While the chikungunya outbreak has slowed on St. Thomas and St. John, the number of cases continues to rise on St. Croix, Health Department epidemiologist Dr. Esther Ellis said Friday.
One person has died, but Ellis said the St. Croix resident had underlying health issues. She said it is still considered a chikungunya-associated death. According to Ellis, the person died in late September but it took “a while” to get confirmation from the lab.
As of Oct. 18, when the latest data became available, the territory has seen 1,048 suspected cases since reporting began with the first confirmed case on St. Thomas on April 12. A total of 76 more cases were confirmed and 16 were considered probable.
This breaks down to 843 suspected cases and 83 confirmed/probable cases on St. Thomas, 42 suspected and four confirmed/probable on St. John and 163 suspected and five confirmed/probable cases on St. Croix.
Ellis expects the St. Croix numbers to rise considerably next week as more data becomes available.
Those numbers do not reflect the entire picture because many people do not report their illness or seek treatment.
“Everyone has a friend or neighbor who’s had it,” Ellis said.
Ellis said that it appears an outbreak lasts about eight months. The first case on St. Thomas was reported April 12, which appears in line with data that shows the St. Thomas and St. John cases are on the decline. However, she said the first case on St. Croix wasn’t reported until June 23, which means that if it follows the normal pattern, the outbreak should wane by February.
She said there was no particular reason why it began on St. Thomas. It’s likely that more people who had chikungunya traveled to that island from infected areas in the Caribbean. Ellis said outbreaks usually begin when the disease is passed to others by multiple people.
Ellis said it’s likely infected people from St. Thomas then traveled to St. Croix. Additionally, infected travelers from other Caribbean islands visiting St. Croix helped its spread.
The chikungunya virus spreads via the Aedes aegypti mosquito.
The local news comes as the Centers for Disease Control announced Thursday that the chikungunya outbreak in the Caribbean, Central America and South America shows no signs of slowing down.
The Pan American Health Organization reported that as of Oct. 31,153 people had died from chikungunya across the Caribbean, South American and Central America. The French islands of Martinique and Guadeloupe had the most, with Martinique having 74 deaths and Guadeloupe having 65. The Dominican Republic had six deaths, French St. Martin, three, and Surinam, one. The PAHO report indicates four people died on Puerto Rico, but Ellis said the number has risen to five. She said all five of those people had underlying health issues.
The outbreak, which began in December 2013, had caused an estimated 795,000 chikungunya fever cases in 37 countries and territories in the Western Hemisphere as of the end of October, the CDC indicated. As of a Nov. 4 CDC report, more than 1,600 travelers returned to the United States with chikungunya fever. Before this outbreak, an average of 28 travelers with chikungunya fever returned to the United States each year.
“Travelers to areas where the chikungunya outbreak continues are at risk of becoming infected. It is important that travelers understand these risks and take appropriate actions to prevent being bitten by mosquitoes,” Roger S. Nasci, chief of CDC’s Arboviral Diseases Branch, said in a press release.
Ellis echoed his concerns and said with the expected uptick in the number of visitors arriving in the territory as the winter season begins, visitors need to take precautions.
The best way to prevent getting chikungunya is to avoid being bitten. The mosquitoes that spread chikungunya bite mostly during the daytime. CDC recommends using insect repellent and wearing long-sleeved shirts and long pants during the day and staying in air-conditioned or well-screened rooms at night. Those using sunscreen should apply insect repellent after sunscreen.
