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U.S. chikungunya cases more than double in one week

The Centers for Disease Control (CDC) announced on June 17 that the number of chikungunya cases reported to them had risen to 57 imported cases and 23 locally acquired cases. The number of case reports more than doubled in one week. Puerto Rico has the only locally acquired chikungunya illnesses at this time.

Compiled list of states and cases of chikungunya as of June 17 2014.
Charles Simmins, based upon publicly available data

At this time, the 48 contiguous states have only seen imported cases of chikungunya. Along with the 56 cases reported by the CDC, at least a dozen other illnesses have been confirmed by state health departments and media reports. Illnesses have been reported from 16 states. Florida reports 42 imported chikungunya cases as of June 14. Haiti is the source of 31 of those illnesses.

Florida has eight chikungunya cases above the total reported by the CDC. Rhode Island has reported two, while Mississippi and Tennessee have reported one each. WSB in Atlanta is reporting that, as of June 17, Georgia is investigating two possible chikungunya cases in American aid workers recently returned from Haiti.

The one imported chikungunya case in Minnesota is that of Dr. Jan Halverson, a pediatric emergency medicine physician who works in Haiti. The story of her chikungunya infection appeared in the Star Tribune on June 16.

Dr. Jennifer Halverson went to bed one evening in April after celebrating her birthday with colleagues in Haiti and awoke in the middle of the night with crushing joint pain — a characteristic of the infection caused by chikungunya (roughly pronounced “chicken-gun-ya’’). The pain left her immobile and delayed her return to Minneapolis, where she is an emergency room physician for Children’s Hospitals and Clinics of Minnesota.

“I’ve broken a bone. I’ve had other medical issues,” she said Monday. “I don’t think I’ve ever been in so much pain.”

Physicians describe the joint and muscle pain associated with chikungunya as "debilitating". In many cases, the pain is so severe that the patient is unable to get out of bed. Studies have shown that significant numbers of patients will experience pain for weeks, months or even years after recovering from the illness. The joint pain may be constant or may come and go, known as relapsing pain.

Chikungunya can only be caught through the bite of an infected mosquito. The mosquito vector for Caribbean strain of the virus is Aedes aegypti, the Yellow Fever mosquito. The mosquito is native to tropical and sub-tropical climates and has a limited range in the continental United States. It may be found in urban and suburban areas from east Texas to the Atlantic shore and from the Gulf of Mexico north to about the Ohio River.

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