When preparing for a holiday, it is important to keep informed of the current travel advice and health situation in your chosen destination, in order to ensure that you take the most appropriate precautions you can to keep yourself safe.
This should include a trip to a travel health clinic to receive advice, enquire about medicines such as antimalarials, and book vaccinations and boosters for the region you intend to travel in.
A new example of this is the tropical disease chikungunya, but what is it, why has it become enough of a concern that a vaccination is available on prescription, and when would it be necessary to get said inoculation?
What Is Chikungunya?
A mosquito-borne virus spread by the same insects that spread yellow fever, dengue and Zika, chikungunya is a tropical disease that is typically characterised by a combination of fever and what can sometimes be quite debilitating joint pain.
The name is from Makonde, a native language of Tanzania, and means “to become contorted” or “that which binds”, referring to the pain that can make the joints feel like they are locking up.
Aside from the joint pain, the flu-like symptoms are somewhat similar to dengue or Zika, which can lead to a risk of misdiagnosis. This is problematic since chikungunya has the potential for rare but very serious complications, particularly for young children and older adults.
In the overwhelming majority of cases, the nausea, rash, fatigue and fever will dissipate after a few days, whilst the joint pain may endure for a few days. As with many other mosquito-borne diseases, recovery confers with it a degree of immunity.
There is no specific treatment, but fluids and anti-inflammatory painkillers will help to ease some of the symptoms.
Why Is It A Cause For Concern?
There are a few reasons why chikungunya has become an increasing concern for public health experts, something that has made the development and approval of a vaccination welcome.
Part of it is that there have been outbreaks in wider geographical regions than expected, which means that preparation is key to avoid unexpected infection.
Typically, chikungunya is limited to tropical Africa, although it has been found in certain parts of the Americas, Southeast Asia, the Indian Subcontinent and the Pacific Islands. However, there have been smaller isolated outbreaks in Italy and other parts of Southern Europe with a more temperate climate.
It cannot be spread from person to person, and it cannot be found in the UK due to the lack of consistently warm conditions for the virus to breed and spread. It can potentially spread from people to other mosquitoes, however, and this creates the risk of spreading the disease further.
Since 2004, outbreaks have become more frequent, and it has been found in over 110 countries.
When Might You Need Vaccination?
A very recent development when it comes to chikungunya is the approval of the IXCHIQ vaccine as a protective measure to stop the virus from spreading.
It is a live vaccine which uses a weakened form of the disease to train the immune system to recognise chikungunya and provide immunity from the virus following a mosquito bite.
In a study involving over 4,500 people, 99 per cent of those who received the vaccine had suitable immune protection after a month, and continued to have the immunity benefits following a two-year follow-up.
It is currently only available on prescription, provided as a single dose for adults over the age of 18, so a pharmacist at a travel clinic would suggest booking an appointment with your GP if you would necessarily benefit from vaccination.
Typically, the main form of protection from chikungunya, along with other mosquito-borne diseases, is prevention and protection from bites.
Using DEET-based insect repellent on exposed skin, wearing loose, long-sleeved clothes to avoid exposing your skin to bites, using blinds, closing windows and outside doors and sleeping under a mosquito net (especially during the day) are all steps you can take to help protect yourself.
The mosquitoes that spread chikungunya largely proliferate during the day, so take extra precautions from sunrise until sunset. Use air conditioning in your accommodation wherever available.
In areas where potentially infectious mosquitoes are a major concern, a preventative measure is to spray potential breeding sites with insecticide in order to control populations of mosquitoes and kill larvae before they have the chance to grow into full-sized mosquitoes.
As the vaccine is relatively newly approved, the advice for its use could potentially change very quickly, but a pharmacist can help signpost potential ways to keep safe on holiday.