In 2022, Bruce Wale of Victoria, B.C. went to San Jose, Mexico as he had done many times before. But this time, he returned with more than photos and a tan.
Wale contracted the mosquito-borne virus Chikungunya and suffered with debilitating joint pain, among other symptoms, for the next three months.
"I was quite incapacitated for most of that time," he said. "It even affected my breathing. So, I was just really on my back, laying on the sofa or in bed ... three months of pure 'not nice,'" he said.
Wale had never heard of the non-contagious virus, which has symptoms similar to an intense rheumatoid arthritis flare: fever, rash, and sore joints. But climate change, noted by the World Health Organization to contribute to the spread of such vector-borne diseases, paired with Canadians increasingly travelling to regions where the virus is endemic (China, India, Mexico, South America, Africa) increase the risk travellers might catch the virus.
There is now a vaccine for Chikungunya, which Canada is only the 2nd country to approve. The U.S. was first, while Europe is expected to finalize approval this month. Starting Nov. 14, the world's first and only licensed Chikungunya vaccine – IXCHIQ – is available at pharmacies and travel clinics across B.C. and Canada after getting Health Canada approval this summer.
The decision to get the vaccine largely depends on an individual's level of risk tolerance, said Dr. Wayne Ghesquiere, an infectious diseases/tropical diseases and internal medicine consultant, who is also clinical assistant professor of Medicine at the University of Brtish Columbia.
People over 18 traveling to areas where chikungunya is prevalent should consider getting the vaccine, he said, especially older adults who are more likely to get sick. While the virus is rarely fatal unless one has other impacting health conditions, this is "not an insignificant infection", Ghesquiere said.
"It's also not uncommon for people in their 20s, 30s, 40s to get pretty sick. We're talking about fever, rash, but most importantly, it's the arthralgia — in other words, sore joints," he said. "Joints can become quite infected, quite inflamed, and it can last for months. And I underline the S at the end of that word. Some people, it's lasted for years."
Wale, for instance, continues to have joint pain. Though he's since been diagnosed with rheumatoid arthritis, he is skeptical that the Chikungunya is no longer affecting him.
"I have a feeling it's Chikungunya still affecting me," he said.
When weighing risk and whether or not to be vaccinated, it's important to consider planned vacation activities (hiking in the jungle vs. suntanning on a hot beach) and vacation length.
"Should you be getting the vaccine if you're going only for a week or two? Probably not necessarily. It depends on how risk-averse you are," he said. "If you're going to stay there for months then you may want to think about this vaccine."
The vaccine typically costs $225 in Victoria for one dose, which is all that's needed. And it's a vaccine Wale wishes had been available to him.
"I strongly recommend the vaccine. Because, you know, even though I am now immune to it, three months of what I went through is not worth it," he said.
The word ‘chikungunya’ comes from a word in the African Kimakonde language meaning “to become contorted”, which refers to the suffering posture of patients.
Since 2004, Chikungunya outbreaks have become more frequent and widespread, partly due to viral adaptations and climate change, leading the WHO to highlight it as a major public health problem. In 2018, it was added to the WHO list of neglected tropical diseases that required priority research and development.
Vector-borne diseases affect up to 700 million people each year. Common types of mosquito-borne diseases include malaria, dengue, West Nile virus, chikungunya, yellow fever, Japanese Encephalitis and Zika.