Chikun—what?

Kristy Murray urges preventative action in the United States against Chikungunya, a dangerous virus spread by mosquitoes which has already reached the Caribbean.

It’s best to start learning how to pronounce the word “Chikungunya” (chik-en-gūn-ya): this crippling virus that is spread by mosquitoes could soon be making landfall to a city near you.

Chikungunya virus can cause a very severe disease in people, with fevers, headaches, and painfully debilitating joint pain that can last for months to years.  The word “chikungunya” is African (Makonde) in origin and translates to “that which bends up.”  People infected with this virus are literally bent up from the extreme joint pain they experience.  The virus is spread from person to person through Aedes species mosquitoes –  very aggressive day feeders that are widespread throughout the Americas.

This virus was originally identified in Africa more than 50 years ago.  During the first decade of the millennium, the virus began to spread rapidly to India, islands throughout the Indian Ocean, and other parts of Asia.  In 2007, it took only one infected person to travel from India to Italy to create a major outbreak, sickening more than 200 people.

Just a few months ago, in early December of 2013, the virus was found to be circulating in the Caribbean.  This was the first evidence that this virus had made the massive jump to the Western Hemisphere.  In just a few short months, more than 17,000 suspected and confirmed cases have been reported among several island countries throughout the Caribbean and most recently in South America.It has island-hopped from one country to the next, and now it is just a matter of time before it makes its way to the United States.

This week I gave a presentation to first year medical students and asked them if they had ever heard of Chikungunya.  Only a couple of hands went up.  The rest shook their heads.  This is exactly our concern.  Are we ready for a virus that the vast majority of America has never heard of?  Will our medical community be educated and equipped to identify and diagnose cases?  Is our already exhausted public health system ready to take on the burden of a new disease spread by mosquitoes?  Will we need to start screening the blood supply?  What will be the economic impact?

Considering the number of travelers coming from the Caribbean by plane and by sea as well as the vast mosquito populations that are more than capable of transmitting Chikungunya, we have high concerns that the disease could take hold and begin its spread here in the United States, particularly in Texas, Louisiana, Florida, and New York.  At the National School of Tropical Medicine at Baylor College of Medicine and Texas Children’s Hospital, we are laying the groundwork to educate both the public and physicians about this potentially serious disease and create a surveillance network among affiliated hospitals in Texas in collaboration with the Centers for Disease Control and Prevention.

As the weather begins to finally warm up this year, we need to keep this disease in the forefront of our minds and have heightened awareness of its potential emergence.  Quick and early detection of cases will be critical for an adequate public health response to prevent further spread.  We need to be proactive in our approach to this new disease threat, and think not “if” but “when.”

Kristy Murray DVM PhD is associate professor of pediatrics and associate vice-chair for research at Baylor College of Medicine and Texas Children’s Hospital, where she also directs the Laboratory of Vector-borne and Zoonotic diseases.  She is also one of the founding faculty of the National School of Tropical Medicine, Houston Texas, USA.