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Chikungunya's rapid spread challenging Caribbean nations

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Dominica's health minister Julius Timothy has told his nation, in a Dominica News report on April 28, "Presently the ministry of health is being overwhelmed by the presence of of the Chikungunya virus." The tiny Caribbean island has seen over 800 reported cases of the mosquito borne illness since it was first detected in mid-January. Dominica is just one of several locales where the disease has exploded in numbers.

The April 25 report from the Pan American Health Organization (PAHO) on chikungunya cases in the Americas shows 4,116 confirmed and 31,431 suspected cases. On the French island of Martinique, five percent of the population has had either confirmed or suspected chikungunya since the illness was first reported in Dec. 2013. The small island nation of Saint Vincent & Grenadines is the latest to announce locally acquired infections, with 3 confirmed cases and 24 suspect.

The Dominican Republic announced its first confirmed cases of chikungunya the week ending April 18. As of the PAHO report on April 25, it is reporting 17 confirmed and 3,015 suspected cases. Dominican Today, in a news report dated April 28, quotes the Public Health Ministry as announcing 3,690 suspected chikungunya cases throughout the country.

The chikungunya outbreak on the French island of Reunion, off the coast of East Africa, in 2005-2006 suggests the potential growth in the numbers of chikungunya patients. The Institut Pasteur reports that in the 13 month epidemic there were 270,000 cases of chikungunya in an island population of 750,000. More than one third of the island's population was sickened.

Haiti shares the island of Hispaniola with the Dominican Republic. There have been no reports of chikungunya from Haiti. Puerto Rico lies between the Dominican Republic and the islands of the eastern Caribbean where the illness continues to spread. It, too, has not reported any chikungunya cases thus far.

Chikungunya is new to the Americas and there is little or new immunity to the illness among the population. The number of illnesses and the rapid growth in numbers will present difficulties to the public health authorities in most of these impoverished nations.



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