Mayaro Fever outbreak in the Chirumbia Valley, Province of La Convención, Cusco-Peru Region, 2018: Could it be considered an occupational disease

  • Vector-borne
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Background:
In May 2018, the Health Network of La Convención reported an outbreak of febrile eruptive disease, in the Chirumbia Valley, in people who worked entering the forest in a rural sanitation project. Objective: to describe the outbreak, identify the agent, evaluate association with the activity performed and determine the presence of the possible vector.

Methods:
A cross-sectional and retrospective cohort study was designed. Searching for any case of eruptive fever. An epidemiological record was applied to 127 people, with follow-up home visits of 6 months to confirmed cases. Cases were confirmed by RT-CRP, IgM antibodies, and clinical epidemiological correlation. The entomological study was carried out, determining the aedic index and catching other mosquitoes in populated centers, camps, coffee plantations and forests.

Results:
Mayaro fever was identified as the outbreak disease. The index case was a person who attended the arrival of Pope Francis in the neighboring Madre de Dios Region, which had active cases of the disease. Between March-July 2018, 35 cases were confirmed (3 by PCR, 29 by IgM and 3 by clinical-epidemiological correlation), discarding 92 cases. The average age was 42.7±14 years; 60% were male. The most affected community was Santusaires (57.1%). The attack rate was 27.56%. The confirmed cases presented: arthralgias (94.3%), myalgias (85.7%), fever (77.1%), headache (71.4%), lumbago (62.8%), chills (60%) and rash (51.4%). 2 cases were hospitalized, and in the confirmed cases the arthralgias (often intense) remained intermittently for an average of 20±2.5 weeks. Carrying out rubbing and stripping activity in the rural sanitation project was identified as a risk factor (RR=9.44, [IC95%=4.25-20.98], p=0.000). Sabethes and Culex mosquitoes presence were identified as potentially responsible for transmission.

Conclusion:
Mayaro Fever outbreak was confirmed as an emerging disease in the Chirumbia Valley, with a significant presence of intense and prolonged arthralgia, and associated with work in a rural sanitation project. It is necessary molecular studies that explain the long period of convalescence of those affected, which could be associated with the circulating genotype. Mayaro fever should be considered as an occupational disease. Mayaro Fever is in the process of inclusion as a notifying disease in Peru.

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