Further to Current note 51/3402 (available at http://www.hps.scot.nhs.uk/ewr/redirect.aspx?id=75461), the Istituto Superiore di Sanità (ISS) has reported three cases of chikungunya in Anzio, a popular seaside town 50km south of Rome. All of the cases became unwell in August. None of them reported a history of recent travel and the infection is believed to have been acquired locally.
While the overaIl risk of spread is considered to be low (regionally) and very low (nationally / internationally), various measures have been implemented to limit this. These include a retrospective survey to identify other possible cases; surveillance of the vector tiger mosquito (Aedes albopictus) to check its prevalence in the area; a precautionary suspension of blood donations in the area; and general programme of disinfestation to reduce any current vector presence. [Source: ISS website: http://www.iss.it/mipi/index.php?lang=1&id=261&tipo=1, accessed 11 September]
Aedes mosquitoes are particularly persistent and aggressive and bite between dusk and dawn. Methods of bite avoidance include:
- wearing long, loose, lightly coloured clothing to cover up the skin during the day;
- the use of insect repellant containing DEET applied to any exposed skin;
- when sunscreen and DEET are used together, DEET should be applied after sunscreen. The effectiveness of repellant reduces more rapidly than sunscreen, so a further reapplication on top of sunscreen may be necessary;
- the use of permethrin-impregnated mosquito nets protects against early morning bites and should also be used when sleeping during the day;
- the use of air conditioning if available and/or mesh screening of windows and doors;
- eradication of mosquito breeding sites around accommodation/home (e.g. open containers, old tyres or flower pots that may collect water).
Further information on chikungunya is available for clinicians on TRAVAX at http://www.travax.nhs.uk/diseases/non-vaccine-preventable/chikungunya.aspx and for the general public at http://www.fitfortravel.nhs.uk/advice/disease-prevention-advice/chikungunya-fever.aspx. [Source: TRAVAX Outbreak News, 8 September 2017. http://www.travax.nhs.uk/outbreaks/outbreak-record-page.aspx?id=22348]