There are no vaccines against Chagas disease, and current treatment options are mainly ineffective. Travelers should focus on avoiding contact with kissing bugs, which unfortunately have become resistant to first-line repellents and insecticides such as DEET and permethrin in some areas. Mechanical barriers such as mosquito nets and screens can be effective, but avoiding sleeping outdoors, at hostels and in mud houses in endemic areas is the best way to prevent contact with Chagas vectors.
C HI KUN GUN YA This mosquito-borne infection is a viral illness with an incubation period of several days. It causes fever, significant joint pain and sometimes a rash or headache. “Chikungunya” means “that which bends up” in the Makonde language in Tanzania. The pain from the disease can be severe enough to cause those afflicted to bend forward. The bent-over gait and joint pain of chikungunya can be confused with symptoms of decompression sickness, also known as “the bends,” for it too causes sufferers to assume a bent position due to pain. Chikungunya has spread from Africa and Asia to the Caribbean and parts of the Americas. There is no vaccine against chikungunya and no known treatment other than rest and good hydration. Primary preventive measures are protection against mosquito bites (see Protective Measures Against Mosquito Bites under the Common Vector-Borne Diseases heading earlier in this section).
D E N GUE FE VE R Dengue fever is a viral disease transmitted by the Aedes aegypti mosquito, which bites during the day, mainly after sunrise and around sunset. The disease has a sudden onset, with symptoms including fever, severe frontal headache, and joint and muscle pain; nausea, vomiting and a rash may also occur. The disease is usually self-limited and benign, but it may require a long convalescence. Dengue fever can also occur in a severe, fatal form called dengue hemorrhagic fever. 93
