I wrote about an emerging mosquito-borne virus with the strange name of chikungunya in a pair of posts last year. This is a virus that was first discovered more than 50 years ago, but as far as arthropod-borne viruses (“arboviruses”) go, it’s been a minor player for most of that time, as other arboviruses such as yellow fever, dengue, and West Nile caused more disease and death than chikungunya. However, the virus began to rapidly spread beginning in ~2004, causing around a quarter million infections on the island of La Reunion in the Indian Ocean before moving on to cause smaller outbreaks in neighboring countries.

Where else has chikungunya landed? More after the jump…

In 2006, it moved into India, and has since spread there. Good estimates are difficult to come by, but reports suggest that there were more than a million cases there in 2006 alone. This year, the virus caused an outbreak in Italy (where Revere, the lucky bastard, recently got to travel, and describes the outbreak).

This outbreak–the first in Europe–started back in June of this year, when a traveler returned to Italy from India. He had a fever during a visit to his cousin, who then also became ill. Eventually the virus spread to individuals who had no contact with either the index case or his family, and as of September 1st, there were 130 confirmed cases and one death due to the virus.

In my original post on chikungunya, I noted that La Reunion was a tourist destination, and asked:

…how many viremic people [harboring virus in the blood] would it take to enter a country and allow the virus to become established in a new area? What if there are American tourists on La Reunion or other islands in the area who are infected–possibly even asymptomatically–and return to America with enough virus in their blood for a hungry mosquito to pass the infection along? Could we see a new West Nile in America, another arbovirus creeping across the United States?

We’ve seen this now happen in Italy–it just took one tourist to come back and start an epidemic. Of course, in Italy they had a competent vector species–a necessity for the spread of an arbovirus (well, barring potential nosocomial transmission by contaminated needles or other mechanical devices), and the patient returned home while he still was viremic–so local mosquitoes, when taking a blood meal, became infected with the virus, which they then passed to their next victim. This allowed more mosquitoes to become infected, and thereby infect more humans, spreading the virus and prolonging the outbreak.

However, Italy isn’t the only place that chikungunya has been imported–and I don’t have to travel to Italy to be in its geographic proximity. Yes, Iowa had its own imported chikungunya case earlier this year:

An Iowan traveled to India to visit family and friends in June. Several days after arriving, he developed high fevers and muscle pain. He sought treatment at a local hospital in India. After returning to Iowa, the patient developed a rash and continued to have muscle pains and joint pains. The patient reported extensive exposure to mosquitoes while in India. Due to the clinical presentation and travel history, the University Hygienic Lab (UHL) sent specimens to the CDC for testing. In September, CDC notified the Iowa Department of Public Health (IDPH) and UHL that they had confirmed chikungunya virus.

So, what about spread here in Iowa? It seems that the patient here was likely not viremic by the time he returned: no virus in blood, no infection of the local mosquitoes, no secondary cases, no outbreak. But theoretically, it seems to be possible, even in Iowa. From this EID paper, Aedes albopictus, the “Asian tiger mosquito,” has at least been identified previously in Iowa, and this vector can be infected with and transmit the chikungunya virus. It does, however, seem unlikely, as A. albopictus isn’t exactly endemic here from what I understand.

In the southwestern US, it’s another story–and both A. albopictus and A. aegypti can be found there. The CDC suggests that, despite the presence of vector species, an outbreak due to an imported case is unlikely here, due to social and cultural factors such as window screens and air conditioning, which limit our exposure to infected mosquitoes.

Will it be enough? I know I get eaten alive by mosquitoes every time I’m out for more than a few minutes at dusk during the summer; I don’t have any air conditioning; and I keep meaning to repair the hole in my screen door. Granted, I’m also not in the southwest, but we do have West Nile and other arboviruses here. The way chikungunya has spread over the past few years, it seems that it only takes a toehold to spread like mad.

Image from http://en.wikipedia.org/wiki/Image:Aedes_Albopictus.jpg

Comments

  1. #1 jspreen
    November 5, 2007

    While Tara is at it to spread the word with this not really new but, I admit, very promising pandemic hype, may I attract some attention and point to an antidote about which a lot has been written in France last year? Magnesium chloride, MgCl2. Said to be the best. And the cheapest.

  2. #2 Ian
    November 5, 2007

    Can we be sure it’s the same virus? Maybe it just tastes like chikungunya….

  3. #3 Emily
    November 5, 2007

    I love this. The advice is always “Avoid mosquito bites.” How in heck am I supposed to do that? Other than applying deet straight out of the shower, that is? Our screens are a joke.

