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Dengue and chikungunya infections in travelers

Chen, Lin Ha,b; Wilson, Mary Ea,b,c

Current Opinion in Infectious Diseases: October 2010 - Volume 23 - Issue 5 - p 438–444
doi: 10.1097/QCO.0b013e32833c1d16
Tropical and travel-associated diseases: Edited by Joseph M. Vinetz

Purpose of review Dengue and chikungunya are arboviruses that have caused major outbreaks and infected travelers, and both can be associated with fever and rash. We review the recent epidemiology of dengue and chikungunya infections and discuss their clinical presentations, diagnosis, treatment, and prevention. We highlight the findings in travelers.

Recent findings Globally dengue is one of the most common infections associated with travel, and incidence has increased in the Americas in recent years, especially in Brazil. Chikungunya has caused dramatic outbreaks in the Indian Ocean islands since 2004, and has spread to south and south-east Asia. Dengue virus and chikungunya virus also possess the potential to cause autochthonous transmission in temperate regions of developed countries due to the presence of the vector mosquito, Aedes albopictus. Such an outbreak (chikungunya infection) did occur in 2007 in Italy. A mutation in chikungunya virus (A226V) appears to improve virus survival in Aedes albopictus and also increase its virulence.

Summary The findings assist in differentiating dengue and chikungunya from other acute febrile illnesses and from each other. The findings also illustrate potential outbreaks in nonendemic countries, important toward developing control and prevention strategies.

aTravel Medicine Center, Mount Auburn Hospital, Cambridge

bHarvard Medical School

cHarvard School of Public Health, Boston, Massachusetts, USA

Correspondence to Lin H. Chen, MD, Travel Medicine Center, Mount Auburn Hospital, 330 Mount Auburn Street, Cambridge, MA 02238, USA Tel: +1 617 499 5026; fax: +1 617 499 5453; e-mail:

© 2010 Lippincott Williams & Wilkins, Inc.