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March 3, 2023
An increasing number of chikungunya cases has been reported in Paraguay, with more than 70,000 suspected cases since the outbreak began in October 2022, according to a recent CDC HAN alert. Most cases have been reported in the capital district of Asunción and the neighboring Central department. Further spread of the outbreak in Paraguay and to surrounding countries is possible.
Chikungunya virus is a mosquito-borne alphavirus transmitted by infected mosquitoes, and humans are the primary reservoir during epidemics. Beginning in late 2022, Paraguay reported an increasing number of chikungunya case and further increases in case counts are expected, including from other areas in Paraguay and surrounding countries (e.g., Brazil, Argentina, and Bolivia).
Most people infected with chikungunya virus become symptomatic. The incubation period is typically 3–7 days (range 1–12 days). The most common clinical findings are acute onset of fever and polyarthralgia. Joint pains are usually bilateral, symmetric, and often severe and debilitating. Other symptoms can include headache, myalgia, arthritis, conjunctivitis, nausea, vomiting, or maculopapular rash. Clinical laboratory findings can include lymphopenia, thrombocytopenia, and elevated creatinine. Rare complications include uveitis, retinitis, myocarditis, hepatitis, nephritis, bullous skin lesions, hemorrhage, meningoencephalitis, myelitis, Guillain-Barré syndrome, and cranial nerve palsies.
People at risk for more severe disease include neonates exposed intrapartum, older adults (e.g. age > 65 years), and people with underlying medical conditions (e.g., hypertension, diabetes, or cardiovascular disease).
View the full Centers for Disease Control and Prevention (CDC) Health Alert Network (HAN) Health Advisory for more information, including about laboratory diagnosis and treatment of symptoms.