Chikungunya, a viral disease transmitted via the bite of infected mosquitoes, is spreading in Colombia and Nicaragua, and it's made an appearance in the U.S.

The virus has been documented across Asia, Africa, Europe and the Americas, as well as in the Indian and Pacific Ocean, where it's reached endemic and epidemic levels in some parts. Colombia has reported steady growth within recent months, and according to the Pan American Health Organization (PAHO), it has reached 13,000 cases in Colombia. That has brought the number of suspected and confirmed locally acquired chikungunya cases to 232,920 since June 2014. Also, Nicargua saw a gain of 19,000 (from 4645 suspected and confirmed cases to 23697 cases).

Between March 20 and March 27, there've been increases in the number of imported cases in the U.S. (from 2,536 to 2,549), but there were no changes in the 458 cases confirmed in Mexico or the 11 confirmed cases in the U.S. There has been growth suspected cases in El Salvador and other Latin nations.

Travel notices for chikungunya have been in South America, as well as many Mexican states hardest hit by the virus. There have been 1,339,835 confirmed and suspected locally transmitted cases in the Americas since December 2013.

According to the Center for Disease Control and Prevention, at the beginning of 2014, new cases of the virus was reported by U.S. travelers returning from affected areas in the Americas, and local transmission was discovered in Puerto Rico, Florida and the U.S. Virgin Islands. Provision data offered by the CDC, states that as of 2015, chikungunya virus has become a nationally notifiable condition.

That said, Europe and the Americas' infected fare better than some. Beyond minor incidence rates caused by the foreign nation-traveling passengers, Italy is the only European that has had an outbreak. And not a single nation in the Americas has experienced an outbreak yet.

Across 19 states, there have been a total of 68 chikungunya virus disease cases documented and reported to ArboNET, as of March 24. And reported cases are from travellers who've returned from affected areas, not a single locally transmitted case was reported from within the U.S. All reported cases of chikungunya were locally transmitted cases reported from Puerto Rico and the U.S. Virgin Islands. Local transmission risk is low in the U.S., but it is possible, particularly in communities where groups of people annually travel to the Caribbean.

The Tennessee Department of Health encouraged travelers to be mindful of the importance of protecting themselves against the transmission of chikungunya virus and other mosquito-borne illnesses.

"Travel plans to warmer destinations should include necessary precautions to avoid mosquito bites," said TDH Commissioner John Dreyzehner, MD, MPH, according to Outbreak News Today. "Because there is no vaccine to prevent chikungunya virus disease, the only way to prevent its spread is the effective use of repellants and personal protection strategies."

After just four or seven days of being bitten by an infected mosquito, high fever (40°C/ 104°F) sets in. That can be paired with joint pain (lower back, ankle, knees, wrists or phalanges), joint swelling, vomiting, rash, headache, muscle pain, nausea and fatigue.

The name of the illness was derived from an African Makonde word meaning "that which bends up" or "to become contorted" because most patients suffer from stark joint pain. While the symptoms are quite serious, the World Health Organization ensures that chikungunya is rarely fatal, but joint pain can persist for months, or even years, leading to chronic pain or disability.

"People at risk for more serious effects from chikungunya virus disease include newborns, those over age 65 and those with health conditions such as heart disease, diabetes or high blood pressure," said Abelardo Moncayo, PhD, director of the TDH Vector-Borne Diseases program, according to Outbreak News Today. "While there is no medicine to treat or cure the infection, rest, [take] fluids to prevent dehydration and [use] medicines like acetaminophen to relieve fever and pain are helpful. Fortunately, once a person has been infected with chikungunya, he or she is likely to be protected from future infections, and the disease rarely results in death."

Also, pregnant women, long-term travellers, those with arthritis and those who spend a great deal of time outside are more likely to contract chikungunya. Chikungunya can be detected using serological tests, and it's often clinically confused with the far more dangerous virus dengue.

Following recovery, infected parties have life-long immunity. However, there have been no treatments or vaccines developed to protect against or treat chikungunya infection. There has been a huge push to produce a vaccine that will ward off the illness; however, there have not been enough human cases in Texas or Florida to justify pharmaceutical companies spending millions on production. So, protecting oneself against mosquitos with repellent is one's best bet.

Tennessee Department of Health's recommendations for repelling mosquitos includes using insect repellants; dumping standing water, which attracts bugs; using products containing permethrin on clothing, shoes and other items; refraining from the use of perfume or scented fragrances; and wearing long, loose and light clothing when outdoors. Also, one could steer clear of travelling to the Caribbean and possibly Florida, altogether.

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