CHIKUNGUNYA (31): CARIBBEAN *************************** A ProMED-mail post ProMED-mail is a program of the International Society for Infectious Diseases In this update: [1] Caribbean: general [2] St Vincent and the Grenadines [3] Brazil (Amapa state): request for information [4] Dominican Republic and Haiti [5] Caribbean: virus origin ****** [1] Caribbean: general Date: Thu 1 May 2014 Source: Jamaica Observer [edited] The head of the Caribbean Public Health Authority (CARPHA), Dr James Hospedales, has declared the chikungunya virus has reached epidemic proportions in the Caribbean. By definition this is an epidemic since it represents an unusual number of cases of this problem where we would never have it before, Dr Hospedales told the Caribbean Media Corporation (CMC). The mosquito-borne illness was first detected in the Caribbean in December 2013, in St Martin, and last week Antigua and St Vincent and the Grenadines became the latest countries to declare an outbreak. According to Dr Hospedales, as of 28 Apr 2014, there were 4108 probable cases in 14 countries across the region. [If these are the case totals for all the affected Caribbean countries, they are significantly too low. - Mod.TY]. He also stated that Caribbean countries have been putting measures in place to address the spread of the virus. PAHO (the Pan American Health Organisation) since 2012 had done a preparatory briefing, in July of last year [2013] we convened a Caribbean-wide virtual meeting of the chief officers in the countries in the labs, to highlight this emerging threat and to adjust our surveillance protocols and laboratory testing to have early detection. In December [2013], once it came into the region we established an incident management team, and that has regular contact with the countries, with PAHO, with the French and so on, Hospedales said. Chikungunya [virus] is spread by the _Aedes aegypti_ mosquito, which also spreads dengue fever [viruses]. Hospedales noted there are steps that can be taken to contain the disease. Our main recommendations are to continue to educate members of the public on the current situation, and get accurate information to avoid confusion. It is very important to inspect homes and communities to eliminate potential vector breeding sites for the _Aedes aegypti_ mosquito, he said. He also advised that people who are sick with fever and suspect they may be suffering from dengue or chikungunya [virus infections], should use an insect repellant and sleep under a mosquito net. This is not a severe disease, in that people dont die from it, whereas dengue can kill you, but chikungunya [virus infection] has more long term [effect]; a significant percent of people will have joint pains one year, 2 years afterwards, Hospedales said. To date the chikungunya virus has been confirmed in Anguilla, Aruba, Virgin Islands, Dominica, Dominican Republic, French Guiana, Guadeloupe, Martinique, St Barthelemy, St Kitts and Nevis, St Lucia, St Vincent and the Grenadines, St Maarten (Dutch) and St Martin (French). -- Communicated by: ProMED-mail from HealthMap Alerts [Maps showing the location of the affected islands can be accessed at , and at . - Mod.TY] ****** [2] St Vincent and the Grenadines Date: Wed 7 May 2014 Source: I-Witness News [edited] On mainland St Vincent, 2 cases of the mosquito-borne chikungunya virus [infection] have been confirmed, as the total number of confirmed cases in the country has climbed to 39. The Ministry of Health, Wellness and the Environment said on Wed 7 May 2014 that there are 37 confirmed cases of the virus on the northern Grenadine island of Bequia, where an outbreak began in late April [2014]. The illness was first detected in the Caribbean in December 2013, in St Martin, and Antigua and St Vincent and the Grenadines have become the latest countries to declare an outbreak. Luis de Shong, permanent secretary in the Ministry of Health, Wellness and the Environment said on Wednesday that his ministry continues to implement vector control activities against the _Aedes aegypti_ mosquito, which causes [transmits] the chikungunya virus. He said private sector and other key stakeholders such as the National Emergency management Organisation, the Roads, Bridges and General Services Authority, the Ministry of Tourism and the Central Waster and Sewerage Authority are all engaged in the multi-sectorial approach towards fighting this disease. The Ministry of Health, Wellness and the Environment will continue active surveillance and island-wide intense vector control campaign. Additionally, several public outreach programmes have been held and more are scheduled throughout St Vincent and the Grenadines to sensitise Vincentians about the virus and the Ministry urges the participation of all individuals in fighting the _Aedes aegypti_ mosquito and the chikungunya virus, de Shong said. The ministry said it was reiterating the importance of avoiding mosquito bites by implementing vector control measures at the individual and community levels, such as keeping water drums and tanks covered, getting rid of unused tires, keeping the general surroundings clean, the use of appropriate clothing to avoid mosquito bites, and the use of insect repellents. -- Communicated by: Roland Hubner Superior Health Council Brussels Belgium [Maps of St Vincent and the Grenadines can be accessed at and . - Mod.TY] ****** [3] Brazil (Amapa state): request for information Date: Mon 5 May 2014 Source: CBN [in Portuguese, trans. & summ. Mod.TY, edited] In Brazil, occurrences [of chikungunya virus infection?] are due to people who travel to other countries and return while infected. The latest diagnosis occurred in Amapa. -- Communicated by: Roland Hubner Superior Health Council Brussels Belgium [Amapa state borders French Guiana where there is an