Preparedness for threat of chikungunya in the pacific

Abstract

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: Aedes aegypti; Aedes albopictus; CHIKV; Federated States of Micronesia; Indian Ocean; New Caledonia; PPHSN; Pacific; Pacific Public Health Surveillance Network; Papua New Guinea; Yap State; chikungunya; mosquitos; outbreak; preparedness; vector-borne infections; viruses.

Figure 1

Chikungunya epidemic in Papua New Guinea, 2012–2013. Colors denote the time for reports or rumors of emerging clinical disease. When such information was lacking, the date of laboratory confirmation of chikungunya virus infection determined the color coding. Solid colors indicate that cases were laboratory confirmed; striped colors indicate lack of laboratory confirmation.

Figure 2

Distribution of chikungunya vectors Aedes albopictus and Ae. aegypti mosquitos in the Pacific, 2013. Green outline indicates areas where Ae. albopictus mosquitos are confirmed or strongly suspected. Ae. aegypti mosquitos are found in most locations except New Zealand, Hawaii, Futuna, and some remote islands. Dotted lines indicate member countries of Pacific Public Health Surveillance Network.

Figure 3

Direct airline routes to Pacific region destinations from Papua New Guinea (Port Moresby), New Caledonia (Noumea), and Yap State, Federated States of Micronesia.