JEMA : Your Health Promotion Experts

What is the current situation?

In December 2014, Bermuda reported local transmission of chikungunya. Local transmission means that mosquitoes in the area have been infected with chikungunya and are spreading it to people. This is the first time that local transmission of chikungunya has been reported in Bermuda. Chikungunya cases have also been reported in several countries in the Caribbean and Central and South America.

CDC recommends that travelers to Bermuda protect themselves from chikungunya by preventing mosquito bites. Some travelers may be more likely to get chikungunya, have severe disease, or be at higher risk for other reasons. CDC advises travelers in high-risk groups to discuss their travel plans with their health care provider. These groups include the following:

• People who have arthritis

• People with serious underlying medical conditions (such as high blood pressure, heart disease, or diabetes)
• People older than 65
• Women who are late in their pregnancies, because of the risk to babies born at the time their mother is sick
• Long-term travelers, including missionaries and humanitarian aid workers and people visiting friends and relatives
• People who might have difficulty avoiding mosquito bites, such as those planning to spend a lot of time outdoors or staying in rooms without window screens or air conditioning.

What is chikungunya?

Chikungunya is an illness caused by a virus that spreads through mosquito bites. The most common symptoms of chikungunya are fever and joint pain. Other symptoms may include headache, muscle pain, joint swelling, or rash. Chikungunya disease rarely results in death, but the symptoms can be severe and disabling. Most people who get sick feel better within a week. In some people, the joint pain may last for months or years.

Who is at risk?

Travelers who go to these islands in the Caribbean are at risk of getting chikungunya. In addition, travelers to Africa, Asia, and islands in the Indian Ocean and Western Pacific are also at risk, as the virus is present in many of these areas. The mosquito that carries chikungunya virus can bite during the day and night, both indoors and outdoors, and often lives around buildings in urban areas.

What can travelers do to prevent chikungunya?

There is currently no vaccine or medicine to prevent chikungunya. The only way to prevent chikungunya is to prevent mosquito bites. Preventing bites can be difficult, but it is important as you can get sick after just one bite. Follow these steps to reduce the chances that you will be bitten by mosquitoes during your trip.

Prevent mosquito bites:

• Cover exposed skin by wearing long-sleeved shirts, long pants, and hats.
• Use an appropriate insect repellent as directed.
• Higher percentages of active ingredient provide longer protection. Use products with the following active ingredients:
  • DEET (Products containing DEET include Off!, Cutter, Sawyer, and Ultrathon)
  • Picaridin (also known as KBR 3023, Bayrepel, and icaridin products containing picaridin include Cutter Advanced, Skin So Soft Bug Guard Plus, and Autan [outside the US])
  • Oil of lemon eucalyptus (OLE) or PMD (Products containing OLE include Repel and Off! Botanicals)
  • IR3535  (Products containing IR3535 include Skin So Soft Bug Guard Plus Expedition and SkinSmart)
• Always follow product directions and reapply as directed:
• If you are also using sunscreen, apply sunscreen first and insect repellent second.
• Follow package directions when applying repellent on children. Avoid applying repellent to their hands, eyes, and mouth.
• Treated clothing remains protective after multiple washings. See the product information to find out how long the protection will last.
• If treating items yourself, follow the product instructions carefully.
• Do not use permethrin directly on skin.
• Use permethrin-treated clothing and gear (such as boots, pants, socks, and tents). You can buy pre-treated clothing and gear or treat them yourself:
• Stay and sleep in screened or air conditioned rooms.
• Use a bed net if the area where you are sleeping is exposed to the outdoors.

If you feel sick and think you may have chikungunya:

• Talk to your doctor or nurse if you feel seriously ill, especially if you have a fever.
  • Tell them about your travel.
  • For more information about medical care abroad, see Getting Health Care Abroad and a list of International Joint Commission-accredited facilities.
• Use acetaminophen or paracetamol to treat fever and pain.
• Get lots of rest, and drink plenty of liquids.
• Avoid spreading the disease by preventing more mosquito bites.