Are authorities underestimating chikungunya epidemic?

Five months or so ago the head of the Caribbean Public Health Authority, Dr. James Hospedales, indicated that throughout the region chikungunya had reached epidemic proportions—a situation that local authorities have yet to acknowledge.
Chikungunya is a viral disease transmitted to humans by infected mosquitoes. It causes fever and severe joint pain, headache, nausea, fatigue and rash. The disease is said to share some clinical signs with dengue and so far there is no known cure. In about 20 percent of patients, the pain can last a year or more.

Chief Medical Officer Dr. Merlene Fredericks speaks out on chikungunya.

Chief Medical Officer Dr. Merlene Fredericks speaks out on chikungunya.

Before 2013 (when the first case of chikungunya was reported in the Caribbean), hardly anyone in Saint Lucia had heard of it, even though we are now being told it has been around for decades. Despite the myths, conspiracy theories and the unanswered questions, its presence is having a debilitating effect on our already ailing economy and productivity. The matter has so far not been mentioned in the House.

A number of local businesses have been reporting a high volume of related absenteeism. The dreaded illness can last anywhere from one to four weeks on average. School attendance is also being affected and at least one hotelier has said confirmed chikungunya is severely affecting local hotel operations. Could tourism be the reason the authorities have not acknowledged the seriousness of the situation and why they have not gone out of their way to clear up the island-wide garbage that’s home to the dreaded mosquito?

Visitors to the Caribbean are normally advised to pack sunscreen and insect repellent along with their swimsuits. But in recent months, passengers at North American airports were being warned that travel to the Caribbean could hand them an unwanted souvenir.

The island’s Chief Medical Officer, Dr. Merlene Fredericks, insists there is no deliberate effort to temper chikungunya warnings. “Since CARPHA had already declared it an epidemic we saw no need as an individual country to do so as well,” she told the STAR this week. “What we have been doing is putting out regular updates and giving people relevant information so that they can take the necessary precautions. The last thing that we want to do is sensationalize the issue.”

The CMO also confirmed that recently there was a notable spike in the number of reported chikungunya cases here. She said the increase has been recorded mostly in the south of the island, with Vieux Fort, Micoud and Soufriere most affected. “There has also been a slight increase in the number of children being taken to hospital or other medical centers, especially babies, for suspected chikungunya.”

As for the spreading belief that chikungunya is not related to the aedes aegypti mosquito, Fredericks said: “This may cause persons to drop their guard by not paying attention to the environment in and around their homes.”

There are several conspiracy theories on the Internet that the virus was biologically engineered. Some have even suggested that it may be airborne as well.

Chikungunya is not fatal but can be deadly when combined with other serious medical conditions. It is also possible to be infected at the same time with the viruses that cause dengue fever and chikungunya. According to a Pan American Health Organization report, the number of deaths linked to the chikungunya virus in the Caribbean is estimated at 113. However, PAHO reports that it was not yet clear if they were directly attributable to the virus.

Some Caribbean islands are taking legal steps to protect citizens. In Grenada, authorities are considering the re-introduction of the Mosquito Destruction Act of 1952 to deal with the breeding of mosquitoes. The legislation seeks to encourage people to apply proper environmental hygiene practices in an effort to reduce the mosquito population.

As of September 19, 2014, chikungunya transmission had been identified in 34 countries or territories in the Caribbean, Central America, South America, or North America. According to PAHO, a total of 729,178 suspected and 10,845 laboratory-confirmed chikungunya cases had been reported from these areas. As if this was not bad enough, recently the World Health Organization stated that there was evidence some animals including rats may be reservoirs for chikungunya.

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