UPDATE: African Virus Outbreak in Caribbean Stirs Health Warnings
UPDATE: From Bloomberg Business Week
The first known outbreak of the chikungunya virus in the Western Hemisphere has Caribbean governments working to prevent the disease from spreading and damaging the region’s tourism-dependent economies.
About 280 cases of chikungunya, which can cause severe joint pain, fever and headaches, have been reported since early December in Dutch and French Saint Martin, Saint Barthelemy, Martinique, Guadeloupe, Dominica, the British Virgin Islands and French Guyana. Officials from Venezuela to the Cayman Islands have warned of the potential for the mosquito-borne virus, first identified from a patient in Tanzania in 1953, to spread. There is no treatment and the illness is rarely fatal.
“The worst case scenario would be that the impact would be significant and slow down the whole economy in the Caribbean,” James Hospedales, the executive director of the Caribbean Public Health Agency, said by telephone. “The Caribbean is the most tourism-dependent region in the world so if it spreads like wildfire you could scare away tourists.”
Caribbean economies suffered in the aftermath of the global financial crisis as tourism declined and destinations including Jamaica and Grenada struggled under debt loads that exceeded 100 percent of gross domestic product. With economies in North America and Europe rebounding, regional leaders are counting on increased tourism to boost growth.
Spreading the Word
Radisson Hotels International’s Blu resort and spa on the French side of Saint Martin, about 300 kilometers (190 miles) east of Puerto Rico, is offering complimentary mosquito repellent in every room due to the outbreak, concierge Claudette Davis said. The island’s tourism board is working with authorities on the Dutch side, known as Sint Maarten, to ensure visitors are aware of the outbreak and how to avoid it from the moment they arrive, said director Silviane John.
“We’re working closely with them to try to disseminate as much information as possible to airports, hotels and everyone over the radio, TV, newspapers and newsletters,” John said, adding that it is safe to travel to the island.
While chikungunya is a recent arrival to the region, the Caribbean and Central America have a bigger problem with dengue, which can be fatal and is transmitted by the same Aedes aegypti mosquito. About 79,000 cases of dengue were reported in the Caribbean last year, including 141 deaths, according to the World Health Organization. The Dominican Republic accounted for 111 of those fatalities. Approximately 400 million people worldwide suffer from dengue each year, the U.S. Centers for Disease Control and Prevention said.
Mosquito Control
“Governments in this region spend tens of millions of dollars every year to educate people and conduct mosquito control operations,” said Hospedales, adding that researchers may never know how chikungunya first arrived. “It’s important to strike a balance without causing alarm” in terms of warning people about the virus, he added.
Until its appearance in the Caribbean, the disease was more commonly seen in Africa, India and Southeast Asia.
If a person infected with chikungunya travels back from the Caribbean and is bitten by another mosquito, there’s a possibility the virus could spread further into new areas, said Roger Nasci, chief of the CDC’s arboviral diseases research branch. The first case of the disease in Dominica, confirmed yesterday, was from someone who had traveled to Saint Martin, Dominica News Online reported.
“We’re confident that if the virus establishes itself and spreads in the Caribbean and adjacent countries, we will see the introduction of chikungunya through infected travelers,” Nasci said. “Whether it will set up local transmission, maybe eventually, but it’s hard to know the scale.”
To contact the reporters on this story: Isabella Cota in San Jose, Costa Rica at [email protected]; Elizabeth Lopatto in New York at [email protected]
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Original story
First case of chikungunya virus surfaces in Dominica
From Caribbean360
ROSEAU, Dominica, Friday January 17, 2014, CMC – Dominica has recorded its first case of the chikungunya virus but health officials say there is no cause for alarm.
“We can confirm that we have the first local case of chikungunya in Dominica,(but) there is no need for any alarm at this time,” said Chief Medical Officer of Dominica Dr David Johnson, adding that it was ”very importantly for us we want to establish if there are any other cases in Dominica”.
Earlier this week the Trinidad-based Caribbean Public Health Agency (CARPHA) said it is working closely with the French and Dutch authorities after the region recorded its first ever case of chikungunya.
Late last month, CARPHA said it had received notification of 10 confirmed cases of locally acquired chikungunya virus infection on the French side of the Caribbean island of Saint Martin.
Chikungunya is a viral disease, carried mainly by the Aedes aegypti mosquito and causes a dengue-like sickness.
Symptoms include a sudden high fever, severe pain in the wrists, ankles or knuckles, muscle pain, headache, nausea, and rash. Joint pain and stiffness are more common with chikungunya than with dengue.
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 pain may persist longer. Severe cases requiring hospitalisation are rare.
CARPHA executive director Dr. James Hospedales told the Caribbean Media Corporation (CMC) “the Caribbean is at risk, exactly what will happen in the weeks and months ahead we don’t know because it has not been here before but we are at risk”.
He said a few reasons, this is a new virus to the region and therefore the vast majority of people are susceptible.
Dr Johnson said the Dominican person infected with the disease had started showing signs of the sickness in mid-December, and confirmation was given this week by CARPHA.
