In early August 2024, Germany reported its first cases of Oropouche fever, a tropical disease primarily found in Central and South America. According to the Robert Koch Institute (RKI), two travelers from Saxony and Baden-Württemberg contracted the virus during a holiday in Cuba. This development raises concerns about the spread of tropical diseases in non-endemic regions and highlights the importance of awareness and preventive measures for travelers.
Overview of Oropouche fever
Oropouche fever is caused by the Oropouche virus (OROV), an arbovirus transmitted primarily through the bite of infected midges (Culicoides paraensis) and occasionally through mosquitoes (Aedes species). This disease was first identified in 1955 in Trinidad and has since caused numerous outbreaks in countries such as Brazil, Panama, and Peru.
Symptoms and clinical presentation:
- Incubation period: 4-8 days
- Initial symptoms: Sudden onset of fever, headache, myalgia (muscle pain), arthralgia (joint pain), and rash
- Additional symptoms: Nausea, vomiting, dizziness, and photophobia (sensitivity to light)
- Duration: Symptoms typically last for 3-7 days, but fatigue and weakness may persist longer
- Complications: Rare, but include meningitis and encephalitis, particularly in immunocompromised individuals
Most people with Oropouche fever recover within several days to one month. However, in some cases (fewer than one in 20), more serious complications can occur, including meningitis (inflammation of the membranes around the brain and spinal cord), encephalitis (inflammation of the brain), or bleeding. It’s important to note that death from Oropouche fever is rare. Additionally, the symptoms of Oropouche virus disease can be similar to other arboviruses like dengue, chikungunya, Zika, or malaria.
While there has never been a recorded fatality caused by an Oropouche infection, some cases have resulted in hemorrhagic symptoms and neurological complications, which is a particular concern for public health. In serious cases, particularly during large outbreaks, the central nervous system may be affected, leading to symptoms such as severe headache, dizziness, neck stiffness, double vision, uncoordinated movements, and evidence of viral infection in the cerebrospinal fluid.
Epidemiology and transmission
Geographical distribution: Oropouche fever is endemic to tropical regions of Central and South America. Countries with reported cases and outbreaks include Brazil, Peru, Trinidad, Panama, and Colombia. This virus has been identified in both urban and rural settings, affecting a wide range of populations.
Vectors and transmission:
- Primary vector: Culicoides paraensis (biting midges)
- Secondary vectors: Aedes mosquitoes (Aedes aegypti and Aedes albopictus)
- Transmission: The virus is transmitted to humans through the bite of an infected midge or mosquito. There is no evidence of direct human-to-human transmission.
Recent outbreaks and data
Historical outbreaks:
- Brazil: Multiple outbreaks have been reported since the 1960s, with significant urban transmission in cities like Manaus and Belém.
- Peru: Notable outbreaks in the Amazon region, affecting thousands of individuals.
- Trinidad: The first documented outbreak occurred in 1955, leading to the identification of the virus.
Current data:
- 2023: Several outbreaks reported in Brazil, with over 10,000 cases in the northern region.
- 2024: Increasing cases in Panama and Colombia, highlighting the virus’s spread and impact.
There have been recent cases of Oropouche fever in Europe:
- France (French Guiana): In August–September 2020, an outbreak of dengue-like syndrome occurred in a remote rainforest village in French Guiana. Of the tested patients, 82.1% were positive for Oropouche virus, confirming its emergence in this region.
- Italy: In June 2024, Italy reported its first-ever case of Oropouche fever. This marked the first detection of the disease in continental Europe23.
It’s important to note that while Oropouche fever is rare in Europe, health authorities closely monitor such cases to prevent further spread.
Preventive measures and treatment
Prevention:
- Vector control: Reducing the population of biting midges and mosquitoes through insecticide use, elimination of breeding sites, and use of mosquito nets and repellents.
- Personal protection: Wearing long-sleeved clothing, using insect repellent, and staying in air-conditioned or well-screened areas.
Treatment:
- Supportive care: There is no specific antiviral treatment for Oropouche fever. Management focuses on relieving symptoms through rest, hydration, and pain relievers such as acetaminophen or ibuprofen.
- Medical attention: Severe cases, especially those with neurological symptoms, require hospitalization and supportive care.
