Chikungunya -- First Time for Transmission in the Caribbean

    Thanks to a comment on my dengue fever blog post, this post focuses on Chikungunya.

    Chikungunya is an African/Asian virus and according to the World Health Organization (WHO) its name derives from the Kimakonde language (Africa), "meaning 'to become contorted' and describes the stooped appearance of sufferers with joint pain (arthralgia)." Its symptoms include severe joint pain and high fevers that persist for a week or can linger for months.  Most people recover, according to the WHO. So what is it doing in the Caribbean?  No one knows for sure, but at least one of the mosquitos known to carry the virus can withstand temperatures quite well outside of the tropical zone (Aedis albopictus).
      Its appearance in the Caribbean this year is due to a rapid spread by mosquitoes (Aedis egypti and Aedis albopictus and both are known to spread the virus). It is the first time the virus has been transmitted in the Caribbean and not just brought into the islands from travelers who returned with the virus. So far, 55,000 cases have been confirmed according to media reports, and many more may be undiagnosed.
      There is no cure for the virus, and fever control medication is being recommended.  In Haiti, it has been reported that the price has doubled on the island's primary fever reducer.  (In the U.S., increasing prices on commodities beyond 10% in California state law, for example, in a declared public health emergency or disaster is a crime.)
      CDC has issued a "travel alert" but at the lowest level, Level 1, "Watch" which indicates to continue using usual precautions, in this case to avoid mosquito bites, and indicates risk to the traveler is the "[U]sual baseline risk or slightly above baseline risk for destination and limited impact to the traveler."
      Research on Chikungunya virus to lay the groundwork for a potential vaccine was begun by NIH/NIAID funding of the ten year program for Regional Centers of Excellence in Biodefense and Emerging Infectious Diseases which ended this year.
       On June 12, the regional public health authorities will convene to determine what next steps should be taken with Chikungunya and Dengue, both spread by mosquitoes. 

 

WHO world map of countries at risk before the

Dec 2013 first recorded transmission in the Caribbean

 

France was the first to identify the virus in St. Maarten in De 2013 and began tracking its spread.  This figure tracking the cases in the Caribbean is from an article at: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20759