The Centers for Disease Control and Prevention (CDC) yesterday issued a Health Alert Network (HAN) Health Advisory to clinicians and public health officials warning that US travelers could be affected by a growing chikungunya outbreak in Paraguay.
Since the chikungunya outbreak began in October 2022, the Ministry of Health in Paraguay has reported 71,748 suspected cases of the mosquito-borne alphavirus, with 29,362 of those cases being probable or confirmed. Most cases have been reported in the capital district of Asuncion and the neighboring Central department. Further increases in case counts are expected.
Paraguay is among several countries in the region of the Americas seeing an increase in chikungunya activity. In February, the Pan American Health Organization reported that cases in the region were up sharply in 2022, with 271,000 illnesses reported, up from 137,000 in 2021.
The virus is transmitted primarily by infected Aedes aegypti and Aedes albopictus mosquitoes. The incubation period in infected people is typically 3 to 7 days, and the most common symptoms are acute onset of fever and joint pain. No specific antivirals or vaccines are available.
Ruling out dengue
The CDC says travelers returning from Paraguay with signs and symptoms consistent with chikungunya infection should be tested and evaluated. The health advisory also notes that clinicians should rule out infection with dengue virus, which is also transmitted by mosquitoes, has similar symptoms, and circulates in Paraguay and surrounding countries.
The health advisory advises state and local health departments to report confirmed chikungunya cases to the CDC.