Despite the fact that the Dominican Republic didn't experience its first autochthonous, or locally acquired chikungunya cases until early April 2014, four months after the initial cases were reported in the Western Hemisphere on the island of St. Martin in December, the number of cases on the eastern side of Hispaniola has exploded with cases accounting for nearly half of all cases reported in the Caribbean.
According to the Pan American Health Organization (PAHO) weekly chikungunya report for the Caribbean issued June 20, the Dominican Republic is now at 89,738 cases, up from 77,000 one week ago.
The PAHO reports that the total number of autochthonous chikungunya cases in the Caribbean now stands at 189,055 cases making the Dominican Republic a 47 percent contributor to the total in the region.
The fact that the spread of chikungunya is so rapid and widespread in the area comes as no surprise according to experts who have been watching the virus for years.
The authors of "Preparedness and Response for Chikungunya Virus Introduction in the Americas" published by the PAHO and the Centers for Disease Control and Prevention (CDC) in 2011 said, “The broad distribution of mosquitoes capable of spreading chikungunya virus, coupled with the fact that people in the Americas have not been exposed to chikungunya virus, places this region at risk for the introduction and spread of the virus.”
The Dominican Republic's neighbor to the west, Haiti, is also struggling with an epidemic of the mosquito borne virus. Although the PAHO is only reporting a little over 12,000 cases, the Haiti Ministry of Public Health and Population (MSPP) reported today 39,343 cases as of epidemiological week 23.
In the United States to date, no locally acquired chikungunya cases have been reported; however, in Puerto Rico, the CDC reports 23 indigenous cases.
The World Health Organization (WHO) describes the symptoms of chikungunya as follows:
Chikungunya is characterized by an abrupt onset of fever frequently accompanied by joint pain. Other common signs and symptoms include muscle pain, headache, nausea, fatigue and rash. The joint pain is often very debilitating, but usually lasts for a few days or may be prolonged to weeks.
Although the disease is rarely fatal, the pain is very real. Minnesota pediatric emergency medicine doctor, Dr. Jen Halverson describes the disease from first hand experience after contracting it while on a volunteer trip to Haiti last month:
It was really difficult to move without severe pain. I've had a broken bone before; this was more severe than a broken bone. The Haitians are calling this the fever that breaks your bones, and for good reason