26/08/2015
The first case of infection in Spain has occurred in Gandía, Valencia on the Costa Azahar, which is 65 kilometres (40 miles) south of Valencia and 96 km (60 miles) north of Alicante.
Health authorities have been notified to be extra vigilant after the first case of chikungunya virus to have been contracted in Spain has been diagnosed in Gandía, in the Valencia region.
The Chikungunya virus is usually thought of as a tropical disease as the majority of cases occur in Africa, Asia, the Caribbean and India, although other sporadic outbreaks have been reported in recent years in the Mediterranean in Italy and France. ( Italy 2007, 200 cases, one fatal, Var in France 2 cases in 2010 and 12 in Montpellier in 2014)
Chikungunya can only be transmitted through mosquito bites and the reason health authorities in Spain have been notified to be extra vigilant is due to the presence of the Tiger Mosquito in Mediterranean coastal areas of Spain.
There is no vaccine for Chikungunya,and no effective anti-viral treatment, but the virus is rarely fatal, although it can cause complications in those with other pre-existing debiliating medical conditions and the more mature.
Infection causes fever, joint pain, fatigue, nausea, headaches and muscle pain, and treatment tends to focus on relieving symptoms. Most people recover within 7 to 10 days although swollen joints can continue for some months in extreme cases.
There are many cases of the virus reported in Spain every year, but up until this case these have always been travellers returning to Spain from infected countries who are already carrying the virus. As it takes several days for symptoms to appear following infection, many travellers do not realice they have been infected until returning home. Spanish health authorities say that more cases are likely to have occurred without the public attributing them to this virus, as the symptoms are often mistaken for flu.
Last year 266 cases of chikungunya were reported in Spain and so far this year there have been 86 cases, 18 of them in the Valencia region, all imported via returning travellers.
The 60 year old man in Gandia has become the first person to contract the virus in Spain, which means that he has been bitten by a mosquito carrying the virus in Gandía in the Valencia region, leading, naturally, to the conclusión that there may be other cases in the offing and that the disease could now start to spread throughout Spain. In order for the virus to spread the mosquito must bite one host person carrying the virus ( who has probably been on holiday) and then bite another healthy individual, and so the cycle begins.During the 7 day period in which neither victim is aware they are carrying the virus they could conceivably be bitten by other mosquitos, spreading the virus further.
The individual concerned first reported symptoms on the 7th July and was hospitalised between the 11th and 16th July without a diagnosis being made as he had not travelled to infected countries. However, after his release he continued to suffer joint pain, and a blood test confirmed his illness as chikungunya. He has since made a full recovery according to a spokesperson from the Valencia Health Authority.
Aedes albopictus, better known as the Tiger Mosquito, has been present in Spain since 2004, the first case reported in the Cataluña region. Since then it has gradually spread along the Mediterranean coastline and is reported to be present in Cataluña, the Valencia Region, first arrived 2013 ( Alicante Province Marina Alta) and Murcia( Spring 2015) although may well have spread further.
The ECDC , the European Centre for Disease Prevention and Control undertook a rapid risk assessment this week ( Click to read full pdf)after the case was reported and says that “The patient developed symptoms on 7 July while travelling in France, had no history of travel outside the EU during at least three months, and was most likely infected in the city of Gandía, Valencia community in Spain.
The report of an autochthonous case of chikungunya in Spain is not unexpected. The competent vector, Aedes albopictus mosquito, has been present in Valencia since 2013, and imported cases of chikungunya have been reported from the city of Gandía where the climate is conducive to chikungunya transmission.
Europe is vulnerable to autochthonous transmission of chikungunya virus in areas where mosquitoes capable of carrying the disease are established and where climate is conducive to chikungunya transmission. The risk of onward transmission in Europe is linked to imported cases from chikungunya-endemic areas elsewhere in the world.
The current world-wide epidemiological situation of chikungunya has resulted in an increased number of imported chikungunya cases in Europe, mainly originating from the Americas.
Exposure to infected mosquitoes is the principal risk for infection in currently affected areas. Prevention of chikungunya is based on vector control and personal protection against mosquito bites.”
Detailed information about the Tiger Mosquito in Spain can be read by clicking “The Tiger Mosquito in Spain”, but it should be pointed out that the range of this mosquito is very limited, only 200 metres, hence the slow spread along the Spanish coast. This mosquito is particularly bothersome as it feeds during the day, and is known as the forest day mosquito in some areas of Asia for this specific reason. However, it requires water for reproduction, and a great deal of preventative action by the public can help to limit its spread by ensuring that no pools of static water are available in which it can breed in areas where infestation could potentially occur.
If you do live in an area where populations are known to exist, then eliminating locations in which breeding could occur is highly advisable, taking precautions to cover as much flesh as possible and using mosquito repellent products are also practical measures which can be followed.
In the Valencia region increased vigilance is being undertaken to prevent the mosquito population becoming extensive and around the city of Valencia last week an additional 300 traps were laid to attract the insects due to the recent rains and high humidity, conditions which favor reproduction.
With this case now becoming public knowledge, increased vigilance can be applied and preventative measures taken to help limit the spread of both the mosquito and chikungunya.
But above all, please don´t panic. In spite of its name and the headlines already starting to appear in media who prefer shocking to informing, this is NOT a highly contagious, dangerous virus which could spread like wildfire throughout Spain overnight.
Image: Wikipedia
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