Federal health officials are stepping up efforts to detect and prevent Oropouche virus, releasing updated testing guidance, a new response plan and case definitions.
U.S. case counts have risen to 52, including one case of neuroinvasive disease, according to the Centers for Disease Control and Prevention (CDC). The emerging virus is spread by biting midges and certain mosquitoes and is particularly concerning for pregnant people, as evidence suggests it can cause severe outcomes if passed to their fetus.
Most of the U.S. cases have been in Florida, but cases also have been reported in California, Colorado, Kentucky and New York. All have been travel-associated.
The CDC first sounded the alarm last month in response to a concerning increase in Central and South America. Those locally acquired cases have grown to nearly 10,000 and have been reported in Bolivia, Brazil, Colombia, Cuba, the Dominican Republic and Peru. At least two people have died.
Symptoms of Oropouche virus disease include abrupt fever, severe headache, chills, myalgia and arthralgia, according to the CDC. People also may experience photophobia, dizziness, retroorbital or eye pain, nausea/vomiting or a maculopapular rash that starts on the trunk and goes to the extremities. It is not uncommon for symptoms to recur days or weeks after initial onset. About 4% of patients develop neurological symptoms.
The CDC will provide clinical diagnostic testing for patients with a suspected case of Oropouche virus disease using serum or cerebrospinal fluid submitted through state health departments. To meet the definition of a suspected case, a patient must have been in an area with Oropouche virus circulation within two weeks of initial symptom onset and also meet the following criteria:
- abrupt onset of reported fever, headache and one or more of the following: myalgia, arthralgia, photophobia, retroorbital/eye pain or signs and symptoms of neuroinvasive disease (e.g., stiff neck, altered mental status, seizures, limb weakness or cerebrospinal fluid pleocytosis); and
- tested negative for other possible diseases, in particular dengueB; and
- absence of a more likely clinical explanation.
The CDC also has created a response plan to assist health departments and a webpage with an expert answering questions about Oropouche in pregnancy. Last month, it released clinical considerations for pregnant people with Oropouche and guidance for evaluating and managing their infants.
There are no vaccines for Oropouche. Everyone should protect themselves from insect bites, especially during travel to the Amazon basin, South America and the Caribbean and for three weeks after, according to the CDC. Pregnant people should reconsider nonessential travel to areas with outbreaks.
Resources
- Oropouche information for clinicians from the CDC
- CDC interim guidance on testing for Oropouche
- Information for parents from HealthyChildren.org on preventing infections during pregnancy
