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2013–2014 chikungunya outbreak

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2013–2014 Chikungunya Outbreak
DateDecember 2013(2013-12)
Location
Caribbean

North America
Mexico
United States(Florida)

Central America
Belize
Costa Rica
El Salvador
Guatemala
Honduras
Nicaragua
Panama

South America
Brazil
Colombia
Ecuador
Paraguay
Venezuela
Deaths183
Reference:PAHO(February 6, 2015)[1]

The2013–2014 chikungunya outbreakrepresented the first recordedoutbreak of the diseaseoutside of tropical Africa and Asia. In December 2013, the first locally transmitted case ofchikungunyain the Americas was detected inSaint Martin.Shortly after the first case the disease began to spread rapidly throughout the Caribbean region. By the end of the year, it had spread toMartiniqueandGuadeloupe,with suspected cases inSaint Barthélemy.By the end of January 2014, cases had been confirmed in Saint Barthélemy, as well as theBritish Virgin Islands,Dominica,andFrench Guiana.On the basis of 4,000 confirmed cases and over 30,000 suspected cases, theCaribbean Public Health Agency(CARPHA) declared a Caribbean-wide epidemic of the virus in early May. By the end of May, four cases of chikungunya had been confirmed in Florida. By July 2014 there were an estimated 355,000 cases in the Caribbean.[2]By August 2014, 25 Caribbean countries had confirmed at least one case.[3]The epidemic was over by 2015.

Background[edit]

Main article:Chikungunya

Chikungunya is anarboviruscommon to tropical regions of Africa and Asia. It is spread to humans byAedesmosquitoes (primarilyAedes aegypti) that breed in stagnant water.[4]The virus was first isolated in 1953, and likely first arose during the 1700s.[5][6]

Chikungunya is characterized by a sudden high fever and intense joint pain, between four and seven days after infection.[4][7]It can also cause headaches, muscle pain, fatigue, and rashes.[8]Most infected patients recover within 10 days, and deaths are rare. However, in some cases joint pain can linger for months or years. There is novaccineor treatment for chikungunya and preventing its spread is difficult.[4]Outbreaks are primarily dealt with through preventive measures, such as wearing long-sleeved clothing, andvectorpopulation control.[9]

First cases[edit]

In early December 2013, health officials confirmed two cases of locally transmitted chikungunya on the French half ofSaint Martin.It was announced to the public on December 17, by which time 10 cases had been confirmed and many more suspected cases were undergoing lab tests. Vice PresidentGuillaume Arnelldeclared that his country had an "obligation" to prevent the disease from spreading. "It started here so we have to contain it here", he said.[5]Swift action was taken, and aPan American Health Organizationrepresentative said she was satisfied by the response.[5]Even so, there were 66 confirmed cases by the end of the month, including at least one case on the Dutch half of the island, and more than 180 suspected cases. The virus had also spread toMartinique(3 cases) andGuadeloupe(1 case) by the end of the year. InSaint Barthélemy,there were 21 suspected cases.[9]

Previously, chikungunya had not been found in the Americas.[4]Although it had never previously been found, it was considered an emerging threat and preparations for its spread were underway by 2012. In July 2013, a Caribbean-wide virtual meeting was held to educate high-ranking medical personnel on how to detect the virus.[10]It is unclear how the virus first spread to the Americas' mosquito population.[5]

Spread of the chikungunya virus[edit]

By January 21, 2014, cases had been St. Barthelemy and theBritish Virgin Islands.DominicaandFrench Guianaboth had one reported case due to travel in the affected islands.[11]At the start of April, chikungunya was confirmed in theDominican Republic.[12]On 24 April,Saint Vincent and the Grenadinesannounced the island had three confirmed cases of chikungunya and an outbreak was officially declared. Two days later,Antigua and Barbudaannounced its first confirmed case, on the island of Antigua. Four other cases were suspected.[7]

At the end of April, there were more than 4,100 probable cases of chikungunya across fourteen different Caribbean countries.[13]In addition to thirteen island nations, the virus had been confirmed in French Guiana. Martinique, Guadeloupe, and St. Martin had the most reported cases.[4]

During the week of April 27, 2014, health officials from multiple agencies met in the Dominican Republic to discuss the outbreak.[4]On May 1, theCaribbean Public Health Agency(CARPHA) declared a Caribbean-wideepidemicof the virus.[10][13]The United States-basedCenters for Disease Control and Preventionsaid it was "working with state health departments to increase awareness about chikungunya and to facilitate diagnostic testing" in preparation for possible introduction intoSouth Florida.[4]

As of May 19, 2014, the Dominican Republic had over 32,000 reported cases of chikungunya, representing 68% of the total cases registered to date.[14]By the end of May, four cases had been confirmed in Florida.[15]Over 50,000 people were suspected to have contracted the virus in total.[16]

