Source Florida Arbovirus Surveillance – Week 24
# 8754
If you want to gauge the latest fashion trends, you go to Paris. If you are looking for the latest in bleeding edge technology, you go to Silicon Valley. But if you are interested in monitoring imported mosquito-borne disease threats to the United States, the place to pitch your tent is Florida.
With well over 80 million visitors each year, Florida is the top travel destination in the world.
And many of those travelers come from places around the world where dengue, malaria, and chikungunya are endemic. Which means that nearly every week, some number of infected travelers unpack their bags in Florida.
Up until 2009, Florida had kept dengue at bay for 6 decades. But one (or likely, more) infected international travelers arrived in Key West, and the virus jumped into the local mosquito population (see MMWR: Dengue Fever In Key West).
Since then, we’ve seen sporadic locally acquired dengue cases in south Florida(see Florida: Dengue Forces Suspension Of Blood Donations In Two Counties), likely due to repeated `reseeding’ of the virus among local mosquito populations.
The concern is, that the same thing could happen with malaria, or the recently emerged Chikungunya virus, which is now exploding across the Caribbean.
In 2013, Florida recorded 120 imported cases of Dengue (plus 23 locally acquired cases), 53 imported cases of malaria (0 local cases), and 0 imported cases of Chikungunya.
Today, the Florida Department of Health’s weekly Arbovirus surveillance report – Week 24 has come out, and we find – while no locally transmitted cases have been reported – travel associated dengue, malaria, and chikungunya cases continue to rise.
Over the past week, four new malaria importations, and 17 new Chikungunya importations were reported.
International Travel-Associated Dengue Fever Cases: Twenty-four cases of dengue with onset in 2014 have been reported in individuals with travel history to a dengue endemic country in the two weeks prior to onset. Countries of origin were: Bolivia, Brazil (2), Caribbean, Cuba (8), Dominican Republic (4), Guadeloupe, Honduras, Puerto Rico (3), Trinidad, and Venezuela (2). Counties reporting cases were: Alachua, Broward (2), Clay, Hillsborough (3), Marion, Miami-Dade (10), Orange, Osceola (3), Pinellas, and Seminole. Four of the cases were reported in non-Florida residents.
In 2014, 16 of the 24 cases of dengue reported in Florida have been serotyped by PCR. Additional serotyping and strain typing are being conducted.
International Travel-Associated Chikungunya Fever Cases: Forty-two cases of chikungunya with onset in 2014 have been reported in individuals with travel history to a chikungunya endemic country or area experiencing an outbreak in the two weeks prior to onset. Countries of origin were: Dominica, Dominican Republic (8), Haiti (31), and Martinique (2). Counties reporting cases were: Brevard, Broward (7), Charlotte, Clay, Duval (2), Flagler, Hillsborough (3), Lake, Lee, Leon, Miami-Dade (7), Orange (3), Osceola, Palm Beach (7), Pasco, Santa Rosa, Seminole, St. Lucie, and Volusia. Eight of the cases were reported in non-Florida residents.
International Travel-Associated Malaria Cases: Eighteen cases of malaria with onset in 2014 have been reported. Countries of origin were: Angola, Dominican Republic, Equatorial New Guinea (2), Ghana, Guatemala, India, Ivory Coast (2), Kenya, Sierra Leone (4), Sudan, Uganda (2), and multiple sub-Saharan African countries (1). Counties reporting cases were: Broward (4), Duval, Escambia, Hernando, Hillsborough (3), Miami-Dade (2), Okaloosa, Orange, Osceola, Palm Beach, Pasco, and Santa Rosa. Two of the cases were reported in non-Florida residents.
Thirteen cases (72%) were diagnosed with Plasmodium falciparum. Three cases (17%) were diagnosed with Plasmodium vivax.One case (5.5%) was diagnosed with Plasmodium malariae. One case (5.5%) was diagnosed with Plasmodium Ovale.
The good news is, despite repeated introductions this spring, we’ve not seen any local transmission of these mosquito-borne diseases in Florida. The not-quite-so-good news is our mosquito season is really just getting started.
While there are no vaccines available for these viruses, these are still largely preventable diseases. Local Health departments urge people to always follow the `5 D’s’ of prevention:
