Caribbean chikungunya cases top 170,000
By Lisa Schnirring Staff Writer From CIDRAP News
The number of chikungunya cases in parts of the Caribbean continued to surge last week, pushing past 170,000 cases, with the first cases confirmed in El Salvador, west of the main outbreak area, and more imported cases detected in the United States and other countries.
The outbreak has grown to 170,566 suspected or confirmed cases of the mosquito-borne disease, which is 35,139 higher than the 135,427 cases reported the previous week, according to a Jun 13 report from the Pan American Health Organization (PAHO). The number of deaths remained the same, at 14.
Over the past few weeks, most new cases are suspected infections reported from the Latin Caribbean countries, such as the Dominican Republic, where suspected cases rose from 52,976 to 77,320 last week. Guadaloupe and Martinique also reported thousands of new cases, but no new case totals were given for Haiti, another country that has recently been hard hit by the outbreak.
In the non-Latin areas that were mainly affected earlier in the outbreak, new cases were reported by Dominica, the Turks and Caicos Islands, and the US Virgin Islands.
The outbreak started in December on the French side of St. Martin. The European Centre for Disease Prevention and Control (ECDC) said Jun 13 in its weekly communicable disease threat update that nearly 150,000 probable and confirmed cases have been reported in the region, which was lower than PAHO’s total. It added that most of the affected areas continue to report more cases, but especially Haiti and the Dominican Republic.
The ECDC said the outbreak in still expanding, and it urged health officials to be vigilant for imported cases in tourists returning from the Caribbean.
El Salvador reports first cases
Elsewhere, health officials in El Salvador on Jun 14 confirmed that the virus is spreading in the country, with at least 1,200 people who have been diagnosed with the disease, Agence France-Presse (AFP) reported.
El Salvador appears to be the westernmost area to be affected by the outbreak. Unlike other affected areas, it is in Central America and is located on the Pacific Ocean, not on the Caribbean Sea.
The country’s health minister Violete Menjivar, MD, said the positive tests will be confirmed by the US Centers for Disease Control and Prevention (CDC). She told a state-run TV station that cases were found just outside of San Salvador, the country’s capital.
Imported cases rise
Two more countries—Venezuela and Brazil—reported imported cases, raising that total from 35 to 59, according to the PAHO report.
At least two more US states reported their first imported cases.
The Rhode Island Department of Health (RDDH) confirmed two chikungunya infections in travelers who returned from the Dominican Republic on May 19 and May 29, according to a Jun 13 statement. The infections were detected after patients presented to their physicians with fever, muscle aches, and joint pains. The RDDH said it is investigating a few more suspected cases.
Meanwhile, the Tennessee Department of Health (TDH) confirmed its first case, in a resident of Madison County, according to a Jun 13 press release. It said multiple people from Tennessee and other states who recently traveled to the Caribbean now have symptoms of the illness. The TDH did not specify what country or island the patient who tested positive for the virus had visited.
State medical entomologist Abelardo Moncayo, PhD, said patients with chikungunya symptoms should minimize their exposure to mosquitoes to reduce the risk of transmission. “A mosquito can pick up the virus from an infected human and infect other people,” he said.
Tim Jones, MD, Tennessee’s state epidemiologist, said in the statement that the virus is spread by mosquitoes that feed during the day and are found in abundance in Tennessee.
The Rhode Island and Tennessee cases raise the number of US states reporting imported cases to 12, with most cases in Florida, according to a Jun 10 CDC update. The agency said a travel-linked case has been reported in the US Virgin Islands and a locally acquired case has been reported in Puerto Rico.
PHOTO: Aedes mosquito RedingerS / iStock
For more on this story go to: http://www.cidrap.umn.edu/news-perspective/2014/06/caribbean-chikungunya-cases-top-170000
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US travellers to Caribbean alerted on Chikungunya virus
From Guyana Times
Atlanta’s Centre for Disease Control (CDC) is advising US travellers to the Caribbean to protect themselves from mosquito bites, in light of the raging chikungunya virus there.
The warning was issued at the start of the summer vacation period when travel to the Region increases.
According to news reports over the weekend, the viral illness has surfaced across the US carried by recent travellers to the Caribbean.