  4. #4 Braganza
    November 5, 2007

    What is the mechanism of magnesium chloride ?

    JSpreen,

    I wanted also to co-sponsor your research on the ebola virus, up to £50, but I have been thinking that you may have problems with malaria, and I am not sure that you could cure it with your nutrition/ meditation techniques, and I dont know if it is a good idea to send you to the border of Congo. How would you treat yourself if you catch malaria ?

  5. #5 jspreen
    November 5, 2007

    jspreen, I wanted also to co-sponsor your research on the ebola virus, up to £50,

    You’re welcome but unless someone comes up with some very good arguments against my “It’s all a WHO/CDC hype” hypothesis mentioned some posts earlier, I don’t think it’s very clever to spend money on Ebola research.

    but I have been thinking that you may have problems with malaria

    Hey, malaria! Why did everybody forget about that? Let’s pump money in malaria research instead of chasing hypothetical viruses. A close friend of mine suffered from malaria, years ago. He went on a safari and had an attack. During a several days lasting coma he has been taken care of by some local medicine man. No trace of amoebae has been detected ever since. I tell you, many things are known by mankind. Let’s go and collect wisdom from new or forgotten sources.

    and I am not sure that you could cure it with your nutrition/meditation techniques

    Apart proposing food to starving people and critical introspection to preposterously self-sufficient members of the Scientific Community, I have no nutrition or meditation techniques to offer to anyone.

    and I don’t know if it is a good idea to send you to the border of Congo.

    Maybe you’re right; I’ve never been there so I can’t tell.

    How would you treat yourself if you catch malaria?

    I think it would be best not to catch it to start with. You may be assured that before taking off to the DRC, I would collect all information I can find about malaria. I have some vague idea that malaria is linked to some traumatic incident in the family. For instance, some years ago I heard about a French doctor who has been working in Africa for over 20 years, boasting he’d never catch malaria, and who fell ill in France at his daughter’s wedding. Coincidence? Maybe, maybe not. Anyway, I think that is a far more interesting subject than the bullshit dug up by emerging viruses hunters. Would you be with me on this?

  6. #6 jspreen
    November 5, 2007

    What is the mechanism of magnesium chloride ?

    I have no idea so I Googled: mechanism “magnesium chloride” chikungunya

    But when I started to scroll through the pages, I suddenly stopped and said to myself: “Why! Can’t they look it up for themselves?”

  7. #7 jen_m
    November 5, 2007

    Well, of course we can google it ourselves. But if you’re going to endorse it as an “antidote”, it would be helpful for you to mention whether you intended us to rub it on ourselves, take it orally, or sprinkle it on stagnant water to prevent mosquitoes from hatching. (Or put it to some use other than my imaginings here.)

    Additionally, I am not surprised that your friend survived malaria without trace of amoebae, as the organisms responsible for malaria are Plasmodium spp., which belong to a different phylum. But then, rejection of the biological classification system is just part of your Bechampian philosophy.

  8. #8 jspreen
    November 5, 2007

    Additionally, I am not surprised that your friend survived malaria without trace of amoebae, as the organisms responsible for malaria are Plasmodium spp., which belong to a different phylum.

    Good!!! Glad to know there are some wise guys around to help get the details straight. Plasmodium spp., huh? Some might ask, “What’s in a name?” but what the heck, let it be!
    But then again, don’t you think the possible implications of my proposition is about 100,000,000,000 light years beyond your trivial correction?

  9. #9 jen_m
    November 5, 2007

    What suggestion? Feeding people? I am all in favor of feeding people. I am even more in favor, if it’s possible, of ensuring clean drinking water, since people die more rapidly from dehydration than malnutrition, and diarrheal diseases tend to produce both dehydration and significant electrolyte imbalance.

    Or did you mean the magnesium chloride? Magnesium salts have been used as laxatives for hundreds if not thousands of years. I would not suggest that people in a region with such a problem of diarrheal disease, particularly among infants and children, be treated with magnesium chloride taken internally, which is why I asked how and to whom you were proposing administering these salts.

    I was not entirely polite, I grant. I apologize. I am short with you because I have cultured bacteria and used them to infect human tissue culture, and I have tailored viral phages to infect bacteria with particular traits, all with my own hands and eyes. I know these things are true because I have proven them to myself firsthand. You speak of them with scorn, and so I respond in a haughty tone.

