GEORGE TOWN, Cayman Islands -- In December 2013, the World Health Organization (WHO) reported the first local transmission of chikungunya virus in the Western Hemisphere identified in Saint Martin. Fifteen Caribbean countries have since reported cases of chikungunya: Anguilla, Antigua and Barbuda, British Virgin Islands, Dominica, the Dominican Republic, Guadeloupe, Guyana, Haiti, Martinique, St Barthelemy, St Kitts and Nevis, St Martin, St Vincent and the Grenadines, Saint Lucia (imported case) and St Maarten.
As of 16 June 2014, a total of 165,800 suspected and 4,805 laboratory-confirmed chikungunya cases had been reported from these areas. More than 95% of these cases have been reported from five jurisdictions: Dominican Republic (77,320 cases), Martinique (35,000), Guadeloupe (35,000) Haiti (11,802), and St Martin (3,380).
The chikungunya virus is transmitted by the Aedes aegypti mosquito that also transmits dengue.
“So far there have been no suspected cases in the Cayman Islands, should there be any we have arrangements with the Caribbean Public Health Agency in Trinidad (CARPHA) for Laboratory testing,” said Medical Officer of Health Dr Kiran Kumar.
“There are no borders for communicable diseases. The easy access and frequency of air travel to endemic areas put persons at risk for the chikungunya virus. If someone is bitten by an infected mosquito in countries where chikungunya exists, the infection can be acquired. It is therefore paramount that the public protect themselves from mosquito bites by using mosquito repellents, wearing long sleeve clothing and pants tucked into socks during travels, as chikungunya is a mosquito borne disease,” he noted.
Chikungunya is characterized by an abrupt onset of fever frequently accompanied by joint pains. The joint pains are often very debilitating, but usually last for a few days or may be prolonged to weeks. Most patients recover fully, but in some cases joint pains may persist for several months, or even years. Occasional cases of eye, neurological and heart complications have been reported.
Serious complications are not common, but in older people, the disease can contribute to the cause of death. Often symptoms in infected individuals are mild and the infection may go unrecognized, or be misdiagnosed in areas where dengue occurs.
The symptoms appear between four to seven days after the bite of an infected mosquito. The majority of clinical signs and symptoms last three to 10 days, but joint pains may last for months or years. Severe cases requiring hospitalization are rare.
There is no specific treatment for chikungunya infection, nor any vaccine to prevent it.
Measures for controlling the spread of chikungunya are the same of those applied for the control of dengue as both diseases are transmitted by the same mosquito, Aedes aegypti. Therefore, until a new vaccine is developed, the only effective means of prevention is to protect individuals against mosquito bites.
Visitors or returning residents from the endemic countries, with fever and severe joint pains, should consult a physician and advice of travel history to enable them to assess and test for chikungunya.
Key facts on chikungunya
• Chikungunya is a viral disease transmitted to humans by infected mosquitoes. It causes fever and severe joint pain. Other symptoms include muscle pain, headache, nausea, fatigue and rash.
• The disease shares some clinical signs with dengue, and can be misdiagnosed in areas where dengue is common.
• There is no cure for the disease. Treatment is focused on relieving the symptoms.
• The proximity of mosquito breeding sites to human habitation is a significant risk factor for chikungunya.
• Since 2004, chikungunya fever has reached epidemic proportions globally, with considerable morbidity and suffering.
• The disease occurs in Africa, Asia and the Indian subcontinent. In recent decades mosquito vectors of chikungunya have spread to Europe and the Americas. In 2007, disease transmission was reported for the first time in a localized outbreak in north-eastern Italy.