The Centers for Disease Control and Prevention issued a word of warning Wednesday to anyone headed to the Caribbean this holiday season after the island of St. Martin reported a small outbreak of the mosquito-born chikungunya virus, which can leave those infected in severe and debilitating pain.
The CDC said that while outbreaks of chikungunya have been documented in parts of Africa, Europe, Asia and the Pacific, this marks the first time the disease has been reported among non-travelers in the Western Hemisphere. Consequently, the CDC issued a travel health notice Wednesday advising people planning a trip to St. Martin to take steps to protect themselves against mosquito bites. Those steps include wearing long sleeves and pants, purchasing insect repellent and using air conditioning and screens on windows and doors to keep mosquitoes out.
The World Health Organization has confirmed 10 cases of the virus on St. Martin to date, and all were on the French side, which is home to some 35,000 inhabitants on this divided island. The Dutch Sint Maarten has, thus far, remained unaffected, though testing to confirm other suspected cases is ongoing.
CDC noted that the affected St. Martin residents had not traveled abroad recently, suggesting that the chikungunya virus was present in island populations of mosquitoes and being spread locally. It warned that further spreading on St. Martin to other Caribbean islands and even mainland America was possible in the coming months.
“Microbes know no boundaries, and the appearance of chikungunya virus in the Western Hemisphere represents another threat to health security,” CDC Director Tom Frieden said in a statement. “CDC experts have predicted and prepared for its arrival for several years and there are surveillance systems in place to help us track it. To protect Americans, we have to support and maintain capacity to detect and respond to the emergence of new viruses."
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The same mosquitoes that spread the more common dengue virus also carry chikungunya. Known by the scientific names of Aedes aegypti and Aedes albopictus, these mosquitoes are found throughout the Caribbean, the tropics and parts of the southern United States.
Dengue virus can cause Dengue fever, a painful and debilitating infection that is more commonly referred to as the bone-cruncher or breakbone fever due to severe pain in the joints. Similar to Dengue, symptoms of chikungunya include fever, joint and muscle pain, headache and rash -- all of which last for about a week. CDC advised anyone returning from the Caribbean with such conditions to seek immediate medical assistance.
Chikungunya means “that which bends up” in the Makonde language of southeast Africa. The saying reflects how patients suffering from the virus are often stooped in pain. Despite the unnerving effects and the possibility of long-term joint pain, however, chikungunya is rarely fatal.
CDC said it has been working since 2006 with the Pan American Health Organization to prepare for the arrival of chikungunya in the Americas, and conducted a planning workshop for 22 Caribbean countries to increase awareness. It noted that there is no vaccine and no specific treatment for the infection, though anyone who endures chikungunya is thought to confer lifelong immunity.
More than 100 laboratory-confirmed cases of chikungunya were identified in the United States between 1995 and 2009, but none of the infected contracted the disease in the Western Hemisphere. All but three of the cases occurred between 2006 and 2009 with travelers to India and Indian Ocean Islands, where there were large outbreaks of the disease.
The CDC said it was particularly concerned about the possibility of an outbreak in the Caribbean because an estimated 9 million U.S. residents travel to these paradisiacal islands each year. An increase in mainland travelers returning to the U.S. with chikungunya could cause local transmission of the virus if a mosquito bites an infected person and then bites other people.