    I raised the issue of “the name” because it’s not just a name – it’s an issue of a whole different organism, etiology, and disease. Picking at little (English) language errors is stupid when a site attracts people from all over the globe. It is not a minor point to me, but of course because you do not believe that organisms can cause disease in the first place, it is wholly trivial to you what we call them.

    I believe, based on the existing biomedical science, that humoral and cellular immunity are impaired by protein and micronutrient malnutrition, so feeding people well will help them fight off infectious disease; that life stresses can impair immune surveillance; that electrolyte imbalance can so damage nonspecific immune protection that opportunistic infections can take root. Clean water, adequate diet, and a reasonably safe environment are essential to health. They are not, however, sufficient. Vaccination can help.

  10. #10 Jim
    November 5, 2007

    Don’t waste your time with jspreen. I suspect the reason he decided to let us look it up ourselves is his google search listed above gives three pages of results and not one result looks to give a mechanism for MgCl2 effectiveness (at a quick glance). It’s typical jspreen. Make a rediculous claim, be called on it to cite evidence, realize there isn’t any and tell said person to find it themselves. Rinse and repeat.

  11. #11 cooler
    November 5, 2007

    I wonder what our scientific godfather Dr. shyh ching lo would think of this?

    Tara have you built a shrine of worship in your house for your scientific master Dr. Lo? Or are you still infatuated with psuedoscientists like jp moore who make fun of people while they die of cancer?

    We shall all bow our heads on awe of shyh ching lo, the miltary’s highest ranking infectious disease pathologist, moment of silence please, moment of silence and homage for the only scientist to discover a microbe mycoplasma incognitus/penetrans that killed and sickened every animal inoculated. Oh jolly hell, it was part of an illuminati plan, google project day lily to find out how and why Lo knew so much about these pathogens…..part of the biological weapons program………………

    Oh father Lo teach these ignorant young scientists the way, show the the light to us all father Lo, all mediocre scientists on these blogs here must bow to you in eternal worship. All the people who are infected with this microbe that can masquerade as many different illnesses and who are being given a revolving door of garbage can diagnosis, your suffering is the cause of incompetent frauds like Fauci who sabotaged your shining light, oh father Loving Lo show us the way.

    (if you cant tell im joking around a little in this post you have no sense of humor whatsoever, in addition to having Lo envy syndrome…LOL)

  12. #12 cooler
    November 5, 2007

    Oh Lest me forget, thats Dr. Lo MD PHD. Bow our heads once again.

  13. #13 John Givens
    November 5, 2007

    What utter bullshit.

    If you go thru life as a hammer, everything begins to look like a nail.

    If you go thru life as a epidemiologist, everything begins to look like an epidemic.

    If you go thru life as a scientist, everything begins to look like a grant opportunity.

    Nobody cares about this harmless passenger virus.

  14. #14 John Marley
    November 6, 2007

    So many trolls, so few coconut cream pies.

    Such a dilemma.

  15. #15 cooler
    November 6, 2007

    Trolls are a lot more interesting than talking about these boring meaningless topics. whats on for next week, how flys make love in the Congo?

  16. #16 Tara C. Smith
    November 6, 2007

    cooler, for someone who bitches as much as you do about my writing, you sure spend an awful lot of time around here. Is someone forcing you to read this? Go outside and get some fresh air or something. Hell, start your own “I hate Tara” blog if you’re so bored by my topics.

  17. #17 cooler
    November 6, 2007

    Did you build a shrine yet for Dr. Lo? Maybe you should talk about more important topics, like the 2 top cancer researchers garth and nancy nicolson new book Project Day lily about the mycoplasma biowarfare program.

    I’m trying to recover from this infection, until then the scientists who ignored Lo’s research will hear me bitch. Kind of hard to go get fresh air when youre sick, if you dont beleive in it then go get an inoculation from the armed forces of pathology with mycoplasma incognitus/penetrans and see how you feel, see how easy it is to get fresh air.

  18. #18 cooler
    November 6, 2007

    I shall be fully recovered soon though, and am already feeling 50% better, and will hopefully be off these blogs and hanging out with my friends like I used to within 6 months or so. I cant beleive scientists and doctors are just leaving people to rot and die of this infection, Lo clearly proved it was pathenogenic to humans in 1990, every animal he inoculated died and he found it no healthy controls, and it was slowly spreading through the population, when I went to the doctors for years with no diagnosis I should have been made aware of this.

  19. #19 jen_m
    November 6, 2007

    I thought it was your sister who was sick, cooler.

  20. #20 cooler
    November 6, 2007

    nope, I dont have a sister.

  21. #22 Dr. Duke
    November 6, 2007

    In this thread cooler claims not to have a sister.