The virus is transmitted by aedes egypti mosquitoes and there is no vaccine for the illness.
While the virus does not typically lead to death, conditions can become debilitating. Symptoms can become emphasised and dangerous for adults over 65, newborns and individuals who already have health issues like diabetes, heart disease or high blood pressure. Most common symptoms are fever and joint pain as well as headache, muscle pain, joint swelling, or rash. Joint pain can take up to a few months or longer for full recovery.
The Caribbean Public Health Agency (CARPHA) last week reported that the number of confirmed and suspected cases rose to 135,651, up from just over 100,000 on June 2. The virus has been detected in 20 Caribbean countries and territories, with the largest outbreak in The Dominican Republic.
CARPHA said travellers to the following Caribbean islands are at risk of getting chikungunya: Anguilla, Antigua, British Virgin Island, Dominica, The Dominican Republic, French Guiana, Guadeloupe, Guyana, Haiti, Martinique, Puerto Rico, Saint Barthelemy, Saint Kitts, Saint Lucia, St Martin, St Vincent and the Grenadines and St Maarten (Dutch). The Dominican Republic has had more than 77,000 suspected cases since January, including 20,000 new suspected cases in the last week.
Confirmed cases were reported in North Carolina, Nebraska and Indiana last week. Florida with 25 cases has the majority in the US, according to the CDC.
Trinidad and Tobago (TT) Health Minister Fuad Khan said his country has been working hard to prevent the virus from coming to his country.
“The reason TT hasn’t gotten Chikungunya yet is because a lot of work is being done by agencies, including the Insect Vector Unit and others, to try to control mosquito spread. TT can stay free of this if we keep doing the right things…Use insect repellant or citronella oil. Check water storage units or your plants daily. If necessary, call the Insect Vector Control Unit and they’ll come and spray,” he added.
Travellers to Africa, Asia, and islands in the Indian Ocean and Western Pacific are also at risk as the virus is present in many of these areas.
For more on this story go to: http://www.guyanatimesgy.com/?p=66770&utm_source=rss&utm_medium=rss&utm_campaign=us-travellers-to-caribbean-alerted-on-chikungunya-virus
Minnesota doctor bit by emerging virus
By Jeremy Olson From Star Tribune
Minnesotan was helping in Haiti when struck by a mosquito-borne illness.
A pediatrician providing charitable maternity care in Haiti is one of the first Minnesotans to contract a mosquito-borne virus that is being monitored by federal health officials after migrating from Africa and spreading rapidly in the Caribbean.
Dr. Jennifer Halverson went to bed one evening in April after celebrating her birthday with colleagues in Haiti and awoke in the middle of the night with crushing joint pain — a characteristic of the infection caused by chikungunya (roughly pronounced “chicken-gun-ya’’). The pain left her immobile and delayed her return to Minneapolis, where she is an emergency room physician for Children’s Hospitals and Clinics of Minnesota.
“I’ve broken a bone. I’ve had other medical issues,” she said Monday. “I don’t think I’ve ever been in so much pain.”
Federal health officials are concerned that the virus will eventually spread to the United States much as the West Nile virus did — perhaps when an infected traveler returns to the U.S. and is bitten by a mosquito, which then carries the infection to other people who are then bitten by more mosquitoes.
So far this year, the U.S. Centers for Disease Control and Prevention has reported 38 cases of Americans being infected, all on Caribbean islands. (One is considered a domestic case because it occurred in Puerto Rico.) More than 130,000 cases have been reported in the Caribbean since the first known regional transmission of the virus occurred on the island of St. Martin last December.
Halverson’s infection was reported to the CDC after she returned to Minnesota and visited the HealthPartners Travel and Tropical Medicine Center in St. Louis Park.
While the fatality rate from chikungunya is low, the fever can be severe and the joint pain can linger for months after the immediate symptoms have receded, said Dr. Pat Walker, medical director of the clinic. “It’s really just beginning to peak in the Caribbean. So we’re going to start to see more imported cases back in the U.S.”
The risk of additional infections occurring in Minnesota is low, compared to other states, because the two types of mosquitoes known to carry the chikungunya virus don’t circulate this far north. Transmission from an infected person to a mosquito can happen only during the initial acute stage of the infection, which lasts about a week, Halverson said.
