Arboviral Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA.
Clin Infect Dis. 2011 Mar 1;52(5):e121-6. doi: 10.1093/cid/ciq214. Epub 2011 Jan 17.
Chikungunya virus (CHIKV) represents a threat to the United States, because humans amplify CHIKV and vectors that transmit CHIKV are present.
We described the epidemiology of laboratory-confirmed chikungunya fever (CHIK) cases in the United States in 1995-2009 and compared states with CHIKV vectors with states with returning viremic CHIK cases. For 2006-2009, we evaluated reporting of CHIK cases to ArboNET, the arboviral surveillance system.
In 1995-2009, 109 CHIK cases were identified in the United States; all adult travelers. Sixty-two subjects (57%) had recently visited India, and 13 (12%) had CHIKV viremia. Of the 26 jurisdictions with CHIK cases, 22 (85%) reported the presence of CHIKV vectors. Twelve viremic travelers returned to 6 states with CHIKV vectors. Of the 106 cases identified in 2006-2009, only 27 (25%) were reported to ArboNET, with a median of 122 days (range, 44-273 days) between illness onset and reporting.
No locally acquired CHIK cases were identified. However, several viremic travelers returned to states with CHIKV vectors and presented a risk for local transmission. Incomplete and delayed reporting made ArboNET less useful. To minimize the risk of CHIKV spread in the United States, healthcare providers and public health officials should be educated about recognition, diagnosis, and reporting of CHIK cases.
基孔肯雅病毒（CHIKV）对美国构成威胁，因为人类可扩增 CHIKV，且存在传播 CHIKV 的病媒。
我们描述了美国在 1995-2009 年间实验室确诊的基孔肯雅热（CHIK）病例的流行病学情况，并将有 CHIKV 病媒的州与有返国带病毒 CHIK 病例的州进行了比较。对于 2006-2009 年，我们评估了向虫媒病毒监测系统（ArboNET）报告 CHIK 病例的情况。
在 1995-2009 年间，美国共发现 109 例 CHIK 病例；所有病例均为成年旅行者。62 名患者（57%）近期曾到访印度，13 名（12%）有 CHIKV 病毒血症。在有 CHIK 病例的 26 个司法管辖区中，有 22 个（85%）报告存在 CHIKV 病媒。12 例带病毒旅行者返回了有 CHIKV 病媒的 6 个州。在 2006-2009 年间发现的 106 例病例中，只有 27 例（25%）向 ArboNET 报告，发病和报告之间的中位数时间为 122 天（范围为 44-273 天）。
未发现本地获得性 CHIK 病例。然而，有几个带病毒的旅行者返回了有 CHIKV 病媒的州，存在本地传播的风险。ArboNET 的报告不完整且延迟，使其用处降低。为了最大程度地降低 CHIKV 在美传播的风险，应向医护人员和公共卫生官员进行有关 CHIK 病例的识别、诊断和报告的教育。
