05 September 2007
I would like to bring to your attention an outbreak of Chikungunya Fever in July and August in Ravenna in the Emilia-Romagna Region of eastern Italy.
Chikungunya Fever is a mild self limiting illness characterised by fever, joint pain, muscle pain and headache. Very occasionally it can produce more severe disease especially in elderly and debilitated patients. Treatment is symptomatic only (non-steroid anti-inflammatory medication and simple antipyretics). Currently, pregnant women, those living with significant immunosuppressive disease and patients suffering from severe chronic illness are being advised to consult their physicians prior to travelling to areas of high risk.
The causative agent, Chikungunya virus is an Arbovirus transmitted by Aedes mosquitoes. It is endemic in parts of Africa, Southeast Asia and on the Indian sub-continent. There have been a number of large outbreaks the most notable being in that in the Indian Ocean basin in 2006; during that outbreak there were over 250,000 cases on the island of Réunion alone.
In the outbreak in Italy, there have been over 150 cases to date; this being the first description of indigenously transmitted Chikungunya Fever in Italy. The Italian authorities have put in place control measures including fogging to control mosquito populations around the city of Ravenna. Beyond the area around Ravenna, the risk of Chikungunya is considered to be low.
Ravenna is located on the eastern Adriatic Italian coast, north of Rimini and San Marino and on a level with Bologna. It is very likely that Irish holidaymakers will have travelled or stayed in the area during the exposure interval of July-August 2007 and may have been exposed to local mosquitoes.
The National Virus Reference Laboratory will provide the necessary diagnostics. Serological testing (IgM and IgG) and PCR on individuals who have suspicious symptoms (further information is available here http://www.ndsc.ie/hpsc/A-Z/Vectorborne/ChikungunyaFever/Factsheet) can readily identify the presence of the virus and requires only a 10ml sample of clotted blood.
Further information can be found at: http://www.ndsc.ie/hpsc/A-Z/Vectorborne/ChikungunyaFever/ and http://www.eurosurveillance.org/ew/2007/070906.asp#1. In addition, the European Centre of Disease Prevention and Control (ECDC) provides information on Chikungunya at http://www.ecdc.eu.int/Health_topics/Chikungunya_Fever/Chikungunya_Fever.html.
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