Halverson said her infection left her bedridden, and that even rolling over caused pain. Many other volunteer doctors in Haiti suffered infections this spring as well — some of them underestimating her pain until they suffered it themselves, she said.
“There’s sort of this chikungunya walk that we all talk about,” she said. “It’s pretty unmistakable” as people walk hunched over in tiny steps. Halverson has continued to suffer joint pain, often in different parts of her body each day. Flare-ups occur when she reaches to tie her shoes or tries to open a bottle.
The doctor believes her symptoms will recede over time, but she worries about the impoverished people in Haiti, and what prolonged joint pain could mean to low-income workers whose jobs often require manual labor.
“You take them out of work for a week,” she said, “and it really impacts their families. It affects their life.”
For more on this story go to: http://www.startribune.com/lifestyle/health/263384281.html
NC’s first case Chikungunya confirmed in resident who recently travelled to Caribbean
From High Country Press
Chikungunya virus is transmitted through the bite of an infected mosquito, and the Asian Tiger mosquito that is commonly found in North Carolina could effectively transmit this virus.
North Carolina’s first case of chikungunya was confirmed in a resident who recently travelled to the Caribbean. Chikungunya virus is transmitted through the bite of an infected mosquito, and the Asian Tiger mosquito that is commonly found in North Carolina could effectively transmit this virus. At this time, there have not been any cases of the disease known to have been acquired in North Carolina or the continental United States.
Symptoms of chikungunya usually begin three to seven days after being bitten by an infected mosquito. Symptoms typically include the sudden onset of fever and severe, often disabling, joint pains in the hands and feet. Many patients feel better within a week; however, the joint pain may persist for months in some people. Newborns exposed during delivery, adults over 65 years and people with chronic medical conditions have a greater risk for a severe form of the disease.Prior to its introduction in the Caribbean, chikungunya was established in East Africa, India, the Indian Ocean and the Western Pacific regions. It was introduced in the Caribbean in December 2013 through travelers returning from affected areas. As of June 6, chikungunya has caused illness in over 130,000 persons in the Caribbean.
DHHS’ Division of Public Health advises persons traveling to countries where chikungunya transmission is occurring to:
Take personal precautions to prevent mosquito bites; and
Immediately consult a medical provider if they develop fever in the two weeks after their return home.
“With North Carolina residents traveling to and from the Caribbean and other affected areas, we have been monitoring for possible imported cases,” said Dr. Megan Davies, DHHS’ State Epidemiologist. “Anyone experiencing symptoms of chikungunya should contact a physician and minimize exposure to mosquitoes to reduce the risk of transmitting the virus to others. Travelers who visit countries where chikungunya is widespread should take extra precaution against mosquito bites.”
To protect yourself and your family against mosquito bites:
Wear light-colored long pants and long-sleeved shirts.
Reduce time spent outdoors, particularly during early morning and early evening hours when mosquitoes are most active.
Apply EPA-approved mosquito repellents such as DEET, picardin, oil of lemon eucalyptus or IR3535 to exposed skin areas. Always follow guidelines when using mosquito repellent.
Since mosquitoes may bite through thin clothing, spray clothes with repellent containing permethrin or another EPA-registered repellent will give extra protection.
DHHS’ Division of Public Health strongly recommends that all North Carolina residents take measures to decrease environmental conditions favorable to breeding for the species that could transmit this infection, the Asian Tiger mosquito. This mosquito is an aggressive daytime biter, breeds in small water containers and does not travel long distances. To reduce mosquito breeding areas around your home:
Remove any containers that can hold water;
Change the water in bird baths and pet bowls frequently and repair leaky outdoor faucets;
Cover rain barrels with tight-fitting screens or lids;
Keep gutters clean and in good repair; and
Use screened windows and doors and make sure screens are not torn and fit tightly.
To learn more about chikungunya virus, please visit: http://www.cdc.gov/chikungunya/
To learn more about chikungunya and its introduction into the Americas, please visit: http://www.paho.org/hq/index.php?option=com_content&view=article&id=9053&Itemid=39843
To learn more about how to prevent mosquito bites, please visit: http://epi.publichealth.nc.gov/cd/arbo/prevent.html
IMAGE: ae_aegypti_ae_albopictus
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