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Canadians flying to popular destinations like Cuba are being warned to take precautions against insects that spread the rare and potentially deadly Oropouche virus, also known as Oropouche fever.
This week, U.S. officials have reported 21 cases of Oropouche virus disease among travelers returning from Cuba from August 16. Most recovered without treatment, while three patients recovered after hospitalization.
The virus is usually spread through bites from certain species of mosquitoes (and midges) that are not native to Canada.
But doctors here are being asked to watch for infections in returning travelers. Although Oropouche virus disease has previously circulated in Central and South America and the Caribbean, cases this year have been higher than expected, with human infections reported in places where they had not been detected before, in new areas of Brazil, Bolivia and Cuba.
It is unclear how the virus affects the health of a fetus, so precautions are recommended during pregnancy.
“Historically it’s generally been reported as quite mild, but with some of these emerging data about neurological complications and even fatalities — it’s something that needs to be watched,” said Dr. Zain Chagla, an infectious disease physician and associate professor of medicine at McMaster University with training in tropical medicine.
“These are areas of the world that Canadians visit, and while there is no local circulation [in mosquitoes]“But it still means that travelers will have to be assessed on this upon their return,” Chagla said.
Here’s a look at the disease that has emerged updated Canada Travel Health Alertsthe US and Europe.
What is the Oropouche virus?
Oropouche virus is endemic, or naturally occurring, in tropical forests. It was first identified in 1955 on the island of Trinidad and takes its name from a nearby village and wetlands.
It is sometimes called sloth fever, since the disease was first discovered in Brazil, in a blood sample from the animal.
How does it spread?
The Oropouche virus is mainly spread through the bite of a small fly, the so-called ‘midge’, and through certain species of mosquitoes.
“While the species of mosquito (Culicoides-paraensis) and mosquito (Culex quinquefasciatus) known to transmit Oropouche virus disease have not been detected in Canada, but have been detected in the United States,” the Public Health Agency of Canada (PHAC) said in response to questions from CBC News.
Scientists say high temperatures, humidity and the season affect the mosquito population.
There is no evidence of human-to-human transmission.
What are the symptoms?
The flu-like symptoms resemble those of other tropical diseases such as dengue fever and the Zika virus which hit the headlines in 2015. A major Zika outbreak in Brazil caused a rise in microcephalyin which the baby’s brain is underdeveloped, according to the Pan American Health Organization (PAHO).
“It is a sudden fever, headache which unfortunately is resistant to many of the treatments, [as well as] “Muscle pain, joint pain,” said Andrea Vicari, head of PAHO’s unit dedicated to pandemic preparedness and response.
“It can be quite a painful disease, but usually the disease goes away on its own.”
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According to the U.S. Centers for Disease Control and Prevention, other symptoms may include sensitivity to light, dizziness, pain behind the eyes, nausea, vomiting and skin rash.
Symptoms usually last less than a week, but can often return days or weeks later. Most people recover within a few days to a month.
“Oropouche fever may be confused with dengue fever,” the Canadian travel health alert reads.
How serious is it?
According to the CDC, about 60 percent of people infected with the Oropouche virus show symptoms.
The US agency estimates that one in 20 patients may develop more serious symptoms, such as bleeding and brain inflammation, including meningitis and encephalitis.
In July, Brazilian health authorities reported that two healthy, non-pregnant women with the infection had died.
The World Health Organisation said they were the first fatal cases from the infection in Brazil and the Americas region.
Diseases transmitted by insects that infect humans, such as Lyme disease and West Nile virus, are on the rise in Canada. The shorter, less severe winters caused by climate change have allowed these insects to expand their range.
As of July 20, WHO has reported more than 8,000 confirmed cases of Oropouche this year, including more than 7,200 in Brazil, as well as Bolivia, Peru, Colombia and Cuba.
Brazilian authorities also reported five cases in pregnant people, with evidence of transmission of the virus to the fetus, with consequences such as fetal death or birth defects, including microcephaly.
“Until more evidence is available, pregnant women travelling to infected destinations are advised to strictly follow recommendations for preventing insect bites,” a PHAC spokesperson said.
“Pregnant women should discuss the risks of their travel plans with their health care provider and should see their health care provider if they feel unwell after travel.”
How is it treated and prevented?
There are no vaccines to prevent infection and no specific medications to treat the symptoms of Oropouche virus.
The best way to prevent infection is to make sure you don’t get bitten.
That’s why federal officials advise consulting with a health care provider or visiting a travel health center, preferably at least six weeks before you travel, for personalized health advice and recommendations.
When traveling, people are advised to avoid insect bites at all times by:
- Always use an approved insect repellent (bug spray) on bare skin. For best results, read and follow all label directions.
- Consider limiting outdoor activities when mosquitoes and gnats are most active.
- Cover with light-colored, loose clothing made of tightly woven materials such as nylon or polyester. Wear long pants and tucked-in long-sleeved shirts with closed shoes or boots and a hat.
- Use a mosquito net when you sleep outside (day or night) or in buildings that are not completely closed off.
- Consider getting approved clothing treated with insecticide.
What now?
U.S. and Canadian officials said they are working to quickly detect and monitor the virus and disease so they can take preventive public health measures.
All suspected Oropouche virus disease samples from provincial and territorial laboratories are sent to PHAC’s National Microbiology Laboratory in Winnipeg for confirmatory testing.
