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Slow reporting clouds issue of chikungunya growth

Contra Costa County Mosquito and Vector Control District technician David Wexler releases Gambusia affinis, more commonly known as mosquito fish, into a neglected pool infested with mosquitos at a foreclosed home in Pleasant Hill, CA
Contra Costa County Mosquito and Vector Control District technician David Wexler releases Gambusia affinis, more commonly known as mosquito fish, into a neglected pool infested with mosquitos at a foreclosed home in Pleasant Hill, CAPhoto by Justin Sullivan/Getty Images

The latest data on the chikungunya outbreak in the Western Hemisphere was released by the Pan American Health Organization (PAHO) on Aug. 9. It reported information received through Aug. 1, week 32. The PAHO notes a total of 576,535 confirmed and suspected chikungunya illnesses since the disease was first diagnosed on French St. Martin in early Dec. 2013.

Reporting issues with a large number of nations and territories continue to be a problem. Dutch St. Martin, for example, is 20 weeks behind in reporting to the PAHO and has reported 123 confirmed cases of chikungunya. A report from the Dutch National Institute for Public Health through July 14, still not current, shows 372 confirmed illnesses.

The two nations on the island of Hispaniola reported 75 percent of all suspected and confirmed chikungunya cases this week. An additional 63,000 suspected cases were reported by the Dominican Republic, and since the mosquito borne illness reached that nation, an estimated three percent of the population has contracted the disease. The Dominican Republic is a week behind with reporting and Haiti is four weeks behind.

The various islands in the French Antilles are two weeks behind and there are no changes for the week. Guadeloupe has reported that 17.5 percent of its population has contracted chikungunya since the beginning of 2014. Martinique's toll is lower, at 14 percent of the population.

Canada appears in the PAHO's weekly report for the first time. It shows eight imported, or travel associated, chikungunya cases for the week.

Puerto Rico is four week behind in reporting to the PAHO but has reported more data to that agency than to the Centers for Disease Control. For week 28, the Commonwealth reported 17 imported chikungunya cases, 386 locally acquired cases and 1,596 suspected cases. For week 32, the CDC received reports from Puerto Rico of 16 imported and 201 locally acquired chikungunya illnesses.

The PAHO report shows that just five nations or territories of 43 were current with reporting. Of the 43, ten are reporting only travel associated chikungunya illnesses. The remainder have a mix of confirmed, suspected and imported cases.

The issues surrounding reporting of chikungunya cases are complex for many of the affected governments. They are, in general, poorly equipped to deal with a public health emergency much less devote scarce resources to paperwork and reporting. In addition, the news about chikungunya can directly affect travel and tourism as it has in Haiti, where some aid agencies have cancelled trips. Some local governments may be using slow reporting to downplay the risks in their area and prevent the loss of vital tourism revenues.