Ross River Virus Disease; Ross River Fever; RRV Infection
Ross River virus disease (Ross River) is a mosquito-borne illness that can cause swollen or painful joints, fever, rash, and fatigue. Ross River virus belongs to a group of viruses called alphaviruses and it is endemic to Australia, Papua New Guinea, and many South Pacific Islands. Learn about the virus, prevention, and treatment.
Aedes aegypti mosquito, female
Image by CDC/ Paul I. Howell, MPH; Prof. Frank Hadley Collins; Photo credit: James Gathany
Overview
Aedes aegypti
Image by Muhammad Mahdi Karim/Wikimedia
Aedes aegypti
Aedes aegypti in Dar es Salaam, Tanzania
Image by Muhammad Mahdi Karim/Wikimedia
About Ross River
Key Points
Ross River virus is primarily spread through the bite of an infected mosquito.
Symptoms can include swollen or painful joints, fever, rash, and fatigue.
There are no vaccines to prevent or medicines to treat Ross River virus disease (Ross River).
You can reduce your risk by taking steps to prevent mosquito bites.
Overview
Ross River virus is spread through the bite of an infected mosquito. Rarely, Ross River virus has spread through blood transfusion or from mother to baby during pregnancy.
Most cases of Ross River occur in Australia and Papua New Guinea. Cases have also been identified previously in many south Pacific islands including Fiji, American Samoa, New Caledonia, and the Cook Islands.
Ross River virus belongs to a group of viruses called alphaviruses. Symptoms can include swollen or painful joints, fever, rash, and fatigue. Death from Ross River has never been reported.
There are no vaccines to prevent or medicines to treat Ross River. Reduce your risk of infection from Ross River virus by preventing mosquito bites.
Source: Centers for Disease Control and Prevention (CDC)
Additional Materials (1)
Aedes Mosquito
Vector for Dengue Virus.
Image by ProjectManhattan/Wikimedia
Aedes Mosquito
ProjectManhattan/Wikimedia
Symptoms
Ross River Virus Disease
Image by Philipp Klapsing, J. Dick MacLean, Sarah Glaze, Karen L. McClean, Michael A. Drebot,Robert S. Lanciotti,Grant L. Campbell/Wikimedia
Ross River Virus Disease
Patient 1: ankle swelling, pain, tenderness, erythema, and warmth on day 10 of illness.
Image by Philipp Klapsing, J. Dick MacLean, Sarah Glaze, Karen L. McClean, Michael A. Drebot,Robert S. Lanciotti,Grant L. Campbell/Wikimedia
Ross River: Symptoms
Many people infected with Ross River virus have no symptoms. For people with symptoms, the time from an infected mosquito bite to feeling sick (incubation period) is usually 7 to 9 days but can range from 3 to 21 days.
Symptoms can include swollen or painful joints, fever, rash, and fatigue.
Death from Ross River has never been reported.
If you think you or a family member might have Ross River virus disease (Ross River), talk with your healthcare provider.
Source: Centers for Disease Control and Prevention (CDC)
Diagnosis
Blood Test
Image by shameersrk/Pixabay
Blood Test
Image by shameersrk/Pixabay
Ross River: Diagnosis
Talk to your healthcare provider if you are sick and have recently traveled to an area where Ross River virus might be present including Australia, Papua New Guinea, and some South Pacific Islands.
Tell your healthcare provider when and where you traveled.
Your healthcare provider can order blood tests to look for Ross River virus or other viral infections that can cause similar symptoms.
Source: Centers for Disease Control and Prevention (CDC)
Treatment
Aspirin
Image by Chaval Brasil from Campinas, SP, Brasil/Wikimedia
Aspirin
Aspirin on a dark background
Image by Chaval Brasil from Campinas, SP, Brasil/Wikimedia
Ross River: Treatment
There are no vaccines to prevent or medicines to treat Ross River.
Rest, fluids, and over-the-counter pain medicines might relieve some symptoms.
Some patients might need to be hospitalized for intravenous fluids and supportive care for pain, fever, or other related problems.
Source: Centers for Disease Control and Prevention (CDC)
Prevention
DEET
Image by CDC
DEET
This image depicts a mother in the process of correctly applying mosquito repellant spray to her daughter’s right forearm. When spending long periods of time outdoors, reapply insect repellent according to product label instructions. In 2014, the first locally acquired case of chikungunya, a mosquito-borne disease, was reported July 17, in Florida. This case represented the first time that mosquitoes in the continental United States were thought to have spread the virus to a non-traveler.The best way to protect yourself and your family from chikungunya, as well as other mosquito-borne illnesses, including Zika virus, is to prevent being bitten by mosquitoes, by using insect repellent, wearing long sleeves and pants, using air conditioning or window/door screens to keep mosquitoes outside, and reducing mosquito breeding grounds, especially standing water.
Image by CDC
Preventing Ross River
Key Points
Ross River virus is spread through the bite of an infected mosquito.
Ross River virus disease (Ross River) cases have mainly been in Australia and Papua New Guinea.
The best way to prevent Ross River is to protect yourself from mosquito bites.
Prevention tips
Ross River virus is spread to people through the bite of an infected mosquito. Mosquitoes bite during the day and night.
There are no vaccines or medicines to prevent Ross River.
People who live in or travel to Australia and Papua New Guinea should take steps to prevent mosquito bites.
Use insect repellent
Wear long-sleeved shirts and pants
Treat clothing and gear with 0.5% permethrin.
