NTDs: Dengue and chikungunya – those pesky mosquitoes can kill you

This post is the 3rd in a series highlighting the WHO’s list of 17 Neglected Tropical Diseases (now technically 18 as mycetoma was added to the list at the 69th World Health Assembly in May 2016). To read the previous posts in this series click here.

Aedes egypti mosquito, the vector of both dengue and chikungunya. Courtesy CDC.

Dengue and chikungunya are both mosquito-borne viral diseases.The incidence of dengue has increased 30-fold over the last 50 years. In the 100 endemic countries, 50 to 100 million infections occur each year, meaning almost half of the world’s population is at risk of contracting dengue. Chikungunya has been identified in over 60 countries in Asia, Africa, Europe and the Americas. In 2013, chikungunya was first identified in the Caribbean where it then spread to 43 countries and territories in the WHO Region of the Americas. However, cases have been decreasing according to PAHO (Pan American Health Organization) but chikungunya is still a threat as Argentina experienced their first case in early 2016.

Countries with current or previous local transmission of chikungunya virus, listed in below data table

Chikungunya distribution (as of April 2016). Courtesy CDC.

dengue map

Map of dengue distribution (2010). Courtesy of Brady, OJ et al.

Dengue and chikungunya have similar symptoms so chikungunya can be misdiagnosed as dengue in areas where dengue is very common. The common symptoms include debilitating joint pain, muscle pain, nausea, headache and rash. Dengue is especially nasty as it has the potential to result in a potentially fatal condition called severe dengue (also known as dengue hemorrhagic fever). Severe dengue is potentially fatal due to plasma leaking, fluid accumulation, respiratory distress, severe bleeding or organ impairment. There are 4 serotypes of dengue, DEN-1, DEN-2, DEN-3, DEN-4 (very clever naming scheme right?) and infection with one gives the survivor lifelong immunity, but if that unlucky person gets infected with another serotype their chances of developing severe dengue increase.

Neither dengue nor chikungunya have specific treatments. Prevention for both include your general mosquito control techniques like getting rid of standing water, using insecticides as necessary, wearing long sleeves and pants, using bug spray, making sure your windows/doors have screens,etc. On the bright side, dengue does have a licensed vaccine. Dengvaxia (by Sanofi-Pastuer) was first registered in Mexico in 2015 and is for use by folks aged 9-45 living in dengue endemic areas. A WHO vaccine position paper outlining WHO recommendations will be publishing in July 2016.

When it comes to dengue and chikungunya, save yourself from bone-breaking pain and avoid mosquito bites as much as possible.

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