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A2 Chikungunya at the Door - Dj Vu All Over Again?--David M. Morens and Anthony S. Fauci
Pages 133-135

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From page 133...
... In December 2013, an outbreak of chikungunya fever appeared in the French sector of Saint-Martin/Sint Maarten and spread epidemically throughout the French West Indies to other Caribbean islands and contiguous Central and South American countries. By July 11, 2014, the Pan American Health Organization had reported more than 355,000 suspected and confirmed cases of chikungunya fever from more than 20 countries or jurisdictions in the Americas, with continuing local transmission and epidemic spread.
From page 134...
... Mosquito-borne arboviruses typically exist in locale-specific enzootic cycles involving nonhuman vertebrates and one or more mosquito vectors. They may occasionally break out of their ecologic niches to infect humans, but human outbreaks are usually constrained by proximity to enzootic foci.
From page 135...
... In 2004, another ECSA chikungunya virus spread pandemically from East Africa across the Indian Ocean, causing epidemics and seeding outbreaks as far away as Italy, France, and Southeast Asia. In the process, the virus acquired envelope gene mutations, giving rise to an ECSA Indian Ocean Lineage (IOL)


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