Assessing Fever in Returning Travelers: Part II

  Zika continues to be the virus of the day for returning travelers, but there are several other diseases that we need to consider in these patients when they present to us in the emergency department. Chikungunya is epidemic in many of the same countries as Zika and can be even more devastating. And Avian and MERS-CoV is still present in many countries. Unlike patients infected with Zika virus, these patients do require isolation to protect our health care staff from infection. Chikungunya Chikungunya, which means “to walk bent over,” was likely endemic but unrecognized in the United States before the mosquito eradication programs initiated in the 1950s. While the presentation of chikungunya is similar to that of dengue, with fever, a petechial rash, and arthralgias, bleeding is usually less severe. However, the associated arthralgias are much more painful and can last from months to years. Chikungunya has a similar incubation period as dengue, 2-14 days, but most patients present by day four. Treatment is supportive and includes adequate pain control; there are no medications that specifically treat chikungunya. Immunity does develop after infection with chikungunya, but it is short-lived and not lifelong. Until outbreaks of recent years, chikungunya was a painful disease with a high morbidity but a very low mortality; however, changes in the virus have increased disease severity. Chikungunya is now being transmitted by Aedes albopictus, a temperate mosquito capabl...
Source: EPMonthly.com - Category: Emergency Medicine Authors: Tags: Uncategorized Source Type: news