Chikungunya outbreak in the Caribbean region, December 2013 to March 2014, and the significance for Europe

Abstract

, two laboratory-confirmed cases of chikungunya without a travel history were reported on the French part of the Caribbean island of Saint Martin, indicating the start of the first documented outbreak of chikungunya in the Americas. Since this report, the virus spread to several Caribbean islands and French Guiana, and between 6 December 2013 and 27 March 2014 more than 17,000 suspected and confirmed cases have been reported. Further spread and establishment of the disease in the Americas is likely, given the high number of people travelling between the affected and non-affected areas and the widespread occurrence of efficient vectors. Also, the likelihood of the introduction of the virus into Europe from the Americas and subsequent transmission should be considered especially in the context of the next mosquito season in Europe. Clinicians should be aware that, besides dengue, chikungunya should be carefully considered among travellers currently returning from the Caribbean region.

Interspecies transmission and chikungunya virus emergence

“…As millions of persons became infected, thousands of air travelers introduced this new Indian Ocean Lineage (IOL) of CHIKV, also derived from an ECSA enzootic strain (Figure 1), into nearly all regions globally, and local transmission ensued in northern Italy [7] and southern France (Figure 2) [8,9]. Al-though importations were also documented in transmission-permissive regions of the Americas, autochthonous cases were not detected in the Western Hemisphere until late 2013 on the Island of St. Martin in the Caribbean [10,11]. Subsequently, CHIKV spread to nearly all Caribbean Islands and into northern South America, Central America, and Mexico.…”

CD8+ T Cells Control Ross River Virus Infection in Musculoskeletal Tissues of Infected Mice

“…In addition, local transmission of CHIKV has been documented for the first time in several locations, including Italy, France, New Caledonia, Papua New Guinea, and Yemen (7–11). Most recently, autochthonous transmission of CHIKV has occurred for the first time in the W. Hemisphere, with over 750,000 confirmed and suspected cases reported from a number of Caribbean islands as well as a few countries in Central America and in South America (12, 13). …”

γδ T Cells Play a Protective Role in Chikungunya Virus-Induced Disease

“…Infected visitors to these areas of CHIKV epidemics returned to Europe, Australia, the United Kingdom, Japan, Belgium, Canada, and the United States (10)(11)(12)(13)(14)(15), and importation of human cases to northern Italy, New Caledonia, China, the French Riviera, and Saudi Arabia produced autochthonous outbreaks resulting from infection of naive mosquito populations (16)(17)(18)(19)(20). In late 2013, the first local transmission of CHIKV in the Americas was identified in Caribbean countries and territories, indicating that mosquito populations in these areas had become infected with the virus and are competent to transmit it to humans (21)(22)(23). Since that time, a total of approximately 1.2 million suspected and over 24,000 confirmed cases of CHIKV have been reported in 44 countries or territories in the Caribbean or South America (24), including hundreds of travelers returning to the United States, with subsequent localized transmission in Florida in 2014.…”