Choose lodging with air conditioning or screens on windows and doors or use a mosquito net if you will be sleeping outdoors
Source: Centers for Disease Control and Prevention (CDC)
Additional Materials (1)
DEET
This image was captured during the 2016, Zika outbreak in Puerto Rico, by CDC staffer, Maureen Fonseca-Ford, who described the scene as follows, “While on deployment to Puerto Rico for the Zika response in May, 2016, we conducted many focus groups with pregnant women, and intercept interviews. Many women were low-income, low-literacy, young, and pregnant, yet they were some of the participants, who gave us some of the richest feedback, for improving the Zika communication materials in Puerto Rico. We have been working with the CDC Division of Vector-Borne Diseases (DVBD), and US-Mexico Unit (USMU), to create effective, field tested materials, and this experience was one of the first times in CDC’s outbreak history, where behavioral science has been included at the outset of the response. This was a joint effort with Puerto Rico’s Department of Public Health.”
Image by CDC/ CDC Connects; Photo credit: Maureen Fonseca-Ford
An Aedes Mosquito and Dengue, Zika, and Chikungunya Viruses
Image by NIAID
An Aedes Mosquito and Dengue, Zika, and Chikungunya Viruses
An Aedes mosquito and colorized 3D renderings of dengue (green), Zika (yellow), and chikungunya (red) virus capsids. Renderings based on x-ray crystallography data. Credit: NIAID
Image by NIAID
Clinical Diagnosis, Treatment, and Prevention of Ross River Virus Disease
Key points
Ross River virus disease is a mosquito-borne illness characterized by fever, arthralgias, and rash.
It is endemic to Australia, Papua New Guinea, and many South Pacific Islands.
There is no specific treatment for Ross River virus disease; clinical management is supportive.
Counsel patients about using personal protective measures to prevent mosquito bites.
Patients with Ross River virus disease should not donate blood for 4 months after their illness.
Epidemiology
Ross River virus is an RNA virus in the genus Alphavirus (family Togaviridae) that was discovered near Ross River in Queensland, Australia in 1963.
Ross River virus is endemic in Australia and Papua New Guinea. There are approximately 4,000 cases of Ross River virus disease reported in Australia each year. Most cases there occur from January through April, but in some areas, disease occurs year-round.
There was a large outbreak in 1979–1980 in many South Pacific Islands including Fiji, American Samoa, New Caledonia, and the Cook Islands with over 50,000 reported cases. Since that time, cases have been reported in several travelers to Fiji, and serosurveys suggest that Ross River virus is either established or has been reintroduced multiple times in at least some Pacific Island countries.
Clinical features
Patients with Ross River virus disease most commonly report polyarthritis, fever, fatigue and rash. Arthritis is usually symmetrical and involves peripheral joints, including knees, ankles, wrists, fingers, and metacarpophalangeal joints. Rash occurs primarily on the limbs and trunk and is typically maculopapular, with purpuric and vesicular rashes less common. Most symptoms resolve after a few weeks, but joint pain and fatigue can persist for six months or more. No fatal cases of Ross River virus disease have been reported.
Diagnosis
The differential diagnosis will vary depending on the travel destination of the patient. In travelers to Australia, it might include other arboviral diseases, such as Barmah Forest virus disease, or non-arboviral diseases such as adenoviral, enteroviral, or rickettsial infections. In a traveler to Papua New Guinea or Pacific Island nations, possible arboviral diseases also include dengue, chikungunya, and Zika virus disease.
Testing for Ross River virus infection can be performed at CDC. There are no commercially available tests for Ross River virus infection in the United States.
Please contact your state health department if you have a patient with an acute illness that might be compatible with Ross River virus disease (including appropriate travel history). They can assist you with determining if samples should be sent to the CDC Arbovirus Diagnostic Laboratory for further testing. Specimens should be submitted to CDC through state health departments. All results will be sent from CDC to the appropriate state health department.
Treatment and prevention
Currently there are no specific medications for Ross River virus disease. Supportive care is recommended for any patient suspected of having Ross River virus disease. Over-the-counter pain relievers, rest, fluids, and physical therapy can be used to relieve some symptoms. Patients should be advised to avoid aspirin containing drugs or other nonsteroidal anti-inflammatory drugs if dengue virus disease is suspected or has not been ruled out. In severe cases, patients may need to be hospitalized to receive supportive treatment, such as intravenous fluids, pain medication, and nursing care.
No Ross river virus vaccines are available for use in humans. In the absence of a vaccine, prevention of Ross River virus disease depends on personal protective measures to decrease exposure to infected mosquitoes. This includes using insect repellent, wearing long-sleeved shirts and pants, and treating clothing and gear with 0.5% permethrin. Travelers should choose a hotel or lodging with air conditioning or screens on windows and doors or use mosquito nets.
Ross River virus can rarely be transmitted through blood transfusions. People with Ross River virus infection should not donate blood for 120 days (4 months) after their illness. Ross River virus infections temporally associated with blood transfusion should be reported promptly to the appropriate state health department.
Source: Centers for Disease Control and Prevention (CDC)
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Ross River
Ross River virus disease (Ross River) is a mosquito-borne illness that can cause swollen or painful joints, fever, rash, and fatigue. Ross River virus belongs to a group of viruses called alphaviruses and it is endemic to Australia, Papua New Guinea, and many South Pacific Islands. Learn about the virus, prevention, and treatment.