Emerging Infectious Diseases
Volume 21, Number 4—April 2015
http://wwwnc.cdc.gov/eid/

Perspective
Reappearance of Chikungunya, Formerly Called Dengue, in the Americas
Scott B. Halstead
Author affiliation: Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
Abstract
After an absence of ≈200 years, chikungunya returned to the American tropics in 2013. The virus is maintained in a complex African zoonotic cycle but escapes into an urban cycle at 40- to 50-year intervals, causing global pandemics. In 1823, classical chikungunya, a viral exanthem in humans, occurred on Zanzibar, and in 1827, it arrived in the Caribbean and spread to North and South America. In Zanzibar, the disease was known as kidenga pepo, Swahili for a sudden cramp-like seizure caused by an evil spirit; in Cuba, it was known as dengue, a Spanish homonym of denga. During the eighteenth century, dengue (present-day chikungunya) was distinguished from breakbone fever (present-day dengue), another febrile exanthem. In the twentieth century, experiments resulted in the recovery and naming of present-day dengue viruses. In 1952, chikungunya virus was recovered during an outbreak in Tanzania, but by then, the virus had lost its original name to present-day dengue viruses.

Synopsis
Evolution of Ebola Virus Disease from Exotic Infection to Global Health Priority, Liberia, Mid-2014
M. Allison Arwady , Luke Bawo, Jennifer C. Hunter, Moses Massaquoi, Almea Matanock, Bernice Dahn, Patrick Ayscue, Tolbert Nyenswah, Joseph D. Forrester, Lisa E. Hensley, Benjamin Monroe, Randal J. Schoepp, Tai-Ho Chen, Kurt E. Schaecher, Thomas George, Edward Rouse, Ilana J. Schafer, Satish K. Pillai, and Kevin M. De Cock
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (M.A. Arwady, J.C. Hunter, A. Matanock, P. Ayscue, J.D. Forrester, B. Monroe, T.-H. Chen, T. George, E. Rouse, I.J. Schafer, S.K. Pillai, K.M. De Cock); Ministry of Health and Social Welfare, Monrovia, Liberia (L. Bawo, M. Massaquoi, B. Dahn, T. Nyenswah); National Institutes of Health, Bethesda, Maryland, USA (L.E. Hensley); US Army Medical Research Institute of Infectious Diseases, Frederick, Maryland, USA (R.J. Schoepp, K.E. Schaecher)
Abstract
Over the span of a few weeks during July and August 2014, events in West Africa changed perceptions of Ebola virus disease (EVD) from an exotic tropical disease to a priority for global health security. We describe observations during that time of a field team from the Centers for Disease Control and Prevention and personnel of the Liberian Ministry of Health and Social Welfare. We outline the early epidemiology of EVD within Liberia, including the practical limitations on surveillance and the effect on the country’s health care system, such as infections among health care workers. During this time, priorities included strengthening EVD surveillance; establishing safe settings for EVD patient care (and considering alternative isolation and care models when Ebola Treatment Units were overwhelmed); improving infection control practices; establishing an incident management system; and working with Liberian airport authorities to implement EVD screening of departing passengers.