A little update on insect-borne diseases and travel

I just came across this today and thought to pass it along. Of course, Lyme disease is not mentioned nor mention of ticks, spiders, and other biting insects as vectors. This article is primarily about mosquitoes. Still, there are some sobering numbers and cautions here. Anybody with a chronic infection such as Lyme disease or co-infections of Lyme, should be wary of traveling to an area where the likelihood of picking up yet another infection is high. Many people can apparently carry Lyme disease bacteria within their bodies for a long time without symptoms. But, the classic Lyme onset scenario is when some even relatively-innocuous environmental stressor or additional infection occurs, and then the whole house of cards comes crashing down. The immune system can only handle so many challenges at one time.

http://www.consultant360.com/exclusives/vector-borne-diseases-pose-threat-travelers

Vector-Borne Diseases Pose A Threat to Traveler

Wed, 04/09/14 - 09:20

Vector-borne disease—those carried by insects and small animals (eg, malaria, dengue, yellow fever, and West Nile virus)—affect more individuals each year as globalization, travel, and climate change continue to shift the natural boundaries of these vectors away from their traditional regions. Today, roughly 50% of people living in the Western Hemisphere are at risk.

The chikungunya virus first debuted in the Americans in 2 cases on the island of Saint Martin in December 2013. By the end of March 2014, more than 3000 cases have been confirmed in 10 Caribbean countries.(3)

Researchers are now warning that the virus may soon be classified as an epidemic, particularly as travelers from across the world arrive to Brazil next month for the FIFA World Cup.

Brazil reports the highest incidence of dengue; the dengue and chikungunya viruses are transmitted by the same mosquitoes.(1)

Chikungunya can cause fever and severe joint pain, often in the hands and feet, which can sometimes lead to permanent disability. Mortality can reach 1 in 1000. Symptoms commonly begin within 3 to 7 days.

There is no vaccine or medication to prevent the chikungunya disease. If infected, avoiding mosquito bites will help prevent the spread of the virus.

"We as a world are in some ways more vulnerable than ever," said Tom Frieden, director of the CDC, "and that means that we as a world need to collaborate more effectively than ever so we can build the capacity to find new diseases, outbreaks and threats wherever they emerge promptly, and respond effectively."

Countries in the Americas have had success in the past fighting vector-borne disease. Malaria has gone down 60% and malaria deaths declined by 72% between 2000 and 2012.3  A majority of the progress can be credited to publicly-funded programs controlling mosquitoes and other insects, as well as vaccination campaigns against these illnesses.

In honor of World Health Day 2014, the Pan American Health Organization (PAHO) and the World Health Organization (WHO) (3) urge governments to continue to publicly fund vector-control programs and invest in water sanitation and waste collection. Health authorities say countries should improve monitoring of these diseases as well as drug resistance.

"The successes achieved so far are today being threatened by the expansion of mosquitoes and other vectors into new habitats and by the emergence of insecticide and drug resistance," said Carissa F. Etienne, director of PAHO/WHO.

When traveling in a mosquito-heavy area, individuals should use air conditioning and/or window and door screens, wear repellent on exposed skin, wear long-sleeved shirts and long pants, wear permethrin-treated clothing, empty standing water from outdoor containers, and support local vector control programs. People at increased risk for severe diseases should not travel to areas with ongoing outbreaks.

by Michael Potts

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   1. American Society for Microbiology. Chikungunya poised to invade the Americas [press release]. 2014 Apr 7. Available at:  https://www.asm.org/index.php/journal-press-releases/92908-chikungunya-poised-to-invade-the-americas. Accessed April 9, 2014.

   2. CDC. Chikungunya virus. Available at:http://www.cdc.gov/chikungunya/pdfs/CHIKV_FACT%20SHEET_CDC_General%20Public_cleared.pdf. Accessed April 9, 2014.

   3. World Health Organization/Pan American Health Organization. Step up the fight against vector-borne diseases in the Americas [press release]. 2014 Apr 4. Available at:http://www.paho.org/hq/index.php?option=com_content&view=article&id=9436.... Accessed April 9, 2014.d