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Preparedness and response for Chikungunya virus introduction in the Americas
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Preparedness and response for Chikungunya virus introduction in the Americas
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    Preface -- Acknowledgments -- Abbreviations and acronyms -- 1. Background and rationale -- 2. Epidemiology -- 3. Clinical -- 4. Laboratory -- 5. Case management -- I6. Surveillance and outbreak response -- 7. Vector surveillance and control -- 8. Risk and outbreak communication -- 9. Conclusion -- 10. Appendices -- Appendix A. Viral Isolation Protocol (for Cell Culture) -- Appendix B. Real-Time Reverse Transcriptase-Polymerase Chain Reaction Protocol -- Appendix C. IgM and IgG Serologic Assay Protocols -- Appendix D. Example of a Case Report Form -- Appendix E. Report for an Event or Outbreak of Public Health Importance -- Appendix F. Vector Control Procedures -- Appendix G. Vector Control for CHIKV Containment -- Appendix H. Model for Risk and Outbreak Communication Plan -- Appendix I. Meeting of the Technical Advisory Group of Preparedness and Response for Chikungunya Virus Introduction in the Americas -- 11. References.

    Pan American Health Organization (PAHO), with the support of the Division of Vector-borne Diseases of the United States Centers for Disease Control and Prevention (DVBD, CDC), created a working group and convened a meeting in Lima, Peru, on July 21-23, 2010, to discuss the threat this virus represents and to examine measures that might be taken to mitigate this vii threat (see Appendix I for additional details on the meeting). These preparedness guidelines are the result of this collaboration.

    The contents of this document were written by J. Erin Staples, Ann Powers, Kay Tomashek, Robert S. Lanciotti, Elizabeth Hunsperger, Jorge Munoz, Harry Savage, John-Paul Mutebi, Roberto Barrera, Emily Zielinski-Gutierrez, Carmen Perez, and Roger S. Nasci of the DVBD, CDC.The publication of these guidelines was possible thanks to funding from the U.S. Centers for Disease Control and Prevention.

    The Pan American Health Organization/World Health Organization (PAHO/WHO), in collaboration with the U.S. Centers for Disease Control and Prevention (CDC), has published new guidelines on chikungunya, a mosquito-transmitted virus transmitted that causes fever and severe joint pain. The Guidelines for Preparedness and Response for Chikungunya Virus Introduction in the Americas aims to help countries throughout the Americas improve their ability to detect the virus and be prepared to monitor, prevent, and control the disease, should it appear. Hundreds of people who have traveled from the Americas to Asia and Africa in the past five years have become infected with the chikungunya virus. While the virus has not spread locally in the Western Hemisphere, experts say there is a clear risk of its introduction into local mosquito populations. Local transmission could occur if mosquito populations in the United States or elsewhere in the Americas became infected with the virus and began spreading it to people in that area. From 2006 to 2010, 106 laboratory-confirmed or probable cases of chikungunya were detected among travelers returning to the United States. This compares with only three cases reported from 1995 to 2005. Since 2004, chikungunya virus has caused massive and sustained outbreaks in Asia and Africa, infecting more than 2 million people, with attack rates as high as 68% in some areas. With the movement of travelers, local transmission has taken place in areas where the virus was not previously found, including northern Italy and southern France. Nine cases have been reported in the French territories of the Americas since 2006 (three each in Martinique, Guadeloupe, and Guaina). To date, none of the cases has led to local transmission; however, they demonstrate the ongoing risk of introduction and possible sustained transmission of chikungunya virus in the Americas, experts say. The name chikungunya means "that which bends up." The disease is rarely fatal, but the severe joint pain it produces can last for months. There is no specific treatment or commercially available vaccine against the disease. Chikungunya virus is spread through the bite of infected mosquitoes, particularly Aedes aegypti and Aedes albopictus (the "Asian Tiger Mosquito"). Aedes aegypti, which can also transmit dengue and yellow fever, is common in tropical and subtropical areas of the Americas, including the southern United States. Aedes albopictus is found in more temperate areas of the Americas and is widespread in the southeastern states and East Coast of the United States.

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