[1] Haiti Date: Wed 28 May 2014 Source: Twitter, Laurent Lamothe, Prime Minister of Haiti [edited] [11 802 chikungunya virus infections by department:] Ouest 10 649 cases (77 per cent of total cases), Nord Est 678 cases (5 per cent), Artibonite 475 cases (3 per cent). -- Communicated by: Roland Hubner Superior Health Council Brussels Belgium [Maps of Haiti can be accessed at and . - Mod.TY] ****** [2] Dominican Republic Date: Wed 28 May 2014 Source: Dominican Today [edited] President Danilo Medina on Tuesday [27 May 2014] instructed all Government agencies to join the fight against the chikungunya virus, which has sickened more than 32 000 people in just 2 months. Concerned with mounting chikungunya cases across the country, Medina ordered all staff of nearly 400 000 workers from most departments to take part on Friday [23 May 2014] in the nationwide push to eliminate the breeding sites of the mosquito that transmits the disease in all households. Around 400 000 government workers will visit households to orient families about the disease and eliminate the tanks and other water recipients to store water, where the mosquito breeds. -- Communicated by: Roland Hubner Superior Health Council Brussels Belgium [The 28 May 2014 edition of Noticias SIN ( in Spanish) reported the 1st suspected fatality from a chikungunya virus infection in the Dominican Republic. The numbers of suspected chikungunya virus infections in the Dominican Republic are conflicting. The 26 May 2014 edition of 7 Dias ( in Spanish) reported that there were 38 000 suspected cases, yet the 28 May 2014 edition of Listin Diario ( in Spanish) stated that to date there are more than 57 000 cases of chikungunya virus infection. Maps of the Dominican Republic can be accessed at and . - Mod.TY] ****** [3] Puerto Rico Date: Thu 29 May 2014 Source: La Prensa [in Spanish, trans. Mod.TY, edited] A 16 year old girl became the 1st person affected with chikungunya virus in Puerto Rico, as confirmed today [29 May 2014] by the Minister of Health, Ana Ruis Armendariz. The youth was attended to in a urgent care unit, but was referred to her home for supportive therapy because her condition did not require hospitalization. The minister said that, through the Office of Epidemiology and Research, the Department of Environmental Health and Biosafety began investigations to determine the source of exposure of the patient in order to identify other possible cases. Personnel from the Secretariat of Environmental Health said inspections were being carried out inspections in order to identify mosquito breeding sites in places such as septic tanks, storm drains, and areas of stagnant water in the communities of interest. Chikungunya virus is not transmitted person to person, instead by _Aedes aegypti_ mosquitoes, the same ones that transmit dengue [viruses] which occurs all over Puerto Rico. -- Communicated by: Roland Hubner Superior Health Council Brussels Belgium [This appears to be a locally acquired infection, since no travel to localities where transmission is occurring is mentioned. If so, then there is one or more other cases in Puerto Rico as yet undetected. Maps of Puerto Rico can be accessed at and . - Mod.TY] ****** [4] Barbados ex Dominica Date: Fri 30 May 2014 Source: RJR News, Weekend Nation report [edited] Health Authorities in Barbados are now reportedly trying to come to grips with what are believed to be the 1st 2 cases of the dreaded chikungunya virus [infection] in that Caribbean nation. The Weekend Nation is reporting that, while no official announcement has so far been made by the Ministry of Health, the newspapers investigations revealed that in both cases the victims had just returned from Dominica, where medical officials are dealing with a major outbreak, of the mosquito-borne virus. A man from Hopewell, St Thomas, who returned from Dominica on 13 May [2014] after spending 6 weeks there with his wife, reportedly explained that he was only now getting relief from the excruciating pain brought on by the virus. The man explained that, while in Dominica almost everyone he came into contact with had the virus and he and his wife did everything possible to avoid being bitten by mosquitoes that transmit the illness. When he got back to Barbados with no symptoms, he said, he was extremely relieved. Then last week Wednesday [?21 May 2014] when I was working in the afternoon I realised I could not walk. My knees started to hurt so bad, the auto mechanic revealed. -- Communicated by: Roland Hubner Superior Health Council Brussels Belgium [Both of these cases were imported from Dominica. It remains to be seen if they were sources of chikungunya virus ongoing transmission in Barbados. Maps of Barbados can be accessed at and Maps of Dominica at and . - Mod.TY] ****** [5] St Lucia Date: Tue 27 May 2014 Source: Jamaica Observer [edited] St Lucia health officials are warning of an increase in the number of cases of chikungunya virus [infection] and that the situation on the ground is believed to be much worse than the figures presented. Epidemiologist Neham Jn Baptiste said the island had so far recorded 20 confirmed cases and 120 suspected cases of the virus that is spread by the _Aedes aegypti_ mosquito. The situation on the ground is believed to be much worse than the figures