V.I. Health Department issues advisory about mosquito-borne virus

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After the nearby British Virgin Islands announced three confirmed cases of the mosquito-borne Chikungunya virus on Monday morning, the V.I. Health Department on Wednesday night issued a public advisory.

Chikungunya is a virus that is transmitted to people by the bite of an infected mosquito. According to the Centers for Disease Control and Prevention, it can cause an illness that is most often characterized by fever, joint pain, headache, fatigue, nausea, vomiting, muscle pain and rash.

The symptoms of Chikungunya can be similar to dengue fever, and the prevention measures are the same: Taking steps to avoid being bitten by mosquitoes, said Dr. Erin Staples, a medical epidemiologist with the CDC's Division of Vector-Borne Diseases.

Those steps include eliminating standing water in and around the home and using mosquito repellents.

The strain of Chikungunya that has been spreading through the Caribbean is being carried by the same species of mosquito, the Aedes, that typically carries dengue fever, according to Staples.

In its announcement Monday, the BVI Government said that the three confirmed Chikungunya cases - which were all on Jost Van Dyke - were among people who had not traveled recently.

"It is important to note that these confirmed cases were not exposed to travel, which alerts us that the virus is already in our mosquito population," Dr. Ronald Georges, Medical Officer of Health in the BVI Ministry of Health and Social Development, said in the prepared statement.

Staples said that so far, no confirmed cases of Chikungunya have been reported in the U.S. Virgin Islands or in Puerto Rico.

However, Chikungunya - which has occurred in Africa, Southern Europe, Southeast Asia and islands in the Indian and Pacific Oceans - has been spreading rapidly across the Caribbean.

"It's been unfolding for the last month and a half," Staples said.

The Pan American Health Organization confirmed the first cases of locally acquired Chikungunya in the Americas on Dec. 6 in St. Martin.

By Dec. 20, Chikungunya had been confirmed in Martinique, followed by Guadeloupe and St. Bart's, Staples said.

As of Friday, there had been 286 confirmed cases of Chikungunya in the Caribbean, with more than 200 of those in the French part of St. Martin, according to information from the Pan American Health Organization.

That figure does not include the three cases in the BVI, although Donna Eberwine Villagran, a Pan American Health Organization spokeswoman, said the BVI Government has since reported the confirmed cases on Jost to the organization.

The symptoms of Chikungunya are similar to dengue, with some variation, and usually begin three to seven days after being bitten by an infected mosquito, according to the CDC. The Chikugunya virus was first isolated in Africa in the 1950s.

The most common symptoms, the CDC says, are fever and severe joint pains, often in the hands and feet.

"It causes more pronounced or severe joint pain, which tends to affect multiple joints, typically in the arms, leg and feet," Staples said of Chikungunya compared to dengue.

Most Chikungunya patients feel better within a week or so, according to the CDC.

However, some people with Chikungunya may develop prolonged joint pain that can last for months, according to the CDC. Such prolonged joint pain is not typical for dengue.

Fatalities from Chikungunya virus are rare, and no hemorrhagic cases related to Chikungunya have been documented, according to the CDC.

Treatment for Chikungunya is based on relieving symptoms.

Staples said that the CDC has been discussing the Chikungunya situation since December with public health officials in the territory and in Puerto Rico.

Dr. Hillary Woodson, a physician at Red Hook Family Practice on St. Thomas, said she is not any more concerned over Chikungunya than other mosquito-borne diseases, like dengue. The advice she gives her patients to avoid being bitten by mosquitoes is the same, she said.

"I do tell my pregnant patients - part of my counseling for them - is to get a mosquito net for the crib," she said.

According to the CDC, people at increased risk for severe Chikungunya disease if they become infected include newborns exposed during delivery, the elderly, and people with medical conditions, such as high blood pressure, diabetes and heart disease.

The V.I. Health Department has notified doctors in the territory about the possibility that Chikungunya could be on the way and urged them to be vigilant for it, according to the Health Department's advisory.

That advisory asked that residents alert Health to standing pools of water near their homes that cannot be emptied by residents that may benefit from larvaciding. People can contact Health's Environmental Health Division by calling 773-1311, ext. 3109 on St. Croix, or 715-5111 in the St. Thomas-St. John District.

Chikungunya is reportable by law and physicians must report all suspected cases to the Health Department using the V.I. Notifiable Disease Form by fax at 713-1508, the advisory said.

Residents should spray insecticide in dark areas, such as closets, to kill the Aedes Aegypti mosquito, which carries chikungunya.

Other tips include:

- Keep tires in a dry place, and punch holes in them to make sure water drains out.

- Put plants that currently are in water into soil.

- Empty flowerpot bases weekly.

- Cover or turn upside down food containers for animals and buckets that hold water.

- Repair or replace damaged screens; keep windows and doors without screens closed; and place a screen or mesh over the overflow pipe of cisterns.

- Cover infant cribs with mosquito netting.

- Use mosquito repellents containing DEET. Follow instructions carefully and use on arms, legs, ankles and nape of neck. Avoid applying to children younger than 2 years old or to the hands of older children.

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