As of late September 2014, Health Minister Nancy Pérez ofVenezuelastated that only 400 Venezuelans were infected with chikungunya[17]while theCentral University of Venezuelastated that there could be between 65,000 and 117,000 Venezuelans infected.[18]The Venezuelan government has announced a three-stage plan to counter the outbreak, with Health Minister Pérez stating that the key function is to eliminate areas of mosquito breeding.[19]

By November 2014 most of the Caribbean Islands were affected and the Pan-American Health Organization reported about 800,000 suspected cases alone in the Caribbean.[20]

References[edit]

  1. ^"Número de casos informados de artritis epidémica chikungunya en las Américas - SE 5 (February 6, 2015)".Pan American Health Organization.RetrievedFebruary 11,2015.
  2. ^"Chikungunya outbreak exceeds 355,000 cases".Center for Infectious Disease Research and Policy(University of Minnesota). July 14, 2014.
  3. ^"Chikungunya in the Caribbean".Centre for Disease Control and Prevention.RetrievedOctober 8,2014.
  4. ^abcdefg"Recently Arrived Chikungunya Virus Gains Foothold In Caribbean".Huffington Post.AP. May 2, 2014.RetrievedMay 2,2014.
  5. ^abcd"Mosquito virus spreads to Caribbean".Caribbean Business.AP. December 17, 2014. Archived fromthe originalon December 21, 2013.RetrievedMay 3,2014.
  6. ^Cherian SS, Walimbe AM, Jadhav SM, et al. (January 2009). "Evolutionary rates and timescale comparison of Chikungunya viruses inferred from the whole genome/E1 gene with special reference to the 2005–07 outbreak in the Indian subcontinent".Infect. Genet. Evol.9(1): 16–23.doi:10.1016/j.meegid.2008.09.004.PMID18940268.
  7. ^ab"Antigua latest Caribbean island to be hit by chikungunya disease".Caribbean 360.April 26, 2014. Archived fromthe originalon October 24, 2017.RetrievedMay 3,2014.
  8. ^"Chikungunya spreading to other countries in the Caribbean".UPI. May 2, 2014.RetrievedMay 2,2014.
  9. ^abLisa Schnirring (December 30, 2013)."Caribbean chikungunya outbreak grows, poses threat to US".CIDRAP.RetrievedMay 2,2014.
  10. ^ab"Chikungunya now an epidemic in the Caribbean".Jamaica Observer.May 1, 2014. Archived fromthe originalon May 3, 2014.RetrievedMay 2,2014.
  11. ^"Mosquito-borne chikungunya virus infects people on 5 Caribbean islands".Canadian Broadcasting Corporation.January 21, 2014.RetrievedMay 2,2014.
  12. ^"Pruebas de laboratorio confirman virus de Chikungunya en Nigua".Diario Libr(in Spanish). April 4, 2014.RetrievedMay 3,2014.
  13. ^abMona Tatum; Kevin Watler (May 2, 2014)."Caribbean-wide Chikungunya epidemic declared".Cayman 27. Archived fromthe originalon May 3, 2014.RetrievedMay 2,2014.
  14. ^Mejía, Odalis (May 20, 2014)."Suben a 32,519 los casos chikungunya; 8,000 en semana".Hoy(in Spanish). Archived fromthe originalon May 25, 2014.RetrievedMay 24,2014.El Ministerio de Salud Pública informó que ascienden a 32,519 los casos de fiebre por chikungunya notificados en todo el país, de los cuales 8,059 se han producido en una sola semana. De estos últimos el 68% se detectó en San Cristóbal.
  15. ^"Fourth Case Of Mosquito Borne Chikungunya Fever Confirmed In Florida".CBS Miami.Miami.May 22, 2014.RetrievedNovember 24,2014.
  16. ^"Salud revela que hay 32,519 casos de chikungunya"(in Spanish). Santiago de los Caballeros: Clínica Unión Médica. May 26, 2014. Archived fromthe originalon May 31, 2014.RetrievedMay 29,2014.Con 32,519 casos, República Dominicana acumula el 68% del registro de chikungunya en 16 países del Caribe, región donde se han contabilizado 51,139 casos y 14 muertes.
  17. ^"Venezuela's Maduro denounces" psychological war "waged by opposition".El Pais. September 19, 2014.RetrievedSeptember 24,2014.
  18. ^Wade, Lizzie (September 23, 2014)."In Venezuela, doctor flees after being accused of terrorism amid fever outbreak".Science.RetrievedSeptember 28,2014.
  19. ^"Venezuelan gov't launches plan against dengue, chikungunya".El Universal. September 29, 2014.RetrievedOctober 3,2014.
  20. ^"Number of Reported Cases of Chikungunya Fever in the Americas, by Country or Territory 2013/2014 (to week noted)"(PDF (348 KB)).paho.org.Pan American Health Organization.November 14, 2014.RetrievedNovember 24,2014.
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