NY Travel Clinic

New mosquito-borne illness in Haiti

The CDC reports that the Mayaro virus, first isolated in Trinidad in 1954, has been detected in Haiti. The Mayaro virus (MAYV; genus Alphavirus, family Togaviridae)   is a single-stranded positive RNA virus with a clinical presentation that can mimic that of chikungunya virus (CHIKV),   dengue virus (DENV), and Zika virus (ZIKV) infections.

It’s transmitted mainly through mosquito vectors, especially those of genus Haemagogus, but also Aedes spp. mosquitoes.  The natural reservoirs of MAYV are mainly nonhuman primates, but also birds and reptiles.

Blood samples were obtained from 177 children, from May 2014 through February 2015, who met the criteria for acute undifferentiated febrile illness.  The virus was identified in an 8-year-old boy who had fever and abdominal pain, and his abdomen was soft and not tender. His blood sample tested negative for chikungunya, but positive for dengue virus.  Mayaro virus was also detected.

There have been small, occasional Mayaro outbreaks (30–100 cases) in northern South America, within and close to the Amazon forest.


MAYV infection symptoms include fever, arthralgias, myalgias, eye pain, headache, rash, and sometimes nausea and vomiting. Photophobia, abdominal pain, cough, diarrhea, sore throat, and bleeding gums can also be signs.  There has also been a fatal infection associated with hemorrhagic fever.

Dengue fever is endemic to the same areas, and so MAYV infections are probably underdiagnosed because of confusion with other mosquitoborne virus infections, especially DENV. The emergence of CHIKV further adds to this confusion, and prolonged arthralgia is linked with CHIKV and MAYV infections.

The CDC states that, ‘’Our findings suggest that MAYV is actively circulating in the Caribbean region and that there may be a link between the strain circulating in Haiti and the strains that have been circulating in Brazil since isolation of the virus in the 1950s.”

It isn’t known if the Mayaro virus has epidemic potential, or if this case signals the start of a new outbreak in the Caribbean.

Glenn Morris, M.D., M.P.H., director of the UF Emerging Pathogens Institute, said, “While current attention has been focused on the Zika virus, the finding of yet another mosquito-borne virus which may be starting to circulate in the Caribbean is of concern. Hopefully we will not see the same massive epidemics that we saw with chikungunya, dengue and now Zika. However, these findings underscore the fact that there are additional viruses ‘waiting in the wings’ that may pose threats in the future, and for which we need to be watching.”

The only way to protect yourself from this virus is to protect yourself from mosquito bites. If you travel to the Caribbean, or to Brazil, or any area with mosquitoborne illness, then wear long sleeves and pants, and use clothing treated with permethrin.

Use products with these repellants:

DEET, such as Off!, Cutter, Sawyer, and Ultrathon.

Picaridin, such as Cutter Advanced, Skin So Soft Bug Guard Plus, and Autan (outside the United States).

Oil of lemon, such as Repel and Off! Botanicals. “Pure” oil of lemon eucalyptus (essential oil not formulated as a repellent) is not recommended.

IR3535, such as Skin So Soft Bug Guard Plus Expedition and SkinSmart.