Oropouche virus disease has reached Europe through travellers. Learn about symptoms, transmission, and risks from official public health sources.
What is Oropouche virus disease?
Oropouche virus disease is a febrile illness caused by an arbovirus of the genus Orthobunyavirus, as explained by the Pan American Health Organization (PAHO). The virus was first identified in 1955 in Trinidad and Tobago. Since then, cases and outbreaks have appeared in several South American countries, most often in the Amazon Basin. The disease is spread mainly through the bite of the Culicoides paraensis midge. Certain mosquitoes, such as Culex quinquefasciatus, can also carry the virus. Symptoms begin suddenly after an incubation period of three to twelve days. Typical signs include fever, intense headache, joint stiffness, muscle pain, and chills. Most people recover within a week, but up to sixty percent may have a relapse of symptoms later. Serious complications such as aseptic meningitis are rare but possible. There is no specific treatment or vaccine for this infection.
Imported cases in Europe
In June and July 2024, Europe recorded its first imported cases of Oropouche virus disease. The European Centre for Disease Prevention and Control (ECDC) reported nineteen cases in three countries: twelve in Spain, five in Italy, and two in Germany. Eighteen of these travellers had visited Cuba, and one had been to Brazil. A case series published in Eurosurveillance described thirteen confirmed infections in people returning from Cuba to Spain during that same period. The patients experienced fever, headache, muscle pain, and joint pain. Three had a biphasic course, meaning symptoms returned after an initial improvement. Two of those three developed short-lived neurological symptoms. The virus was detected in blood and urine, with one urine sample still positive twenty-four days after symptoms began. These findings highlight the importance of considering Oropouche virus in travellers with fever coming from affected regions.
The insect carriers and their range
Oropouche virus is transmitted primarily by the bite of the Culicoides paraensis midge. This tiny insect is widely found in forested areas and near water bodies across the Americas. According to the World Health Organization (WHO), it is the principal vector for the virus. Certain mosquitoes, including Culex quinquefasciatus, can also spread the infection. In Europe, however, the main midge vector is not present. The ECDC explains that the competent vectors described in the Americas are absent from continental Europe. This absence greatly reduces the chance of local transmission. So far, no secondary transmission from an imported case has been reported in European countries. That means the virus has not spread from travellers to local insects or people. The risk of catching Oropouche virus within Europe is therefore assessed as low by official health bodies.
Symptoms and typical course
Infection with Oropouche virus usually causes a sudden fever that lasts up to seven days. Along with fever come intense headache, joint stiffness, muscle pain, chills, and sometimes nausea and vomiting. Patients often feel weak and may need bed rest. Most people recover fully without special medical care. The prognosis is good, and fatal outcomes are extremely rare, according to the ECDC. Up to sixty percent of cases experience a return of symptoms a few weeks after the first episode. These relapses are usually milder but can be alarming. In rare cases, the virus can affect the nervous system, leading to aseptic meningitis, which is inflammation of the membranes around the brain. This usually appears during the second week of illness. Recognising the symptoms helps doctors test travellers returning from affected areas, especially if they have been to regions with ongoing outbreaks.
Recent outbreaks in the Americas
Between January and July 2024, the Americas saw a large outbreak of Oropouche virus disease. The World Health Organization reported 8,078 confirmed cases and two deaths across five countries. Brazil had the highest number with 7,284 cases, including the two deaths. Bolivia recorded 356 cases, Peru 290, Colombia 74, and Cuba 74. The two fatal cases were young women in the state of Bahia, Brazil. Many other countries in South America and the Caribbean have reported outbreaks since late 2023, even in areas where the virus had not been seen before. The Pan American Health Organization notes that this expansion is unusual. The increase in travel and changes in insect populations may play a role. Health officials are monitoring the situation closely. The overall public health risk is considered high at the regional level, but low for the rest of the world.
Risks during pregnancy
Doctors are studying the possible effects of Oropouche virus on pregnancy. The Brazilian Ministry of Health reported six possible cases of mother-to-child transmission during pregnancy. In Brazil, one fetal death and one miscarriage were reported in the state of Pernambuco. Another four newborns with microcephaly were identified in retrospective studies in Acre and Para. Microcephaly is a condition where a baby's head is smaller than expected. The World Health Organization says these cases indicate a possible link between Oropouche infection and vertical transmission. However, these effects are still under investigation and have not been confirmed. The ECDC stresses that the fetopathic effects are not yet proven. Pregnant women travelling to areas with outbreaks should take precautions to avoid insect bites. They should consult a healthcare professional for advice before and after travel.
Protection and awareness for travellers
There is no vaccine against Oropouche virus, so prevention focuses on avoiding bites from midges and mosquitoes. Travellers to affected regions should use insect repellent on exposed skin. Wearing long-sleeved shirts and long trousers helps, especially during dawn and dusk when insects are active. Sleeping under insecticide-treated nets provides extra protection, as the midge is most active at night. The ECDC advises that the risk of exposure in Europe is very low, but travellers returning from outbreak areas should be aware of symptoms. If fever or severe headache develops within a few days of return, seek medical advice and mention your travel history. Doctors can test for Oropouche virus using PCR. Early diagnosis supports better care and helps track the spread. Public health agencies continue to monitor the situation to protect communities and inform travellers.
Sources
- Threat assessment brief - Oropouche virus disease cases imported to the European Union: European Centre for Disease Prevention and Control
- Oropouche virus disease - Region of the Americas: World Health Organization
- Case series of Oropouche fever among travellers returning from Cuba to Spain, 2024: Eurosurveillance
- Oropouche virus disease: Pan American Health Organization