Arboviruses: Dengue, Chikungunya, and Zika Viruses
Dengue, chikungunya, and Zika viruses cause mosquito-borne infections of increasing concern in El Salvador, Guatemala, and Honduras. Dengue fever is endemic throughout much of Central and South America. However, chikungunya first arrived in this region in 2014 after appearing in the Caribbean in 2013. Currently, local chikungunya transmission is occurring in more than 45 countries and territories in the Americas, including El Salvador, Guatemala, and Honduras
28,
29. Active Zika virus transmission has been reported throughout Central America, including El Salvador, Guatemala, and Honduras
30.
Sexually Transmitted Infections (HIV, Syphilis, Gonorrhea, etc.)
HIV screening is not required for refugees before resettlement to the United States. However, HIV screening should be offered to all refugees, in accordance with existing
domestic refugee screening guidelines for HIV developed by CDC. Although HIV prevalence is relatively low in Central America, minors arriving from El Salvador, Guatemala, and Honduras should be screened, as maternal HIV status is likely unknown and vertical transmission is possible. No data are available regarding the prevalence of syphilis, gonorrhea, and chlamydia. Syphilis and gonorrhea screening is done per current CDC technical instructions on all refugees 15 years or older. Any patient, regardless of age, should be tested for syphilis, gonorrhea, or chlamydia if symptomatic or if there is a history of or concern about possible sexual activity or exploitation.
Tuberculosis
El Salvador reported 2,206 new and relapsed cases of tuberculosis in 2014, and a prevalence of 49 cases per 100,000 population
33. Within El Salvador, six new cases of multidrug-resistant (MDR) tuberculosis were confirmed in 2014
33. Guatemala and Honduras both reported higher numbers of cases and prevalence rates than El Salvador. Guatemala and Honduras reported 3,163 and 2,820 new and relapsed cases, respectively
34,
35. Tuberculosis prevalence was 106 per 100,000 population in Guatemala, and 49 per 100,000 population in Honduras in 2014
34,
35. Additionally, 79 new cases of MDR TB were reported in Guatemala and 38 new cases of MDR TB were reported in Honduras for 2014
34,
35.