Over the past several weeks, 16 cases of the 22 imported chikungunya cases in the Cayman Islands originated in Jamaica, where the mosquito-borne virus is rampant, according to residents.
According to the Caribbean Public Health Agency’s latest report, as of October 20 there were 59 confirmed cases of chikungunya in Jamaica, but medical professionals and residents say the prevalence of the virus is hugely under-reported.
Dr. Dayton Campbell, who is the member of parliament for North West Saint Ann Parish in Jamaica, said the figures presented by CARPHA were “ridiculously low.”
“There has been an outbreak of the chikungunya virus locally. It started in the eastern end of the island, but it has pretty much spread to every parish … A large percentage of persons are infected with the virus,” said Dr. Campbell.
He estimates there have been “hundreds of thousands” of cases in Jamaica since the virus was first reported there on July 17 in the Jamaica Observer.
“Just from being around as a doctor, I can say it is in the hundreds of thousands [of cases] by now,” he said.
Carlon Kirton, communications manager of the Caribbean Public Health Agency, said there were several reasons for the disparity between CARPHA’s figures and local reports.
“CARPHA’s chikungunya updates are reported on a weekly basis, which may result in a lag in the number of cases recorded,” she said.
Ms. Kirton said CARPHA’s “sentinel surveillance systems can be used to identify trends or outbreaks of disease,” but added that the figures “do not accurately reflect the total number of cases of a disease.”
Dr. Dayton said he does not rely on official figures as they were usually inaccurate. “We don’t test everyone for the virus, so the number of confirmed cases doesn’t mean that much to me.”
“Many people don’t bother sending their blood sample for testing as it is expensive … so most of the persons wouldn’t be able to afford it. Even if the test does confirm you have the virus, you still would be having symptomatic treatment, as there is no cure for the virus,” he added.
In response to the debilitating illness, a chikungunya hotline has been set up by Jamaica’s Office of Disaster Preparedness and Emergency Management and the Ministry of Health. The hotline has been set up to assist people experiencing symptoms.
Chikungunya is a viral disease transmitted to humans by infected Aedes aegypti mosquitoes. It is rarely fatal. However, the infection can cause death in infants, people with weakened immune systems, and older people. The virus causes fever and severe joint pain and other symptoms can include: muscle pain, headache, nausea, fatigue and rash.
Dr. Dayton said the virus has impacted Jamaican society greatly. “People have been experiencing excruciating pain, most of the people who have the pain assume a bent or flexed position … Productivity has declined, a lot of people have had to be out of work, the schools have also suffered from this, and we’ve had … about five cases where people have died.”
“Mi only afraid of chicken-gun-man,” wrote Jamaican Dancehall artist Beenie Man in his latest song, “Chicken Gunya,” released last month to raise awareness of the virus currently plaguing Jamaica. Over a decade ago, Beenie Man wrote a hit song about dengue fever, a virus with similar symptoms to chikungunya.
‘Walking like someone old’
Michael Smith, a Kingston taxi driver, estimated there have been thousands of cases in the capital alone.
“More than one thousand people [had it] when it just came out …. It was really bad, and a lot of people have it. Like, it was an epidemic breaking out …,” said Mr. Smith.
He said he can pick residents with chikungunya out of a crowd based on the way they walked. “When you see a man walking, you can know that it is chikugunya because he … is walking like someone old, like an old man that uses a stick.”
Like many others, Mr. Smith too was unable to walk when he contracted the virus not too long ago. “I had it for one week. It was very horrible pain. I couldn’t get out of bed, it was very painful, I couldn’t eat. I just wanted something to drink. I had fever and rash like heat rash. I had the fever for three days and the heat rash for four days. I bathed in baking soda to get the rash to go away,” said he said.
He and many others used home remedies to treat the symptoms of the virus, including the painkiller Panadol.
“I know a guy who has it now – he had for about five days now, but he is getting over it. The only one thing you can do is take is Panadol 500, and it works. The doctor said it is going to be in your body for two years, as there is no real medicine to get out of the system,” said Mr. Smith.
Another resident who contracted chikungunya, Anthony Brown, who works in Kingston, said he had severe symptoms of the virus only for two days, but it made him feel like it was his “last minute on Earth.” He said his son who was visiting him also contracted the virus.
“It gave me fever and lymph node [swelling] but no rash; some people get some wicked rash with bumps that leave a mark like chicken pox,” he said.
Mr. Brown added, “There is not a whole heap of people who don’t have it ….”
He questioned how the virus could be spread so widely and so quickly by mosquitos.
“They say it comes from [mosquitos], but I do not believe it is mosquito to the amount of people [who] get it; mosquito could not bring it so far so quickly,” he said. Johnathan Edwards, owner of Bromley resort in the North Coast of Jamaica in Ocho Rios, which offers yoga retreats for overseas guests, said he had been getting cancellations due to chikungunya fears.
“No one wants to get sick. Chikungunya – just the word alone terrifies me,” said Mr. Edwards. “People are nervous about coming down because of chikungunya. Everyone is terrified of any medical disaster. It is unfortunate … the guy who runs [our yoga retreat in April] said he was thinking of canceling it because of chikungunya.”
An information officer at the Office of Disaster Preparedness and Emergency Management in Jamaica confirmed the organization had activated its National Emergency Operations Center in response to the chikungunya virus.
“The current outbreak of the chikungunya virus among the island’s population has necessitated the activation of the National Emergency Operation Center with support from Parish Emergency Operation Centers,” said a representative from the Office of Disaster Preparedness and Emergency Management.”
Since June 25, when the virus was first reported in Cayman, local health officials have investigated 122 suspected cases of chikungunya. Health officials advised earlier this week that the number of confirmed chikungunya cases in Cayman had risen to 26, with four cases contracted locally.
According to Cayman’s Chief Medical Officer of Health Dr. Kiran Kumar, “Cayman Airways is giving the travelers to Jamaica the leaflets [on chikungunya prevention].”
He said CARPHA had advised that as a chikungunya outbreak had been established in Jamaica, “only a limited number of samples with travel history will be tested as all of them will be clinically diagnosed and considered as suspected cases.”
He added that this means that blood tests will only be carried out in cases where patients do not have a travel history, to establish if local transmission in Cayman is occurring.
Compass journalist Jewel Levy contributed to this report.