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June 2012
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Now we have chikungunya to worry about

By Steve Vantreese

No, chikungunya is not the latest treat down at your favorite Mexican fast food place.

Say it as CHICK-un-GUN-ya â ¦ or CHICK-un-GOON-ya. Americans haven't quite settled on a pronunciation yet. It's a mosquito-borne virus new to the United States. But there's every reason to think it's headed our way.

The ailment has its roots in Africa and Asia. It romps in that part of the world. But the virus exploded last year in the island nations of the Caribbean, on the doorstep of North America.

Since then, chikungunya has swept through populations in the Caribbean. And because an estimated nine million Americans visit the Caribbean each year, there's little hope that the virus won't make the short jump to the North American continent.

Indeed, numerous "travel" cases already have been reported in several American states. These are at least as close to home as Tennessee. This chikungunya cases amount to having been bitten by an infected mosquito overseas (where it's established) and bringing the virus home.

No U.S. health officials are yet reporting any sustained domestic cases â “ that is, no cases in which a person has been infected by the bite of a mosquito carrying the virus here in the U.S.

Chikungunya usually is not fatal, but it's said to produce enough aches and pains that someone with a severe case of it might imagine death would be preferable.

According to the Centers for Disease Control, a typical case might be seven to 10 days of low or moderate fever and joint pain. Other common symptoms are headaches, joint swelling, muscle aches and rash. Once you endure this and it goes away, it's thought that the chikungunya veteran is immune to the virus thereafter.

However, chikungunya produces some cases that linger for week or months. Some indications are that it can run on for years with periods of remission alternating with symptomatic flare-ups.

There is no cure for chikungunya, only over-the-counter pain relievers and anti-inflammatory medications for easing symptoms. You can't fix chikungunya; you can only mute its consequences and hope it goes away soon.

Prevention is the best measure. And that could get more critical if the widely expected spread of the virus occurs.

A major vulnerability for America is that chikungunya is spread by a couple of mosquito varieties that are found almost worldwide, including in the southern U.S. Two Aedes genus mosquitoes, Aedes albopictus, the Asian tiger mosquito, and Aedes aegypti, the yellow fever mosquito, are the primary carriers.

The yellow fever mosquito is said to have been a major player in western Kentucky, but nowadays it is much more seldom seen after being largely supplanted by another mosquito species. And wouldn't you know it, the species that mostly replaced it is the Asian tiger mosquito.

The Asian tiger mosquito appeared in the U.S. during the 1980s and flourished thereafter. A mosquito that readily adapts to urban areas as well as rural wetlands, this one holds the most promise of proving the primary future vector for chikungunya.

Both the Asian tiger mosquito and the yellow fever mosquito could make chikungunya a commonplace disease in the southern U.S. In America, only the northern tier states are largely free of the two known vectors of the disease.

Chikungunya is spread simply by one of these carrier mosquitoes biting a human infected with the virus, then biting another person during a subsequent feeding and effectively inoculating the second blood source with the first person's disease.

This new-to-us virus is ever more reason to avoid being mosquito bitten. If and when domestic cases of chikungunya become reality, urgency will heighten. If you have any plans to visit the Caribbean, mosquito deflection should be paramount concern. But even here, right in the back yard, fending off mosquitoes is more advisable than ever.

Just staying out of mosquito-rich environments may not be an option. Life must go on. And Asian tiger mosquitoes do well in even urban and suburban areas, so it's almost impossible to avoid them altogether. They are active day-time biters too, so you can't dodge them just by staying inside at night.

It comes to down to using repellents. The CDC recommends the use of repellents with the old standard DEET as well as new ones with the active ingredients of picaridin, IR3535 and oil of lemon eucalyptus.

DEET in concentrations of about 20 percent are the benchmark protection, but repellent brands such as Cutter, Off and Natrapel that contain picaridin are earning higher marks nowadays because (at least in about 20 percent strength) they seem to hold away mosquitoes for long periods but they don't melt plastics or feel generally icky on the skin as DEET tends to do.

Best total protection comes from putting one of these repellents on exposed skin and having one's clothing treated (sprayed down in advance) with a compound containing .5 percent permethrin. This product (available in Sawyer, Duranon, Repel, Ben's and Ultrathon brands) certainly will fend off mosquitoes. It's superior to other repellent types in keeping away tick and chiggers, too.

Read what's on the repellent containers. Use the right stuff in the right manner and you'll stand a far better chance of dodging a possible chikungunya influx as well as generally annoying pestilence.

Steve Vantreese, a freelance outdoors writer, can be contacted at outdoors@paducahsun.com.


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