V.I. sees 1st locally acquired case of chikungunya


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Officials have confirmed the first locally acquired case of chikungunya - a mosquito-borne virus that has swept rapidly through the Caribbean - in the territory.

The case is on St. Thomas, where a second imported case of chikungunya also has been confirmed, bringing the total number of cases to three, according to public health alert the V.I. Health Department released Wednesday.

The confirmation of a locally acquired case of chikungunya is significant because it means that the virus is present in the local mosquito population, said V.I. Health Commissioner Darice Plaskett.

"Our local mosquito population is now infected, so it means now we have this disease in the territory," Plaskett said. "It's important. Since our local people don't have any immunity to this disease, there's a potential for an outbreak."

People should take precautions to avoid being bitten by mosquitoes, she said. She also urged people who think they may have chikungunya to see a doctor and get tested,

Chikungunya is a virus - transmitted to people by the bite of an infected mosquito - that can cause an illness characterized by fever and joint pain, the most common symptoms, according to the U.S. Centers for Disease Control and Prevention. Other symptoms can include headache, muscle pain, joint swelling and a rash.

Chikungunya symptoms are similar to those of dengue fever and prevention measures - to avoid mosquito bites - are the same. There is no vaccine for chikungunya.

Plaskett said that with chikungunya, death is rare and the symptoms usually are "not as severe as dengue."

On May 14, the V.I. Health Department announced that it had confirmed the territory's first "imported" case of chikungunya in a St. Thomas resident who acquired the virus while on a Caribbean cruise. At that point, Plaskett said she felt it was only a matter of time before a locally acquired case was confirmed in the territory because of the virus' rapid spread through the region.

On Wednesday, the Health Department issued the public health alert noting the locally acquired chikungunya case and another imported case, both of which were confirmed Tuesday.

Plaskett said Wednesday that the two newer cases were in adults who became sick in the last couple of weeks.

"They're recovering well," Plaskett said. None of the cases has required hospitalization.

Although all three confirmed cases so far have been in the St. Thomas-St. John District, Plaskett said mitigation efforts will be territorywide.

The Health Department has been working with the CDC, she said.

Plaskett said that "as early as next week," the CDC will be sending representatives, including epidemiologists and entomologists, "to help strengthen our surveillance, investigation and diagnostic capacity. We want to ensure that anyone who suspects that they're ill with chikungunya, as well as dengue, that they get tested so we can have a better understanding for the prevalence of the disease in the territory."

Plaskett said the team from CDC also will provide education for local health care providers about testing and clinical management of chikungunya.

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

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

The organization's most recent figures, from May 23, showed 4,356 confirmed cases of chikungunya in the Caribbean region and more than 61,864 suspected cases. Those cases stretch from St. Vincent and the Grenadines to the Dominican Republic and Haiti. There have been 13 deaths.

The strain of chikungunya that has been spreading through the Caribbean is being carried by the same species of mosquito, the Aedes. Symptoms of chikungunya usually begin 3-7 days after being bitten by an infected mosquito.

Although symptoms of chikungunya are similar to those of dengue fever, the joint pain - often in the hands and feet - can be more pronounced with chikungunya than with 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.

The advisory from the Health Department asked health care providers to watch for possible chikungunya cases, and said that health care providers are required by law to report confirmed or suspected chikungunya cases to the Health Department using the V.I. Notifiable Disease Form. Forms are to be submitted via fax at 713-1508.

Copies of the form can be found by visiting www.healthvi.org and downloading them under "Forms and Applications."

- Contact Joy Blackburn at 714-9145 or email jblackburn@dailynews.vi.

The most common symptoms of chikungunya are fever and joint pain.

Other symptoms can include:

- Headache

- Muscle pain

- Joint swelling

- Rash

- Fatigue

- Nausea

- Sources: Centers for Disease Control and Prevention, Pan-American Health Organization

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