    But in another thread here cooler claimed that Dr. Lo had saved his sister from a mysterious illness:
    http://scienceblogs.com/aetiology/2007/10/denialism_they_dont_remember.php#comment-617841

  22. #23 Adele
    November 6, 2007

    Yeah Dr. Duke he lied about that like every one thought. Why should you believe a guy who lies like that.

    I wrote it on the other thread about people cooler hangs out with on facebook. They have a group about ICC to, Stop Experimenting on ChildrenThe Guinea Pig Kids

    So the first Arizona facebook guy Seth said
    experimenting on children is sometimes funny
    and the second az facebook guy Rob said
    Yeah, I guess it can be a little funny…like when the kids are Jews..

    Great friends Steve cooler whats with you and people like that?

  23. #24 jen_m
    November 6, 2007

    My multi-link comment is held for moderation, but cooler, you definitely told us a sob story about your sister in several comments in the that thread Dr. Duke linked, and blamed all of us for making her sick.

  24. #25 anon1234
    November 6, 2007

    There has to be a better name than “arboviruses”; that sounds like something you would catch from a tree.

  25. #26 cooler
    November 6, 2007

    Are you people nuts?
    Why should I immediately disclose my personal medical history here, try being sick without a diagnosis for years and then see how easy it is to tell others that you are the one thats sick, its much easier to say a “friend” or “sister” people do that all the time on anonymous blogs, or when they send anonomyous letters to advice givers to avoid embarrsament, especially considering how low some of the people here will stoop, you guys have already not condemned jp moores insulting harvey bialy’s dying of cancer, who’s to say some of you people will not start making fun of my illness?

    I’m almost fully revovered and have found a doctor who is very impressed by Lo’s and nicolsons work and have been on a treatment plan.

    It was kind of obvious all along, what kind of young person sits at home on a blog all day and brings up the same topic over and over, unless it has deeply affected them.

    I will take Tara’s and Darin browns advice and try and stay away from these blogs as much as I can, but the principles are still the same, its disgusting that the pharma/political dominated medical industry complex has caused this infection to slowly spread through the population.

  26. #27 cooler
    November 6, 2007

    I dont even know that guy who said that, stop stalking me, facebook has groups with thousands of members, individual members cant be responsible for what other members say in a group when i dont even know them and just joined like a week ago, thank god im feeling better some of you people are totally mad.

  27. #28 cooler
    November 6, 2007

    You guys are really bad news, try focusing on the science instead of trying to dig up dirt on people. Lo’s brilliant work once again, learn something, folilled kochs postulates more than any other scientist did since koch himself in a series of original papers. Im pretty much done with these blogs, they are useless, I thought when i first came here there would be renoun scientists from around the world, no its the same 4 trolls over and over again. What a joke.

    http://www.aegis.com/pubs/atn/1990/ATN09501.html

  28. #29 jen_m
    November 6, 2007

    *digression about cooler*
    “It was kind of obvious all along, what kind of young person sits at home on a blog all day and brings up the same topic over and over, unless it has deeply affected them?”

    I don’t know, but by that logic, you also witnessed the US gubmint blowing up the World Trade Towers and were extensively exposed to thimerosal in vaccines. At least, based on the intensity and ubiquity of those topics in your comments on Scienceblogs.
    *end digression*

    Returning to the topic at hand – anon1234, you are so right. I am forever thinking arboviruses are arboreal, somehow, and they are really not.

  29. #30 Chris Noble
    November 6, 2007

    If you go thru life as a hammer, everything begins to look like a nail.

    If you go thru life as an asshole, everything begins to look like a toilet bowl.

    .. which explains the Denialist contribution to this thread.

  30. #31 Joe
    November 8, 2007

    @jen_m “Returning to the topic at hand – anon1234, you are so right. I am forever thinking arboviruses are arboreal, somehow, and they are really not.”

    I had the same problem, till I read it here. It reminds me of a seminar I gave concerning picornaviruses. I mentioned that the name means “small RNA virus” and the audience roared with laughter. Afterwards, I asked someone why that was funny- he said it was because the meaning was so obvious, once it was pointed-out.

  31. #32 LR
    October 14, 2008

    Well, this blog has been unusually entertaining, though I was hoping to find out about the MgCl – chikungunya connection, and wanted the actual recipe and dosages that are given on average – did give it in 2006, and saw very fast recovery, but can’t remember the recipe, and would like some more data on it now – anyone with an intelligent answer, I’m not really interested in the ‘touchy-feely’ stuff that went on before.