Abstract
Since the first documented autochthonous transmission of chikungunya virus in the Caribbean island of Saint Martin in 2013, the infection has been reported within the Caribbean region as well as North, Central and South America. The risk of autochthonous transmission of chikungunya virus becoming established in Spain may be elevated due to the large numbers of travellers returning to Spain from countries affected by the 2013 epidemic in the Caribbean and South America, as well as the existence of the Aedes albopictus vector in certain parts of Spain. We retrospectively analysed the laboratory diagnostic database of the National Centre for Microbiology, Institute of Health Carlos III (CNM-ISCIII) from 2008 to 2014. During the study period, 264 confirmed cases, of 1,371 suspected cases, were diagnosed at the CNM-ISCIII. In 2014 alone, there were 234 confirmed cases. The highest number of confirmed cases were reported from the Dominican Republic (n = 136), Venezuela (n = 30) and Haiti (n = 11). Six cases were viraemic in areas of Spain where the vector is present. This report highlights the need for integrated active case and vector surveillance in Spain and other parts of Europe where chikungunya virus may be introduced by returning travellers.
Highlights
Since the first outbreak in Tanzania in 1952, chikungunya has been endemic in some parts of Africa, south-east Asia and in the Indian subcontinent [1]
A total of 264 (19%) suspected cases were laboratory confirmed by CNM-ISCIII during the study period
The distribution of imported cases by month during our study period in Spain shows that the number of confirmed and suspected cases reached its peak during July (Figure 1B)
Summary
Since the first outbreak in Tanzania in 1952, chikungunya has been endemic in some parts of Africa, south-east Asia and in the Indian subcontinent [1]. As at 31 December 2014 (the final day of our study), 24,682 confirmed autochthonous cases and 1,118,763 suspected cases of chikungunya in the Americas had been reported by the Pan American Health Organization (PAHO) [3]. A chikungunya outbreak in 2005 in Réunion, a French overseas department and region, affected 266,000 people (ca 35% of the population), including 783 cases imported to metropolitan France [4]. During this outbreak, a mutation (A226V in the chikungunya virus E protein) that improved the replication in Aedes albopictus was observed, giving rise to a new virus variant whose fitness in this mosquito was increased [5]
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