He said an emergency meeting was then convened for stakeholders to examine their rapid and coordinated response. This involves the clinical management of persons with the signs and symptoms of the virus, the vector control, laboratory support, response, surveillance of the disease and public education.
“With this case showing up on our doorstep, we have already put measures in place in the community of Good Hope where it has occurred. A team is on the ground from the National Pest and Termite Company working alongside the environmental health department and health team members in doing some larva surveys in the community,” said Chief Environmental Health Officer Anthony Scotland.
He said houses would be inspected for mosquito breeding and treated around the island
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Original story:
Caribbean health agency on the offensive against chikungunya disease
From Caribbean360
Chikungunya is a viral disease, carried mainly by the Aedes aegypti mosquito and causes a dengue-like sickness.
BRIDGETOWN, Barbados, Wednesday January 15, 2014, CMC – The Trinidad-based Caribbean Public Health Agency (CARPHA) says it is working closely with the French and Dutch authorities after the region recorded its first ever case of chikungunya.
Late last month, CARPHA said it had received notification of 10 confirmed cases of locally acquired chikungunya virus infection on the French side of the Caribbean island of Saint Martin.
CARPHA executive director Dr. James Hospedales told the Caribbean Media Corporation (CMC) Wednesday that three cases have now been detected in the British Virgin Islands.
“We have prepared ourselves by building the capacity of our staff to do the testing and our staff has been visiting and advising the countries including St. Martin even before this was on the horizon about the mosquito control programmes in the countries.
“We are working closely with the French and Dutch authorities to have a coordinated approach to dealing with the problem by sharing numbers, sharing strategies to mosquito control and so on.”
“My advice would be to stay inform and stay alert to the news and any updated information, secondly we would strongly advised that you go to our web and download the chart which is a checklist of all the breeding places in the yard where mosquitoes can breed.”
Chikungunya is a viral disease, carried mainly by the Aedes aegypti mosquito and causes a dengue-like sickness.
Symptoms include a sudden high fever, severe pain in the wrists, ankles or knuckles, muscle pain, headache, nausea, and rash. Joint pain and stiffness are more common with chikungunya than with dengue.
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 pain may persist longer. Severe cases requiring hospitalisation are rare.
“”The Caribbean is at risk, exactly what will happen in the weeks and months ahead we don’t know because it has not been here before but we are at risk,” Dr. Hospedales told CMC.
He said a few reasons, this is a new virus to the region and therefore the vast majority of people are susceptible.
“They have no resistance to it so that increase the chance of spread. Secondly, the mosquito that transmits the Chikungunya virus, the Aedes mosquito, is the same one that transmits dengue fever and it is common in most of our countries.”
“In fact the Chikungunya is a wakeup call I think that we need to get more serious about mosquito control so that’s another reason why there is risk for spread in the region and the amount of travel in between islands. So for those reasons yes we are at risk for a lot of spread but exactly what will happen we don’t know because it has not been here before”.
Dr. Hospedales said that the regional health agency is concerned about any new virus or infection that emerges in the region.
“We are concerned based on the pattern if behaviour of this disease in Asia and Africa were everybody was susceptible you could have a lot of spread in a short time, with a lot of people being ill temporarily and that not good”.
The European Centre for Disease Prevention and Control (ECDC) has warned of further increased cases of the disease, noting that as of Thursday last week, there were 201 “probable or confirmed cases” in French St Martin and two confirmed cases on the Dutch side of the island.
ECDC also said there were 48 “probable or confirmed cases” in Martinique; 25 “probable or confirmed cases” in St Barthélemy; 10 “probable or confirmed cases, including one imported case from St Martin in Guadeloupe”; and one “confirmed case imported from Martinique in French Guiana.
Dr. Hospedales said that since last year CARPHA has conducted seminars with all the countries, the laboratories and the chief medical officers and epidemiologist to prepare for disease “and to set up…the testing sequence that we will follow if we suspect Chikugunya and capacity is also there in terms of the ability to deal with the vector population and that varies by country.
“Some countries put a lot of attention to it and have a fair amount of control but with the solid waste situation we have in the Caribbean, with rainy season people storing water in drums that are not properly covered and so on”
He told CMC that the situation was the same with the dengue epidemic “ where you have a lot of potential for the breeding of mosquitoes that spreads the dengue and spreads this new virus chikungunya”
But he insisted that the Caribbean has “good capacity to detect, to diagnose and to respond..
“The systems that have been there that are part of the Caribbean surveillance systems and public health system is to detect, to respond, to educate the population, to control the vector. I think we are concern is if there is widespread and very rapid transmission then you could have a very temporary hiccup is how your whole country is run if a large percentage of people is get ill in a short time”.
Dr. Hosepdales is urging residents in the Caribbean to clean their environment in order to minimize the outbreak of the disease.
“If you live in the Caribbean you know about this and we need to get much more serious about the control of our environment. That’s my advice for households and families in the Caribbean. If a person does develop a fever, headache and joint pain which could be dengue or could be chikungunya then go to your health provider”
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