V.I. sees first confirmed case of chikungunya

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ST. CROIX - The V.I. Health Department has confirmed the first "imported" case of chikungunya in the territory, and Health Commissioner Darice Plaskett said she believes it is only a matter of time before someone contracts the mosquito-borne virus locally.

"This is a resident of St. Thomas who took a cruise and who, upon return home, visited a physician, was tested and confirmed to be positive for chikungunya," Plaskett said. "It's not a local transmission. She became infected while visiting another Caribbean island. However, the test was confirmed by the Department of Health."

Because of the time frame between the cruise and the appearance of symptoms, and because of the incubation period of the disease, the Health Department believes the woman did not contract the disease locally.

The woman is doing "OK" and did not require hospitalization, Plaskett said.

Although there have so far been no reports of locally acquired cases of chikungunya in the territory, Plaskett said she believes it likely is imminent because of the rapid spread of the virus across the Caribbean. She urged residents and visitors to take steps to prevent mosquito bites.

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 may include headache, muscle pain, joint swelling or 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.

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.

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

It has spread swiftly from there.

The first locally acquired cases in the British Virgin Islands were confirmed in mid-January.

The Pan-American Health Organization's most recent figures, released May 9, show that there have been 4,175 confirmed cases of chikungunya in 16 countries or territories in the Caribbean and more than 45,000 suspected cases. Those cases stretch from St. Vincent and the Grenadines to the Dominican Republic and Haiti. There have been seven deaths attributed to the virus.

Plaskett said the woman with the confirmed case on St. Thomas had visited several islands during her cruise.

"We did an interview to get a good estimation of that incubation period, and we're comfortable with the information provided that she wasn't bitten by a mosquito while in the territory and while infectious," Plaskett said. Mosquitoes can become vectors for the disease after biting a person who is infectious.

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, so the steps to avoid being bitten are the same.

Symptoms of chikungunya usually begin three to seven days after being bitten by an infected mosquito.

The CDC has issued a Level 1 watch for the Caribbean countries, which means travelers are urged to practice usual precautions to protect themselves against mosquito bites.

The V.I. Health Department on Wednesday issued a public health advisory because of the so-called "imported" case of chikungunya. Any chikungunya cases will be confirmed through labwork with the CDC at this point, Plaskett said.

"It's important for residents, if they suspect they may have symptoms of chikungunya, to see the doctor," Plaskett said. "We want to confirm whether or not there's been an introduction of the virus in the territory."

The chikugunya virus was first isolated in Africa in the 1950s.

Although symptoms of chikungunya are similar to those of dengue fever, the joint pain 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.

Treatment for chikungunya is based on relieving symptoms.

The V.I. Health Department's public health advisory quoted Dr. Marc Jerome, the Health Department's Territorial Medical Director, saying that people most at risk for severe disease include newborns infected around the time of birth, the elderly and people with medical conditions, such as high blood pressure, diabetes or heart disease.

The advisory said 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, which have been distributed to health care providers, can also be found by visiting www.healthvi.org and downloaded under Forms and Applications.

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

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