591290
research-article2015
WHSXXX10.1177/2165079915591290Workplace Health & SafetyWorkplace Health & Safety
Workplace Health & Safety
June 2015
Current Topics
Chikungunya Virus Jennan A. Phillips, PhD, MSN, RN1
Abstract: A mosquito-borne viral disease that is creating increased concern globally is Chikungunya virus (CHIKV). Occupational and environmental health nurses should educate workers about this emerging viral infection.
Keywords: disease prevention, global occupational health, health surveillance, occupational health and safety programs, occupational hazards, health education
W
ork hazards in agriculture, construction, forestry, and other outdoor jobs can include extreme heat and high humidity, but sometimes overlooked are viruses acquired from mosquito bites, such as Chikungunya virus (CHIKV). Two species of mosquitoes typically found in tropical and subtropical climates are responsible for dengue fever and also CHIKV, which has no vaccination or cure. Humans are the main reservoirs of the virus; laboratory workers handling infected blood, and health care workers drawing blood from infected patients, have contracted CHIKV (Staples, Hills, & Powers, 2014). After the first recognized outbreak in 1952, sporadic outbreaks of CHIKV occurred in Africa, Southeast Asia, and India. After 2000, the number of outbreaks increased; nearly 2 million cases were reported in India, Indonesia, Maldives, Myanmar, and Thailand since 2005. European officials reported their first disease transmission during a localized outbreak in northeastern Italy in 2007 followed by outbreaks in France and Croatia. The first case in the
Americas was in St. Martin in 2013; as of April 2015, nearly 1.4 million cases and 191 deaths have been recorded in the Caribbean islands, Latin American countries, and the United States. Global travel contributes to worldwide outbreaks with cases now reported in some Pacific Islands (World Health Organization, 2015). Infected individuals usually develop symptoms 3 days to 7 days after exposure (range = 1 day-12 days), which resolve within 7 days to 10 days. The virus is differentiated from dengue by acute onset of high fever above 39 ºC (102 ºF) with bilateral, symmetric, severe, and often debilitating joint pain (Centers for Disease Control and Prevention [CDC], 2015a). Headache, myalgia, arthritis, conjunctivitis, nausea and vomiting, or maculopapular rash also occur. Although seldom fatal, rare complications include uveitis, retinitis, myocarditis, hepatitis, nephritis, bullous skin lesions, hemorrhage, meningoencephalitis, myelitis, Guillain-Barre’ syndrome, and cranial nerve palsies. Associated laboratory findings are lymphopenia, thrombocytopenia, elevated creatinine, and elevated hepatic transaminases (CDC, 2015a). CHIKV is present throughout the United States (CDC, 2015b) and is reported in the National Notifiable Diseases Surveillance System (NNDSS; CDC, 2015c). Although a field-ready dipstick assay is in development, confirmation of CHIKV is currently through specialized laboratory assays from select state health departments and the CDC. Occupational and environmental health nurses should educate workers about this emerging viral infection and to
report international travel. Workers with underlying health conditions or late in pregnancy are most at risk. Teach all workers to use insect repellent, wear long sleeves and pants, and stay where air conditioning or window and door screens are used when working in or traveling to areas with CHIKV. Removing mosquito breeding grounds (e.g., standing water) is most effective in reducing exposure risk to these aggressive day-time biters. Workers recently returned from CHIKV infected areas complaining of acute onset of fever or polyarthralgia require close monitoring.
References Centers for Disease Control and Prevention. (2015a). Chikungunya virus clinical evaluation and disease. Retrieved from http://www.cdc.gov/chikungunya/hc/ clinicalevaluation.html Centers for Disease Control and Prevention. (2015b). Chikungunya virus 2015 provisional data for the United States. Retrieved from http://www.cdc.gov/chikungunya/geo/ united-states-2015.html Centers for Disease Control and Prevention. (2015c). National Notifiable Diseases Surveillance System (NNDSS) Arboviral diseases, neuroinvasive and nonneuroinvasive. Retrieved from http://wwwn .cdc.gov/nndss/conditions/arboviral-diseasesneuroinvasive-and-non-neuroinvasive/casedefinition/2015/ Staples, J. E., Hills, S. L., & Powers, A. M. (2014). Infectious diseases related to travel: Chikungunya. In The Yellow Book—CDC Health Information for International Travel. Centers for Disease Control and Prevention. Retrieved from http://wwwnc.cdc.gov/travel/ yellowbook/2014/chapter-3-infectious-diseasesrelated-to-travel/chikungunya World Health Organization. (2015). Chikungunya fact sheet. Retrieved from http://www.who.int/mediacentre/factsheets/ fs327/en/
DOI: 10.1177/2165079915591290. From 1University of Alabama at Birmingham. Address correspondence to: Jennan A. Phillips, PhD, MSN, RN, Assistant Professor and Director, Occupational Health Nursing Program, University of Alabama at Birmingham, NB 316 1720 2nd Avenue South Birmingham, AL 35294, USA; email: [email protected]. The author(s) declared no potential conflicts of interest and received no financial support with respect to the research, authorship, and/or publication of this article. For reprints and permissions queries, please visit SAGE’s Web site at http://www.sagepub.com/journalsPermissions.nav. Copyright © 2015 The Author(s) 280 Downloaded from whs.sagepub.com at UNIVERSITE DE MONTREAL on July 7, 2015
research-article2015
WHSXXX10.1177/2165079915591290Workplace Health & SafetyWorkplace Health & Safety
Workplace Health & Safety
June 2015
Current Topics
Chikungunya Virus Jennan A. Phillips, PhD, MSN, RN1
Abstract: A mosquito-borne viral disease that is creating increased concern globally is Chikungunya virus (CHIKV). Occupational and environmental health nurses should educate workers about this emerging viral infection.