outbreak of chikungunya virus transmission going on currently. It is not clear from the report above if the diagnosed case has been confirmed as a chikungunya virus infection. If so, apparently, no ongoing transmission has occurred. ProMED-mail would appreciate receiving additional information about this case, including results of laboratory tests and where the infected individual had been traveling prior to return to Amapa. Maps of Brazil can be seen at and . - Mod.TY] ****** [4] Dominican Republic and Haiti Date: Sat 3 May 2014 Source: Diario Digital Barahona, Listin Diario report [in Spanish, trans. & summ. Mod.TY, edited] At least 10 provinces in the Dominican Republic have reported cases of chikungunya virus infection, said the Vice Minister of Collective Health, Rafael Schiffino, giving assurances that the strategy of the Ministry of Public Health to contain outbreaks are giving very good results. Epidemiological surveillance indicates that there are 6 provinces with local transmission of the virus. In order of virus appearance, they are San Cristobal, San Pedro de Macoris, Distrito Nacional, Santo Domingo, Hato Mayor, and Peravia. Schiffino added that cases of the virus [infection] have been detected in Haiti, implicating its circulation in the entire island [of Hispaniola], and that through the Pan American Health Organization (PAHO), the Dominican Republic is giving its neighboring country technical assistance for detection and control. The epidemiological surveillance system [in the Dominican Republic] reports 7520 suspected cases of chikungunya [virus infection], of which 3974 have been reported in the Nigua community, 3504 in Haina, and 42 in other municipalities in the country. Schiffino stated that the cases are concentrated in the Nigua and Haina communities of San Cristobal [province] which is where the virus was first detected in the country but that the containment strategy where a case is registered has permitted that outbreaks not emerge and only isolated cases are reported. He warned that with this long weekend [1 May holiday], people will travel from one province to another with the possibility of ongoing dissemination of the virus. Thus, the Ministry has been adopting preventive measures including elimination of mosquito breeding sites, house-to-house visits for early detection of cases, to immediately apply containment [measures]. He reminded everyone that the most effective means is for each family take responsibility for the elimination of mosquito breeding sites. [Byline: Doris Pantaleon] -- Communicated by: Roland Hubner Superior Health Council Brussels Belgium [The 6 May 2014 edition of Proceso ( in Spanish) stated that in only 3 days, 1500 patients affected by chikungunya virus infection came to the emergency room of the Juan Pablo Pino Hospital in San Cristobal. Another report issued 1 May 2014 ( in Spanish) indicated that a 39-year-old woman in Haina who appeared to have chikungunya virus infection died. No further evidence is provided establishing chikungunya virus infection as the cause of death. The 6 suspected chikungunya virus infections in Haiti in the Ouest department were also reported in DirecteInfo ( in French). However, the 6 May 2014 edition of Haiti Press Network ( in French) indicates that there are 67 suspected cases of chikungunya virus infection and 14 confirmed cases in Haiti. The confirmed cases are from Leogane, Carrefour, Delmas, Peion ville, Tabarre, Croix des bouquets, Coteaux, and Coteaux (sud). It is of concern that several localities are involved. One hopes that this does not signal the beginning of a significant outbreak in Haiti. ProMED thanks Roland Hubner () for sending these additional reports and thanks David Hawman () for sending a report of the 1st cases of chikungunya virus infection in Haiti. Maps of the Dominican Republic can be accessed at and and of Haiti at and . - Mod. TY] ****** [5] Caribbean: virus origin Date: August 2014 Source: Emerging Infectious Diseases journal [summ., edited] [Ref: Lanciotti RS, Valadere AM: Transcontinental movement of Asian genotype chikungunya virus [letter]. Emerg Infect Dis. 2014 Aug; 20(8)] ---------------------------------------------------------------------- Epidemics [of chikungunya] have been described in Africa, the Middle East, Europe, India, and Southeast Asia. On the basis of detailed clinical descriptions of the disease, chikungunya fever, it appears that chikungunya virus [CHIKV] caused epidemics in the Caribbean (St Thomas, US Virgin Islands) and the southeastern coastal United States during the early 19th century. In agreement with findings in a recent report characterizing the 2013 CHIKV detected on St Martin Island, the phylogenetic tree generated from our sequence data showed that the 2014 CHIKV from British Virgin Islands [BVI] is within the Asian genotype and is closely related to strains recently isolated in China and the Philippines. This finding supports the idea that a single CHIKV strain of the Asian genotype was recently introduced into the Caribbean and is currently moving throughout the region. The 2 CHIKVs isolated in Yap [State, Federated States of Micronesia] in 2013 are most closely related to the CHIKV from BVI, differing by only 18-19 nt. -- Communicated by: Roland Hubner Superior Health Council Brussels Belgium [The complete text of the letter is available at the source URL above. It is of interest to note that this report suggests that chikungunya virus apparently was present in the Americas in the 19th Century. The Asian origin of the current Caribbean outbreak is of interest, and one wonders if it was a single introduction by one viremic traveler or if multiple introductions from Asia occurred. - Mod.TY]
Posted on: Fri, 09 May 2014 06:52:12 +0000
Trending Topics
Recently Viewed Topics
© 2015