Caribbean health agency on the offensive against chikungunya disease

The Trinidad-based Caribbean Public Health Agency (CARPHA) says it is working closely with the French and Dutch authorities after the region recorded its first ever case of chikungunya.

Late last month, CARPHA said it had received notification of 10 confirmed cases of locally acquired chikungunya virus infection on the French side of the Caribbean island of Saint Martin.

CARPHA executive director Dr. James Hospedales told the Caribbean Media Corporation (CMC) Wednesday that three cases have now been detected in the British Virgin Islands.

“We have prepared ourselves by building the capacity of our staff to do the testing and our staff has been visiting and advising the countries including St. Martin even before this was on the horizon about the mosquito control programmes in the countries.

“We are working closely with the French and Dutch authorities to have a coordinated approach to dealing with the problem by sharing numbers, sharing strategies to mosquito control and so on.”

“My advice would be to stay inform and stay alert to the news and any updated information, secondly we would strongly advised that you go to our web and download the chart which is a checklist of all the breeding places in the yard where mosquitoes can breed.”

Chikungunya is a viral disease, carried mainly by the Aedes aegypti mosquito and causes a dengue-like sickness.

Symptoms include a sudden high fever, severe pain in the wrists, ankles or knuckles, muscle pain, headache, nausea, and rash. Joint pain and stiffness are more common with chikungunya than with dengue.

The symptoms appear between four to seven days after the bite of an infected mosquito. The majority of clinical signs and symptoms last three to 10 days, but joint pain may persist longer. Severe cases requiring hospitalisation are rare.

“”The Caribbean is at risk, exactly what will happen in the weeks and months ahead we don’t know because it has not been here before but we are at risk,” Dr. Hospedales told CMC.

He said a few reasons, this is a new virus to the region and therefore the vast majority of people are susceptible.

“They have no resistance to it so that increase the chance of spread. Secondly, the mosquito that transmits the Chikungunya virus, the Aedes mosquito, is the same one that transmits dengue fever and it is common in most of our countries.”

“In fact the Chikungunya is a wakeup call I think that we need to get more serious about mosquito control so that’s another reason why there is risk for spread in the region and the amount of travel in between islands. So for those reasons yes we are at risk for a lot of spread but exactly what will happen we don’t know because it has not been here before”.

Dr. Hospedales said that the regional health agency is concerned about any new virus or infection that emerges in the region.

“We are concerned based on the pattern if behaviour of this disease in Asia and Africa were everybody was susceptible you could have a lot of spread in a short time, with a lot of people being ill temporarily and that not good”.

The European Centre for Disease Prevention and Control (ECDC) has warned of further increased cases of the disease, noting that as of Thursday last week, there were 201 “probable or confirmed cases” in French St Martin and two confirmed cases on the Dutch side of the island.

ECDC also said there were 48 “probable or confirmed cases” in Martinique; 25 “probable or confirmed cases” in St Barthélemy; 10 “probable or confirmed cases, including one imported case from St Martin in Guadeloupe”; and one “confirmed case imported from Martinique in French Guiana.

Dr. Hospedales said that since last year CARPHA has conducted seminars with all the countries, the laboratories and the chief medical officers and epidemiologist to prepare for disease “and to set up…the testing sequence that we will follow if we suspect Chikugunya and capacity is also there in terms of the ability to deal with the vector population and that varies by country.

“Some countries put a lot of attention to it and have a fair amount of control but with the solid waste situation we have in the Caribbean, with rainy season people storing water in drums that are not properly covered and so on”

He told CMC that the situation was the same with the dengue epidemic “ where you have a lot of potential for the breeding of mosquitoes that spreads the dengue and spreads this new virus chikungunya”

But he insisted that the Caribbean has “good capacity to detect, to diagnose and to respond..

“The systems that have been there that are part of the Caribbean surveillance systems and public health system is to detect, to respond, to educate the population, to control the vector. I think we are concern is if there is widespread and very rapid transmission then you could have a very temporary hiccup is how your whole country is run if a large percentage of people is get ill in a short time”.

Dr. Hosepdales is urging residents in the Caribbean to clean their environment in order to minimize the outbreak of the disease.

“If you live in the Caribbean you know about this and we need to get much more serious about the control of our environment. That’s my advice for households and families in the Caribbean. If a person does develop a fever, headache and joint pain which could be dengue or could be chikungunya then go to your health provider”.