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Chikungunya Cases Continue to Rise

The number of suspected chikungunya cases nearly doubled in the last two weeks, Health Department epidemiologist Dr. Esther Ellis said Tuesday.

“That’s typical of an outbreak,” she said.

Ellis said she doesn’t know if the territory has turned the corner on the outbreak that began in May when two cases were reported. It won’t be obvious until the statistics show the number of cases is decreasing, she said.

Meanwhile, the department is gathering statistics so it will know when the outbreak is on the downhill side. Reporting continues to be an issue. While some people do self-report and others seek treatment at medical facilities, many do not.

Chikungunya took hold so easily because, in part, it hadn’t been in the Virgin Islands before. According to Ellis, the population had no immunity.

The first case in the region was reported on French St. Martin in December 2013. Ellis said it’s likely the virus was introduced to the Virgin Islands by several people because that’s usually the way outbreaks like this one begin.

Further increasing its spread, Ellis said about 75 percent of the people bitten by the mosquito that carries the chikungunya virus get sick. This compares to dengue, where only about 25 percent come down with symptoms.

And the territory has a resident population of the Aedes mosquito that transmits the virus.

As of the end of August and using the latest statistics available, the territory had a total of 30 probable/confirmed cases. Of that figure, 28 were on St. Thomas, two on St. John and none on St. Croix.

However, those numbers do not tell the entire story because there were a total of 415 suspected cases. Of that figure, 389 suspected cases were on St. Thomas with St. John having four. St. Croix had 22 suspected cases.

According to the Health Department’s statistics, 97 percent of the cases were acquired locally, two were imported and in six cases the origins are unknown.

Four patients were hospitalized but none have died.

One case that isn’t in Health’s statistics began Sept. 2. Jala Fabri of Okidanokh Goldcraft in Charlotte Amalie said she woke that morning with a fever, severe pain in her ankles and feet, and a mild-looking red rash on her legs.

“I did not go to the ER as I was pretty sure that it was chikungunya from the beginning,” she said.

For the entire week following her initial symptoms, Fabri suffered from a fever, swelling, pain in her ankles and feet, and general malaise, she said. Although the initial rash seemed to disappear that night, she woke up four days later with “a huge rash all over my upper chest and face” but it also abated by the next day.

Tuesday, a week after coming down with the virus, Fabri had improved.

“Well, I am feeling pretty good because I can’t get it again!” she said.

Fabri stressed the importance of prevention, including the use of mosquito repellant, indicating that she will continue to wear spray in the hopes that she will not spread the virus to her family or coworkers.

Fabri contracted dengue fever more than seven years ago.

“I have had dengue, and that was worse,” she said.

The Health Department has been advising residents for months to make sure there is no standing water around. However, Ellis said Tuesday, if people have some standing water they can’t get rid of they can buy larvicide containing the chemical BTI at hardware stores.

Additionally, she said, because people collect water in drums, they should make sure they’re screened so mosquitos can’t get in to lay eggs. Should they get through the screening, she said the mosquitos won’t be able to fly out.

The symptoms for chikungunya usually begin three to seven days after being bitten by an infected mosquito and may include fever, severe joint pains, often in the hands and feet, headache, muscle pain, joint swelling and/or rash. The symptoms can be severe and disabling. Most patients report improvement within a week.

Until a medical provider confirms diagnosis, residents are urged to take pain medications, like Tylenol, that will not cause bleeding complications. Pain medications characterized as NSAIDs such as Aleve and aspirin should be avoided.

Ellis said the mosquito lives mostly in and around houses and bites during the day.

Health spokesman Astia Lebron said the department is evaluating its options for eradicating the mosquitos but advised residents to spray around their houses if they have a mosquito problem.

The Health Department’s multiagency task force is continuing its efforts to deal with the outbreak. Lebron said the department is working with the Education Department, the Department of Licensing and Consumer Affairs, the V.I. Waste Management Authority, Government House, and the Occupational Safety and Health Administration.

To learn more about chikungunya and ways to prevent the spread of the virus, visit www.healthvi.org or the Centers for Disease Control and Prevention’s website at www.cdc.gov/chikungunya. Call the Health Department’s Division of Public Health Preparedness at 773-1311 ext. 3280 or 642-3111. Reach Health’s Bureau of Epidemiology at 773-1311 ext. 3241 or 626-1654.

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