Keywords: disease prevention, global occupational health, health surveillance, occupational health and safety programs, occupational hazards, health education
W
ork hazards in agriculture, construction, forestry, and other outdoor jobs can include extreme heat and high humidity, but sometimes overlooked are viruses acquired from mosquito bites, such as Chikungunya virus (CHIKV). Two species of mosquitoes typically found in tropical and subtropical climates are responsible for dengue fever and also CHIKV, which has no vaccination or cure. Humans are the main reservoirs of the virus; laboratory workers handling infected blood, and health care workers drawing blood from infected patients, have contracted CHIKV (Staples, Hills, & Powers, 2014). After the first recognized outbreak in 1952, sporadic outbreaks of CHIKV occurred in Africa, Southeast Asia, and India. After 2000, the number of outbreaks increased; nearly 2 million cases were reported in India, Indonesia, Maldives, Myanmar, and Thailand since 2005. European officials reported their first disease transmission during a localized outbreak in northeastern Italy in 2007 followed by outbreaks in France and Croatia. The first case in the
Americas was in St. Martin in 2013; as of April 2015, nearly 1.4 million cases and 191 deaths have been recorded in the Caribbean islands, Latin American countries, and the United States. Global travel contributes to worldwide outbreaks with cases now reported in some Pacific Islands (World Health Organization, 2015). Infected individuals usually develop symptoms 3 days to 7 days after exposure (range = 1 day-12 days), which resolve within 7 days to 10 days. The virus is differentiated from dengue by acute onset of high fever above 39 ºC (102 ºF) with bilateral, symmetric, severe, and often debilitating joint pain (Centers for Disease Control and Prevention [CDC], 2015a). Headache, myalgia, arthritis, conjunctivitis, nausea and vomiting, or maculopapular rash also occur. Although seldom fatal, rare complications include uveitis, retinitis, myocarditis, hepatitis, nephritis, bullous skin lesions, hemorrhage, meningoencephalitis, myelitis, Guillain-Barre’ syndrome, and cranial nerve palsies. Associated laboratory findings are lymphopenia, thrombocytopenia, elevated creatinine, and elevated hepatic transaminases (CDC, 2015a). CHIKV is present throughout the United States (CDC, 2015b) and is reported in the National Notifiable Diseases Surveillance System (NNDSS; CDC, 2015c). Although a field-ready dipstick assay is in development, confirmation of CHIKV is currently through specialized laboratory assays from select state health departments and the CDC. Occupational and environmental health nurses should educate workers about this emerging viral infection and to
report international travel. Workers with underlying health conditions or late in pregnancy are most at risk. Teach all workers to use insect repellent, wear long sleeves and pants, and stay where air conditioning or window and door screens are used when working in or traveling to areas with CHIKV. Removing mosquito breeding grounds (e.g., standing water) is most effective in reducing exposure risk to these aggressive day-time biters. Workers recently returned from CHIKV infected areas complaining of acute onset of fever or polyarthralgia require close monitoring.
References Centers for Disease Control and Prevention. (2015a). Chikungunya virus clinical evaluation and disease. Retrieved from http://www.cdc.gov/chikungunya/hc/ clinicalevaluation.html Centers for Disease Control and Prevention. (2015b). Chikungunya virus 2015 provisional data for the United States. Retrieved from http://www.cdc.gov/chikungunya/geo/ united-states-2015.html Centers for Disease Control and Prevention. (2015c). National Notifiable Diseases Surveillance System (NNDSS) Arboviral diseases, neuroinvasive and nonneuroinvasive. Retrieved from http://wwwn .cdc.gov/nndss/conditions/arboviral-diseasesneuroinvasive-and-non-neuroinvasive/casedefinition/2015/ Staples, J. E., Hills, S. L., & Powers, A. M. (2014). Infectious diseases related to travel: Chikungunya. In The Yellow Book—CDC Health Information for International Travel. Centers for Disease Control and Prevention. Retrieved from http://wwwnc.cdc.gov/travel/ yellowbook/2014/chapter-3-infectious-diseasesrelated-to-travel/chikungunya World Health Organization. (2015). Chikungunya fact sheet. Retrieved from http://www.who.int/mediacentre/factsheets/ fs327/en/
DOI: 10.1177/2165079915591290. From 1University of Alabama at Birmingham. Address correspondence to: Jennan A. Phillips, PhD, MSN, RN, Assistant Professor and Director, Occupational Health Nursing Program, University of Alabama at Birmingham, NB 316 1720 2nd Avenue South Birmingham, AL 35294, USA; email: [email protected]. The author(s) declared no potential conflicts of interest and received no financial support with respect to the research, authorship, and/or publication of this article. For reprints and permissions queries, please visit SAGE’s Web site at http://www.sagepub.com/journalsPermissions.nav. Copyright © 2015 The Author(s) 280 Downloaded from whs.sagepub.com at UNIVERSITE DE MONTREAL on July 7, 2015
