Lessons learned from the Chikungunya outbreak in the Caribbean.

Abstract

Despite extensive public health measures in response to the Chikungunya outbreak in the Americas, the number of cases of this disease is rising steadily as more and more countries confirm the presence of this non-fatal but excruciatingly painful and debilitating vector borne disease. The virus has recently spread to almost all countries in the Caribbean, including Haiti, Jamaica, Cuba and the Dominican Republic where the number of suspected and confirmed cases have spiraled out of proportion. The current update on the number of cases in the region are available from the Pan American Health Organization (PAHO).1The Caribbean Public Health Agency (CARPHA)2 report indicates that 181 deaths have been reported in the Caribbean. Some doctors suspect that the number of cases is far higher and is likely to be in the millions. This sharp increase in the number of suspected and confirmed cases has caused public health officials and donor agencies to respond quickly by intensifying vector control measures, increasing public awareness campaigns and distributing medical supplies.In smaller countries like St. Vincent and the Grenadines, the number of confirmed cases as of January 2015 was 1,223, according to a report published by the Ministry of Health, Wellness and the Environment.3 In St. Lucia, health authorities reported that the mosquito-borne disease has now spiralled out of control, affecting persons in all 17 constituencies on that Caribbean island. Guadeloupe and Martinique, both French overseas territories, continue to see an increased number of cases. The United States of America is also reporting cases. As of May 2015, a total of 146 Chikungunya cases have been reported for 2015 to ArboNET (the national surveillance system managed by CDC) from US states and territories.4The big question is despite prior notice that the virus posed an imminent threat to the Caribbean region and despite intensified vector control measures and health promotion activities, why are we seeing such an alarming increase in the number of cases in the Caribbean?The answer may vary according to individual countries. However, there does appear to be some common factors for this increase. These issues must therefore be addressed if we are to see a decrease in the number of cases and also to contain the spread of this virus and other mosquito-borne diseases. No matter what magnitude of vector control measures and health promotion activities that are carried out, if these issues are not addressed, then the number of Chikungunya cases will continue to spiral out of control.The following must therefore be addressed:1. The misconceptions concerning the Chikungunya virus.Despite great public health education, people are still of the view that the virus can be transmitted via close contact or by respiratory droplets and so on. There are many theories surrounding the transmission and spread of the virus in different countries and as such people are not taking the proper protective measures against this disease. Chikungunya is a vector borne disease that is spread by the Aedes aegypti and the Aedes albopictus mosquito. It is only transmitted via an infected mosquito and so transmission by touching, coughing, sexual contact and so on is not possible. It is very important for people to know how the virus is spread so that they can take appropriate measures in protecting themselves.52. People need to seek medical attention when they experience signs and symptoms indicative of the disease. …