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What is it? -

Oropouche fever is a viral disease caused by the Oropouche virus (OROV), which was first identified in Trinidad and Tobago in 1955. The virus has become a significant public health concern in various tropical and subtropical regions due to its potential for widespread outbreaks.

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History -

The Oropouche virus was first isolated from the blood of a patient in the town of Oropouche, Trinidad, in 1955. Since its discovery, the virus has been responsible for several large outbreaks, primarily in South and Central America.

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Geographical origin -

Originally endemic to tropical regions of the Americas (particularly in the Amazon Basin), the Oropouche virus has been documented in countries such as Brazil, Peru, Panama, and the aforementioned Trinidad and Tobago. The potential for global spread has increased with growing international travel and climate change.

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Transmission -

Oropouche virus is primarily transmitted to humans through the bite of infected midges. While transmission can also occur through other arthropods, such as mosquitoes, this is less common. The virus can also be transmitted via blood transfusion or organ transplantation if the donor is infected.

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Ecology -

The small biting midge responsible for most Oropouche infections can be found in tropical and subtropical regions. These insects breed in moist environments, such as riverbanks, marshes, and decaying vegetation.

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Symptoms -

Oropouche fever typically presents with symptoms similar to other arboviral diseases, such as dengue fever. Patients often experience a sudden onset of high fever, joint and muscle pain, and severe headaches. In some cases, a rash may develop, along with dizziness and nausea.

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Duration -

The incubation period for Oropouche fever typically ranges from four to eight days after the initial bite from an infected insect. Once symptoms appear, the acute phase of the disease lasts around one week, but can be debilitating due to the severity of the symptoms.

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Severity -

While Oropouche fever is generally self-limiting (i.e. it resolves itself without treatment), certain cases can lead to complications, especially for people who are immunocompromised or have preexisting health conditions.

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Rare complications -

Rare complications of Oropouche fever include meningitis and encephalitis, which can result in long-term neurological damage. Though these severe outcomes are uncommon, they truly highlight the potential seriousness of this disease.

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Testing -

Diagnosis of the virus is primarily based on clinical symptoms, especially in areas where the virus is known to be present. However, confirmation requires laboratory testing, and accurate diagnosis is crucial for differentiating Oropouche fever from other arboviral infections.

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Differential diagnosis -

Oropouche fever shares symptoms with several other tropical diseases, including dengue fever and Zika virus infection, which makes clinical diagnosis challenging. Physicians often consider the patient's travel history to determine whether they have been exposed to regions that include certain viruses.

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Coinfection -

In regions where multiple arboviruses are endemic, there is a risk of coinfection with Oropouche virus and viruses like dengue or chikungunya. Coinfection can complicate diagnosis, and symptoms may even overlap, causing severe strain in the immune system.

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Treatment -

There is no specific antiviral treatment for Oropouche fever. Management primarily involves supportive care to alleviate symptoms, such as pain relief, hydration, and rest.

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Prevention -

There is no vaccine currently available for Oropouche fever, and so current efforts to prevent infection rely heavily on reducing the population of midges and mosquitoes through insecticide spraying, as well as eliminating breeding sites, and using personal protective measures like insect repellent and bed nets.

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Outbreaks -

Oropouche virus has caused several significant outbreaks in South America, with more than 8,000 confirmed cases so far this year. This number is several times higher than that recorded in 2023.

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First deaths -

Thankfully, the virus has an incredibly low mortality rate, and only two deaths have ever been recorded in its history. Brazil reported the first deaths from Oropouche virus on July 25, involving two young women in Bahia.

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European cases -

Recently, 19 cases of Oropouche virus were detected in tourists returning to Europe, with infections reported in Spain, Italy, and Germany. These cases originated from recent travel to Cuba and Brazil, both of which are experiencing outbreaks.

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Countries at risk -

The European Center for Disease Prevention and Control (ECDC) identified Brazil, Bolivia, Colombia, Peru, and Cuba as areas where Oropouche virus is actively spreading. Any travelers who intend on visiting these countries should be aware of the moderate threat posed by the virus.

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Globalization -

As can be seen from the recent cases found in Europe, globalization and increased travel are significant risk factors for the spread of the virus. Travelers returning from endemic regions could introduce the virus to new areas around the world.

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Pregnant women -

The ECDC raised concerns about the virus' potential to cause stillbirths and birth defects in pregnant women, making the impact on this group potentially more severe than on the general population.

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Mother-to-child transmission -

Brazil is currently investigating eight cases of suspected mother-to-fetus transmission of the virus, with cases under review in states like Pernambuco, Bahia, and Acre.

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Climate change - Climate change is a significant factor in the spread of Oropouche fever. Global warming and changing ecological zones can cause the habitats of midges and mosquitoes to expand. Experts have warned that Southern Europe and North America are increasingly at risk.

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Vaccine development -

Research on Oropouche fever has focused on understanding the virus' biology and potential treatments. No vaccine is currently available, but modern advances in molecular biology offer hope for the future development of effective vaccines or therapies to prevent and treat the virus.

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Animal hosts -

While humans are the primary hosts during outbreaks, Oropouche virus can also infect various animals, including sloths and primates, which is why locals have given the virus the name “sloth fever.” These animals can maintain the virus in nature, allowing it to persist between outbreaks in humans.

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Deforestation -

Controlling Oropouche fever presents significant challenges due to its widespread nature and the lack of a vaccine. Urbanization and deforestation can also increase human exposure to the virus by bringing people into closer contact with animal and insect habitats that carry the virus.

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Vulnerability -

Vulnerable populations (such as those living in poverty or with limited access to health care) are at higher risk of Oropouche fever, as they may have less ability to protect themselves and may face greater challenges in accessing medical care. Public health strategies must consider these disparities to ensure effective disease control.

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Sources of information -

International organizations, such as the World Health Organization (WHO) and the Pan American Health Organization (PAHO), offer essential information for anyone who wishes to understand the virus and its impact. Their involvement is essential for addressing the global threat posed by the virus.

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Technology -

Advancements in technology (such as geographic information systems and mobile health tools) have enhanced our ability to monitor and respond to Oropouche fever outbreaks. These technologies can help people track the spread of the virus and identify hotspots so that they can be more prepared and aware.

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Global health alert -

The rapid spread of Oropouche virus in the Americas and its potential implications for global health have led experts to emphasize the need for vigilance among travelers and public health authorities. If you or a loved one are traveling, we recommend being prepared for whatever may come.

Sources: (The Telegraph) (The Lancet) (WHO) (CDC) (ECDC)

See also: Everything you need to know about Alzheimer's disease

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