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Chikungunya poised to cripple Haiti

Less than a week ago, the Haitian government received test results that showed that chikungunya had appeared in that impoverished nation. The latest data from Haiti, released by the Pan American Health Organization (PAHO) on May 9 shows those 14 confirmed cases and no more. Anecdotal evidence suggests that the illness may be affecting hundreds of Haitians at this time.

Warning for travlers returning from the Caribbean about the signs and symptoms of chikungunya and dengue.
CDC / public domain

John Carroll is a physician from Peoria, IL, working with the charity Haitian Hearts in the capital city Port-au-Prince. In a blog post dated May 10, he described the illness of a local employee that seems to have been chikungunya. On May 9 he visited a local orphanage where he found 25 children and five adults with symptoms suggesting a chikungunya infection.

Dr. Jen Halverson left a comment on one of Dr. Carroll's posts describing what she saw on May 9. At a maternity program in Port-au-Prince, seven pregnant women came in for high fevers and leg pain. Malaria tests were negative. She suspects chikungunya.

The PAHO reported 4,175 confirmed cases of chikungunya region-wide. An additional 45,413 cases are suspected. The illness has been found in 16 different countries and territories.

Chikungunya has made it to the mainland in just one location, French Guyana on the northeastern coast of South America. They are reporting 81 confirmed cases as of May 9. There are no reports of confirmed cases in Central or North America.

The Centers for Disease Control offers a comprehensive description of chikungunya and its symptoms. The illness is spread from patient to patient through the bite of an infected mosquito. Most people will have symptoms, and those symptoms will appear about three to five days after the mosquito bite.

Chikungunya symptoms can vary but the most likely are fever and debilitating joint pain. The illness may also present with headache, muscle pain, a rash and swelling of painful joints.

There is no cure and no vaccine. Treatment can be generally done at home, with over-the-counter pain relievers and rest. The CDC believes that patients will be immune to future infections of chikungunya.

The illness is rarely fatal. It may be more serious in newborns, the elderly and those with co-morbid conditions such as high blood pressure, heart disease or diabetes. In a significant number of patients the joint pain may persist for months or years.

A number of studies suggest that half of all patients may have constant pain or relapsing episodes of pain up to two years after their illness, and ten percent could have pain three to five years after. Few Haitians can afford to be sick and unable to work for several days. For the chikungunya patients who will suffer the debilitating joint pain long-term, the outlook is troubling.