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Chikungunya resurgence in the Maldives and risk for importation via tourists to Europe in 2019–2020: A GeoSentinel case series

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  • Pierre Dudouet, IHU-Méditerranée Infection
  • ,
  • Philippe Gautret, IHU-Méditerranée Infection, Aix-Marseille Université
  • ,
  • Carsten Schade Larsen
  • Marta Díaz-Menéndez, Universidad Autónoma de Madrid
  • ,
  • Elena Trigo, Universidad Autónoma de Madrid
  • ,
  • Frank von Sonnenburg, Ludwig Maximilian University of Munich
  • ,
  • Federico Gobbi, IRCCS Ospedale Sacro Cuore Don Calabria
  • ,
  • Martin P. Grobusch, University of Amsterdam
  • ,
  • Denis Malvy, University Hospital Center of Bordeaux
  • ,
  • Vanessa Field, University College London Hospitals NHS Foundation Trust
  • ,
  • Hilmir Asgeirsson, Karolinska Institutet
  • ,
  • Inés Oliveira Souto, Autonomous University of Barcelona
  • ,
  • Davidson H. Hamer, Boston University
  • ,
  • Philippe Parola, IHU-Méditerranée Infection, Aix-Marseille Université
  • ,
  • Emilie Javelle, IHU-Méditerranée Infection, Aix-Marseille Université, Hopital d'Instruction des Armees Begin

Background: Chikungunya virus (CHIKV) is an arthropod-borne virus mainly transmitted in tropical areas by Aedes spp. mosquitoes. It has been responsible for small-to-large outbreaks in temperate areas including southern Europe and North America. Past outbreaks in 2006 on the islands of Maldives, as well as on other islands in the Indian Ocean and in Southeast Asia, demonstrated for the first time the capacity of CHIKV to disseminate through travel and transcontinental commerce, and revealed the major socio-economic impact of CHIKV epidemics. Recently, CHIKV has been circulating in highly touristic areas including the Maldives, where 1736 cases were notified by the Health Protection Agency during 2019. Case series: Among EuroTravNet/GeoSentinel patient records, eight CHIKV-confirmed cases imported the Maldives to France, Germany, Denmark, Italy and Spain were identified between February 2019 and February 2020; exceeding the total number of CHIKV infections travel-acquired in Maldives reported to this surveillance network during the previous 10 years. Conclusions: The prevention and control of CHIKV introduction into naïve areas colonised by competent vectors is crucial. CHIKV outbreaks must be detected and reported in a timely manner. This must lead to adapted health information for international travellers and to prompt management of suspected imported cases. Conversely, travellers make for excellent sentinels and increased reports of imported cases might reflect a change in the level of endemicity or even herald an outbreak. Feedback to the local health authorities and matching this with local epidemiological surveillance data may lead to health benefits for the local population.

Original languageEnglish
Article number101814
JournalTravel Medicine and Infectious Disease
Number of pages5
Publication statusPublished - 2020

    Research areas

  • Arbovirus, GeoSentinel, Outbreak, Tourism, Travel, Vector-borne disease

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