had bleeding from the nose or gums. Fortunately, it tends to be a mild illness with most patients recovering fully.
There is currently no vaccine against the virus responsible for causing Chikungunya. Travellers to affected areas are advised to take sensible precautions against mosquito bites (advice on protecting yourself from mosquito can be found on HPSC's website http://www.hpsc.ie/hpsc/A-Z/Vectorborne/TravelAdviceforInternationalTravellers).
Although the risk of serious disease is low, certain groups are at higher risk, including:
- Pregnant women
- People with weakened immune systems (such as patients living with cancer or HIV/AIDS) and
- People suffering from severe chronic illness (such as heart, lung or kidney disease and diabetes).
Prevention: It is advised that pregnant women, patients with weakened immune systems and people suffering from severe chronic illness should consult their physicians prior to the travel to areas known to be affected by Chikungunya in order to assess their risk and obtain advice on personal preventive measures.
All travellers to areas known to be affected by Chikungunya should take the following preventive measures to minimise the exposure to mosquito bites while in the areas:
- Use of anti-mosquito devices (insecticide-treated bed nets, coils, smudge pots, spray, repellents) and wearing long sleeve - long leg clothes, especially during the hours of highest mosquito activity (morning and late afternoon). Mosquito repellent based on a 30% DEET concentration is recommended.
- Before using repellents, pregnant women and children under the age of 12 years should consult a physician or pharmacist
- For newborn children under three months, repellents are not recommended; instead, insecticide-treated bed nets should be used.
Further information on Chikungunya is available at:
ECDC - Health Topics: Chikungunya
HPSC - Topics A-Z: Chikungunya