Lucille Blumberg from the Johannesburg site has alerted GeoSentinel® to cases of rash, myalgia and fever reported over the past 2 months mostly from residents of Johannesburg, Gauteng Province. Presenting symptoms are mild-to-moderate headache and myalgia lasting 1-2 days, followed by a rash, initially on the trunk, but progressing over 1-2 days to the limbs, palms and soles. The rash resolves after 3-5 days, but some patients experienced arthralgias of the large joints, and one patient developed joint effusions. The National Institute for Communicable Diseases (NICD) conducted several laboratory tests on over 40 persons, and has confirmed Sindbis infection in the Johannesburg cases and one case of West Nile virus in a patient from a farm in the Northern Cape province. http://ecdc.europa.eu/en/healthtopics/sindbis_fever/factsheet-health-professionals/Pages/factsheet-for-health-professionals.aspx https://wwwnc.cdc.gov/eid/article/14/1/07-0510_article The rash associated with these Sindbis fever cases have included punctate papules on the trunk and limbs, palms and soles, some with small vesicles on the papules and some with characteristic halos around the papules and some with slightly tender generalized lymphadenopathy. The rash associated with the West Nile fever case was more diffuse with a macular/ papular appearance. Sindbis and West Nile virus infections are well documented in South Africa in the summer months. These two viruses co-circulate as they share a common vector – culicine mosquitoes – and avian hosts. Outbreaks of Sindbis and West Nile fevers have been reported simultaneously on the Highveld of South Africa in 1974, 1984 and in 2004. Infections with Sindbis and West Nile viruses should not be confused with tick bite fever. Malaria is also important to consider during the period September to May in all persons with acute febrile illness returning from malaria transmission areas in southern Africa. Please be alert to possible Sindbis and West Nile fever in returning patients presenting with suggestive symptoms. Intending travellers should be alerted to the risk and advised on mosquito bite protection.
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Lucille Blumberg from the Johannesburg site has alerted GeoSentinel® to cases of rash, myalgia and fever reported over the past 2 months mostly from residents of Johannesburg, Gauteng Province. Presenting symptoms are mild-to-moderate headache and myalgia lasting 1-2 days, followed by a rash, initially on the trunk, but progressing over 1-2 days to the limbs, palms and soles. The rash resolves after 3-5 days, but some patients experienced arthralgias of the large joints, and one patient developed joint effusions. The National Institute for Communicable Diseases (NICD) conducted several laboratory tests on over 40 persons, and has confirmed Sindbis infection in the Johannesburg cases and one case of West Nile virus in a patient from a farm in the Northern Cape province. http://ecdc.europa.eu/en/healthtopics/sindbis_fever/factsheet-health-professionals/Pages/factsheet-for-health-professionals.aspx https://wwwnc.cdc.gov/eid/article/14/1/07-0510_article The rash associated with these Sindbis fever cases have included punctate papules on the trunk and limbs, palms and soles, some with small vesicles on the papules and some with characteristic halos around the papules and some with slightly tender generalized lymphadenopathy. The rash associated with the West Nile fever case was more diffuse with a macular/ papular appearance. Sindbis and West Nile virus infections are well documented in South Africa in the summer months. These two viruses co-circulate as they share a common vector – culicine mosquitoes – and avian hosts. Outbreaks of Sindbis and West Nile fevers have been reported simultaneously on the Highveld of South Africa in 1974, 1984 and in 2004. Infections with Sindbis and West Nile viruses should not be confused with tick bite fever. Malaria is also important to consider during the period September to May in all persons with acute febrile illness returning from malaria transmission areas in southern Africa. Please be alert to possible Sindbis and West Nile fever in returning patients presenting with suggestive symptoms. Intending travellers should be alerted to the risk and advised on mosquito bite protection.