Travelers headed to the Caribbean and South America should be aware of a potentially deadly virus emerging there, according to the U.S. Centers for Disease Control and Prevention .
Already, 21 cases of the Oropouche virus – also known as sloth fever, per Scientific American – have been reported among U.S. travelers. All of these cases (reported through Aug. 16) were in travelers who visited Cuba. One of the travelers is from New York and 20 are from Florida.
Since Oropouche is spread mainly through the bites of mosquitos and midges, the CDC said the risk for sustained local transmission in the continental United States is likely low. However, the risk for sustained transmission in Puerto Rico and U.S. Virgin Islands is unknown as of this week.
This virus was first detected in 1955 in a village in Trinidad and Tobago called Vega de Oropouche, near the Oropouche River. Today, the virus is endemic to the Amazon basin.
“The virus circulates in a sylvatic cycle, possibly involving certain vertebrate hosts (e.g., sloths, nonhuman primates, and birds) and mosquitoes, and an urban cycle in which humans serve as amplifying hosts with known vectors being biting midges,” said the CDC.
Late last year, large outbreaks of Oropouche were recorded in the Amazon region, including areas where it was not endemic. With these outbreaks came two reported deaths in Brazil as well as “vertical transmission associated with adverse pregnancy outcomes,” the CDC explained.
In July, the Pan American Health Organization (PAHO) issued an epidemiologic alert about the virus, specifically its association with adverse pregnancy outcomes such as fetal deaths and congenital malformations.
“In addition to approximately 8,000 locally acquired cases in Bolivia, Brazil, Colombia, Cuba and Peru, travel-associated Oropouche virus disease cases have recently been identified in European travelers returning from Cuba and Brazil,” as well as the U.S. travelers from Cuba.
Signs and symptoms of the virus are similar to dengue, Zika, and chikungunya and the incubation period is three to 10 days.
In the U.S., reported symptoms commenced from May through July and usually included fever, muscle pain, headache, fatigue or malaise and joint stiffness. Less common symptoms included diarrhea, abdominal pain, nausea or vomiting, rash, retroorbital pain, back pain and mucosal bleeding. More than 80% of patients had fever and muscle aches and more than 71% had fever and headache, while 62% of patients had all three symptoms.
Most of the patients with Oropouche were evaluated during acute illness, but at least three were evaluated when their symptoms reoccurred. Experiencing recurrent symptoms after the initial illness is a common characteristic of Oropouche. While three of the U.S. patients were hospitalized, no deaths were reported. Indeed, most cases of the virus are mild, according to the CDC.
There are no vaccines to prevent or medicines to treat Oropouche virus. Treatment options help relieve symptoms. Patients are advised not to use nonsteroidal anti-inflammatory drugs to reduce the risk for bleeding.
Those traveling to impacted areas should be aware of the risk for Oropouche virus disease. Preventaive measures include avoiding mosquito and midge bites. Pregnant people should consider canceling travel plans to impacted areas.
“Clinicians and public health jurisdictions should be aware of the occurrence of Oropouche virus disease in U.S. travelers and request testing for suspected cases,” said the CDC. It also said that testing for the virus should be conducted alongside other diseases with similar symptoms, “including dengue, particularly given the recent large dengue outbreak in the Americas with approximately 11 million cases reported since late 2023.”
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