First regional cases of chikungunya virus

The first locally acquired cases of the mosquito-borne chikungunya virus in the Caribbean has been reported on the island of St. Martin.

The Cayman Islands’ Medical Officer of Health Dr. Kiran Kumar said Monday he received notification through the Caribbean Public Health Agency that there is an outbreak of the virus on the French side of St. Martin.

The virus is carried mainly by the Aedes Aegypti mosquito, the same mosquito that carries the dengue virus. Dengue and chikungunya have similar symptoms, including a sudden high fever, severe pain in the wrists, ankles or knuckles, muscle pain, headache, nausea and rash. Other symptoms of chikungunya are joint pain and stiffness.

As with dengue, there is no vaccine or treatment for chikungunya, so doctors treat the symptoms.

“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 hospitalization are rare,” Dr. Kumar said.

Chikungunya has infected millions of people in Africa and Asia since the disease was first recorded in 1952. India, countries in the Indian Ocean, Malaysia, Sri Lanka, Singapore and Indonesia are among the major countries currently with chikungunya.

“It is noteworthy that this is the first time locally-acquired cases of chikungunya have been detected in the Caribbean,” a statement from the Cayman Islands Public Health Department read. “In the Americas, imported cases had previously been reported from Brazil, Canada, French Guiana, Guadeloupe, Martinique and the United States of America.”

According to the Caribbean Public Health Agency, as of last week, there had been 10 confirmed cases of locally acquired chikungunya virus infection on St. Martin. The first case was reported in October. Four additional cases have been identified as probable cases, and 20 other people are suspected of having the disease. Laboratory test results are awaited, the agency said, and it is likely that the number of confirmed cases will increase.

Dr. C. James Hospedales, executive director of the Caribbean Public Health Agency, said that in addition to chikungunya on the French side of the island, both sides of the island were currently experiencing a dengue epidemic.

“Given that the type of mosquito that transmits chikungunya is widely distributed in the Caribbean region and is also known to transmit dengue, the region is at risk for spread of the virus,” he said.

Bill Petrie, director of the Mosquito Research and Control Unit in the Cayman Islands, explained that the 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.

“The best way to protect yourself from the disease it to avoid mosquito bites and to prevent mosquitoes breeding in and around your home environment,” he said.

Dr. Kumar advised visitors or returning residents from the endemic countries with fever and severe joint pains to consult a doctor and advise the physician of their travel history to enable them to assess and test for chikungunya.

The tests for chikungunya will be carried out at the Caribbean Public Health Agency in Trinidad.

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