Chikungunya Closer to Home
ABSTRACT & COMMENTARY
By Stan Deresinski, MD, FACP, FIDSA
Clinical Professor of Medicine, Stanford University, Hospital Epidemiologist, Sequoia Hospital, Redwood City, CA, Editor of Infectious Disease Alert.
SOURCES: WHO. Chikungunya in the French part of the Caribbean isle of Saint Martin. http://www.who.int/csr/don/2013_12_10a/en/index.html
European Centre for Disease Prevention and Control. Autochthonous cases of chikungunya fever on the Caribbena island, Saint Martin. 11 December 2013. http://www.ecdc.europa.eu/en/publications/Publications/chikungunya-st-martin-rapid-risk-assessment.pdf
During an ongoing outbreak of dengue fever on St Martin/Sint Maarten, (the French and Dutch portions of isle of Saint Martin in the northeastern Caribbean 300 km east of Puerto Rico, active case finding detected 5 patients with suspected dengue who had negative testing for this virus at the Arbovirus National Reference Center in Marseille. All 5 patients, whose symptoms began between 12 October and 15 November 2013, had prominent joint symptoms together with fever. Two had confirmed chikungunya infection. With further surveillance a total of 2 confirmed, 4 probable, and 20 suspected cases were detected as of 12 December.
Imported cases of chikungunya have occurred in the Americas in the U.S., as well as in Brazil, Canada, French Guyana, Guadoloupe, and Martinique. All of these countries except Canada have also experienced autochtonously acquired dengue. In the U.S., dengue virus infection has been acquired in Florida in Key West and Martin County, as well as in Hawaii, and in Texas — most recently in Houston. Since Aedes albopictus and Aedes albopictus are each vectors of both dengue and chikungunya virus, with both present in many areas of the Americas, it seemed only a matter of time that locally acquired chikungunya virus infection was detected — and that time has come.
This beautiful Caribbean island is a major tourist attraction, especially at this time of year. It is inevitable that some tourists will bring home something other than just a sun tan — a mosquito-borne infection.