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Chikungunya Spreads Through the Caribbean

Summary and Comment |
June 11, 2014

Chikungunya Spreads Through the Caribbean

  1. Stephen G. Baum, MD

Local transmission of chikungunya virus has now been identified in 17 countries or territories in the Caribbean and South America.

  1. Stephen G. Baum, MD

Chikungunya virus — an alphavirus — and the illness it causes have long been recognized in countries in Africa, Asia, Europe, and the Indian and Pacific oceans. Before December 2013, when locally spread infection was reported from Saint Martin, cases in the Western Hemisphere all involved travelers returning from endemic regions. Since that time, local transmission is known to have occurred in 17 countries or territories in the Caribbean and South America. As of May 30, 2014, 103,018 suspected and 4406 laboratory-confirmed cases have been reported from that area — more than 95% of them in the Dominican Republic, Martinique, Guadeloupe, Haiti, and Saint Martin.

Infection is spread mainly by Aedes aegypti and Aedes albopictus mosquitoes, both of which transmit dengue virus as well. These vectors are prevalent in the Caribbean but also exist in the continental U.S. (NEJM JW Infect Dis Apr 10 2014). Humans are the primary amplifying host. Most infected individuals develop symptomatic disease typified by acute onset of fever and symmetrical polyarthralgia; joint pain may be debilitating and long-lasting. There is neither a vaccine nor a specific therapy.

Comment

Cases have increased this year among travelers returning from affected areas. Local transmission in the continental U.S. is likely to occur, given the frequency of travel to the Caribbean and the presence of the appropriate vector here. Currently, chikungunya is not a nationally notifiable disease, but cases can and should be reported to ArboNET, a passive surveillance system for arboviral diseases.

Editor Disclosures at Time of Publication

  • Disclosures for Stephen G. Baum, MD at time of publication Editorial boards Medical Letter

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