The French islands of the eastern Caribbean continue to be the center of the first outbreak of chikungunya in the Western Hemisphere. The latest case count, released by the European Centre for Disease Prevention and Control on Jan. 13, is 287 confirmed and probable cases. The French site of the island of St. Martin is reporting 201 chikungunya cases in an outbreak that was first detected there on Dec. 6, 2013.
The French island of Martinique has reported 48 cases, while Saint Barthélemy has 25, Guadeloupe has ten and French Guyana has seen one case that was imported from Martinique. French Guyana is reporting 11 suspected cases. The Dutch side of the island of St. Martin has reported two chikungunya cases. The illness has not yet been found elsewhere in the region.
The European Centre for Disease Prevention and Control has this to say:
Epidemiological data indicate that the outbreak that started in Saint Martin is expanding. An increase in the number of cases is expected from the affected areas and the outbreak is likely to continue to spread geographically...
The rapid increase in the number of chikungunya cases forced the Centers for Disease Control to update their travel watch for the Caribbean on Jan. 7. The CDC recommends preventing mosquito bites through the use of repellents as well as sleeping in screened-in rooms or those with air conditioning. There are currently no travel restrictions in place.
Chikungunya is caused by a virus and has no cure. It is carried from person to person by mosquitoes, primarily the Aedes aegypti (the yellow fever mosquito) and the Aedes albopictus (the Asian tiger mosquito). The CDC describes a chikungunya infection in these terms:
a debilitating illness, most often characterized by fever, headache, fatigue, nausea, vomiting, muscle pain, rash, and joint pain ... some patients have prolonged fatigue lasting several weeks. Additionally, some patients have reported incapacitating joint pain, or arthritis which may last for weeks or months.
The CDC states that chikungunya can be mistaken for dengue since the two illnesses are spread by the same mosquitoes and outbreaks often occur simultaneously. Dengue does not produce an extended period of joint pain while chikungunya does not have a hemorrhagic version. Dengue has a higher mortality rate while patients with chikungunya often report much greater pain.