Chikungunya has NOT settled in Spain: welcome to a world where tropical diseases are no longer tropical

Iceland has just confirmed that the Chikungunya diagnosis we were talking about was, in reality, "a laboratory failure". In other words, the European alarm was triggered for the wrong reason.

On June 1, a 37-year-old woman began to experience fever and severe joint pain. Seven days later, while her sister and son began to show similar symptoms, tests confirmed that she was a chikungunya. All three were Icelanders, but they have just arrived from spending a few days in the province of Alicante.

The alarms went off. From Reykjavik to the Coordination Center for Alerts and Health Emergencies in Madrid and from there to the Valencian Community. If the Icelandic authorities are right, it would be the first indigenous case of a tropical disease that has been around for many years. It is not a surprise, it is the chronicle of a disease more than announced. And now that?

What is chikungunya?

The first thing is to stay calm. Yes, it is true that "chikungunya" in the local Bantu language of Tanzania means "doubled man." For the pain, specifically. But, beyond the effect of the name, it is a viral disease that, although disabling and unpleasant, is not fatal.

It was first detected in Tanzania in 1972, but it was around 2013 that it became known internationally when it made the leap to America. To the Caribbean, specifically. Although the disease may be asymptomatic, between 72% and 97% of those infected develop symptoms.

A picture that, in its early stages, closely resembles that of malaria or dengue. It starts as an intense fever that is followed by erythema and, subsequently, a series of very intense pain in the joints. That is the symptom that characterizes it. Also present headache, fatigue, digestive problems or conjunctivitis, but it is rarer.

The fundamental problem is that to date there is no vaccine for chikungunya and the treatment of the disease is focused on alleviating the symptoms. Symptoms that become long: Beyond the acute period, sequelae such as joint stiffness can last for weeks, months and exceed a year.

What does it do in Spain?

In Spain there is only one mosquito that can transmit the disease, it is the famous tiger mosquito. He Aedes albopictus It was first identified in Spain in 2004 in San Cugat del Vallés and, since then, it has been expanding throughout the Mediterranean coast and many areas of the peninsular interior. That indigenous infections can occur is bad news, but it is unreasonable to expect it to develop into an outbreak.

In the first place, because nothing makes us think that the conditions for a massive outbreak exist. “There may be more cases, but for a large outbreak you need a large amount of virus circulating and many infected people. These are not conditions that we have for now, ”explained Ignacio López-Goñi, professor of Microbiology at the University of Navarra.

And secondly, because the sanitary systems and hygienic conditions in Spain are much better than in most places where the outbreaks have exploded. For example, in the Dominican Republic, in just under a year, 486,306 cases of chikungunya were officially registered. 4.6% of the population. But the determining factor was that people did not believe that the disease was transmitted by a mosquito and no measures could be put in place to limit its impact.

Tropical diseases are no longer tropical

The graphs show: a) the number of outbreaks and diseases, b) the type of host, c) the type of pathogen and d) the form of transmission.

Given these data, perhaps the most important aspect of the first autochthonous outbreak of chikungunya is the confirmation that tropical diseases have ceased to be so with climate change and globalization. This is one of the keys to the coming "Age of Epidemics". One was before which the crisis and the cuts in this area left us quite exposed.

If the experts are right, in the coming years, we will see how more and more diseases arrive in the country and, as has always happened throughout history, they change the way we live. It won't come as a surprise, so it's a good idea to be prepared.

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