Caribbean fever

Three Florida women report acquiring chikungunya fever in Caribbean

School children in Roseau, Dominica receive materials about how to prevent the mosquito-borne chikungunya virus, which is caused by the same mosquito that spreads dengue. The awareness activities in April were sponsored by the Dominica’s environmental heath department.
School children in Roseau, Dominica receive materials about how to prevent the mosquito-borne chikungunya virus, which is caused by the same mosquito that spreads dengue. The awareness activities in April were sponsored by the Dominica’s environmental heath department.
Zilma Charles / Dominica Environmental Health Department

The Florida Department of Health is calling on residents and visitors to vigilantly protect themselves against mosquito bites after receiving reports that three women who recently returned from the Caribbean had acquired a viral mosquito-borne disease that’s quickly spreading through that region.

Health Department Spokesman McKinley Lewis said he didn’t know which specific countries the women from Miami-Dade, Broward and Hillsborough counties had visited, only that they reported having chikungunya (ChikV) fever.

Since the disease, commonly found in Africa and Asia, was first detected in the Caribbean in December, it has quickly spread to 15 Caribbean countries and French Guiana in South America. Haiti recently became the 16th nation to confirm cases.

“Chikungunya is a reportable condition in Florida, however, if someone has it and never seeks medical attention, there’s no way we would know,” Lewis said. “People should take every possible measure they can to avoid mosquitoes...once you have the virus, you can infect mosquitoes that don’t have it, which can go along and infect other people.”

Chikungunya fever is transmitted by the same Aedes aegypti mosquito that transmits dengue. But while dengue is much more fatal, chikungunya is easier to acquire, said Dr. Pilar Ramon-Pardo, a clinical management specialist with the the Pan-American Health Organization.

With 4,853 confirmed cases of more than 50,000 suspected cases, and seven deaths, PAHO and the Caribbean Public Health Agency consider the disease “an epidemic.”

“We’re seeing a high number of cases in a very few weeks,” Ramon-Pardo said.

One place where this is true is Haiti, where anecdotal evidence shows it is quickly spreading during the ongoing rainy season and some wonder if the figures are higher than the 1,529 cases a Health Ministry spokesman reported this week.

“I know more than 50 people who have it between my family, friends and work,” said Carolina Sada, a businesswoman and board member of a Prodev Foundation, which runs several schools in the capital. “I am confident that all of the schools in the country and people living in the most vulnerable places, such as Cité Soleil, haven’t been reporting. For me, the real numbers are far higher than 1,500.”

On its Web site, Haiti’s Health Ministry says that the virus is located throughout the country, and Haitians should eliminate puddles and other standing water that help breed mosquitoes. It also says that “in general, symptoms disappear within one to three weeks.”

Experts say while that may be true in some cases, the virus does have chronic, long-term implications, which PAHO has warned regional health officials to be on the lookout for.

“Longer term, some increase in the levels of joint pains and arthritis-like illness in the population can be expected, given the patterns in Africa and Asia, and given what the French islands are reporting,” said Dr. James Hospedales, the executive director of the Caribbean Public Health Agency (CARPHA). “This may be the real ‘legacy’ of ChikV that we will see in time.”

And in post-earthquake Haiti, where 300,000 people suffered injuries during that country’s devastating Jan. 12, 2010 earthquake, people could be at higher risk, Hospedales said.

“From the literature, the persistent arthritis-joint pain following ChikV infection seems more frequent in the presence of pre-existing joint damage, fractures,” he said.

Hospedales said CARPHA plans to set up a study of the first few thousand Caribbean patients in hopes of getting a better understanding of the virus and its effects.

Concerned about the potential economic impact in the region, Hospedales said it’s important for regional hotels and tourism facilities to remain proactive — from making repellant available to taking measures to reduce pests and mosquito breeding sites.

Johnson JohnRose, a spokesman with the Caribbean Tourism Organization, said the group continues to assess the situation but is encouraging “visitors to continue with their travel plans to the Caribbean.”

“Local populations and visitors alike are assured that the Caribbean remains open for business and safe for travel,” he said.

Those who do travel, should coverup by wearing long sleeves, pants, socks and buying some sort of repellant that is going to keep mosquitoes away, the Florida health department said. Repellents with DEET, picaridin, oil of lemon eucalyptus, and IR3535 are effective.

Floridians also should drain water from garbage cans, house gutters, pool covers and any other containers.

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