Preparedness for threat of chikungunya in the pacific

Chikungunya virus (CHIKV) caused significant outbreaks of illness during 2005–2007 in the Indian Ocean region. Chikungunya outbreaks have also occurred in the Pacific region, including in Papua New Guinea in 2012; New Caledonia in April 2013; and Yap State, Federated States of Micronesia, in August 2013. CHIKV is a threat in the Pacific, and the risk for further spread is high, given several similarities between the Pacific and Indian Ocean chikungunya outbreaks. Island health care systems have difficulties coping with high caseloads, which highlights the need for early multidisciplinary preparedness. The Pacific Public Health Surveillance Network has developed several strategies focusing on surveillance, case management, vector control, laboratory confirmation, and communication. The management of this CHIKV threat will likely have broad implications for global public health.
Keywords: chikungunya, CHIKV, Pacific, Pacific Public Health Surveillance Network, PPHSN, Aedes aegypti, Aedes albopictus, outbreak,preparedness, viruses, vector-borne infections, mosquitos, Indian Ocean, Papua New Guinea, Yap State, Federated States of Micronesia, New Caledonia Chikungunya virus (CHIKV) is an alphavirus transmitted to humans by Aedes species mosquitoes, particularly Aedes aegypti and A. albopictus (1). It typically causes fever and severe and persistent joint pain (2). CHIKV was first recognized as a human pathogen in 1952 in Tanzania and, after several decades of little activity, has reemerged globally during the past decade (3). Chikungunya first appeared in the Pacific region in a small outbreak in New Caledonia in 2011 (1), but the virus is now a major threat in this reason. Outbreaks have been confirmed in Papua New Guinea (PNG) in June 2012 (4); New Caledonia in April 2013 (5); and Yap State, Federated States of Micronesia, in August 2013 (6). In this article, we give an overview of the virus, update the recent epidemiology of CHIKV, and assess the risk for CHIKV spread in the Pacific. We draw on lessons learned from the response efforts in the Indian Ocean, where the most devastating chikungunya epidemic so far caused havoc in a setting that is very similar to that of the Pacific Islands (7). We propose a series of public and clinical health measures to help Pacific Island countries and territories prepare for potential outbreaks of CHIKV infection.