presented as according to information from the Ministry of Health. Some persons with chikungunya have opted to use home remedies like bush medicine, rather than reporting their condition to a doctor or health clinic, he added. He said that it is very important to know which areas are affected so as to provide strategic environmental control. While the virus is more prevalent among women, Jn Baptiste said that pregnant women especially must be protected from contracting the virus which he said could be much more harmful to this group. Jn Baptiste said that with the onset of the rainy season, there is also a higher risk of people contracting dengue. He warned that the circulation of chikungunya and dengue at the same time could pose as a major public health threat, he warned. The Pan-American Health Organization (PAHO) reports more than 55 000 suspected and confirmed cases in the Caribbean. -- Communicated by: ProMED-mail from HealthMap Alerts [The number of cases of chikungunya virus infection in St Lucia continues to grow. Maps St Lucia can be accessed at and . - Mod.TY] ****** [6] St Vincent and the Grenadines Date: Wed 28 May 2014 Source: NBC Radio [edited] The Ministry of Health, Wellness and the Environment has announced that there are now 280 confirmed laboratory cases of chikungunya virus [infections] in St Vincent and the Grenadines. Chairman of the National Surveillance Committee in the Ministry of Health, Dr Rosmond Adams tells NBC News 274 of these cases are on the Grenadine Island of Bequia and 6 on mainland St. Vincent. He said the Ministry is continuing to work along with stakeholders to hold public sensitization programs and develop a National program to contain the spread of chikungunya virus. Dr Adams said the Ministry of Health is carrying out vector control activities to eliminate the _Aedes aegypti_ mosquito, which transmits the chikungunya virus. -- Communicated by: Roland Hubner Superior Health Council Brussels Belgium [Maps of St Vincent and the Grenadines can be accessed at and . - Mod.TY] ****** [7] St Kitts and Nevis Date: Tue 27 May 2014 Source: SKN Vibes [edited] Chief Medical Officer (CMO) Dr Patrick Martin has indicated that 21 cases of chikungunya have so far been confirmed in the Federation and it would take the assistance of the entire nation to control its spread. The CMO made this disclosure today (May 27) in a brief interview with this publication. He stated that chikungunya is a virus that is contracted through the bite of an infected mosquito. Dr Martin also stated that currently there are 21 confirmed cases of the illness in St Kitts, but noted that there has been no reported case in Nevis. He said the 1st case was an imported one and the others were local. When asked if there was an outbreak in the Sandy Point area, Dr Martin stressed that the virus was throughout St Kitts. There is no Sandy Point area anymore! Even though we dont have any confirmed cases coming out of Nevis, there are confirmed cases in Antigua and all around us. We all are in the neighbourhood, we all will be affected and we all would be affected because we all have the mosquito, he said. Last week [week of 19 May 2014] however, Acting Chief Environmental Health Officer Alexander Riley stated on WINN FMs Talking Trash Programme that the majority of reported cases had stemmed from Sandy Point. The index case was in Sandy Point and so what you find is that most of the cases that weve been having, suspected and confirmed cases, is in the Sandy Point area, he said. Dr Martin however maintained that the cases were island-wide and the Ministry is seeking the publics assistance to curb its spread. The Ministry of Health is seeking the cooperation of the general public to keep the mosquito burden to a minimum by searching and destroying all receptacles that can collect water. And the Ministry is also doing some aerial spraying, he explained. He however stressed that spraying is not as effective as having the breeding sites destroyed. Aerial spraying is less effective than destroying the breeding site; and to destroy the breeding sites we need the continuous cooperation of the general public. Some persons have been doing a good job, but there are other persons who need a little more encouragement. He advised that the message be made public so that people would be aware that it is not just a Ministry of Health control at all...it is for everybody. Dr Martin said all hands need to be on deck to control and stop the spread of Chikungunya. -- Communicated by: Roland Hubner Superior Health Council Brussels Belgium [Maps of St Kitts and Nevis can be accessed at and . - Mod.TY] ****** [8] Guyana Date: Wed 28 May 2014 Source: Guyana Times [edited] Health Minister, Dr Bheri Ramsaran on Tuesday [27 May 2014] revealed that 2 cases of chikungunya [virus infections] have been identified in Guyana. He made this disclosure at a media briefing during which he said that the cases were from Canje, Berbice, and authorities have since dispatched a 5-member medical team to the area. The Minister said after there was an outbreak of the disease in the Caribbean, steps were taken by the Health Ministry to monitor the situation in Guyana. Dr Ramsaran disclosed that they had quietly engaged in a countrywide campaign, which saw medical staff at the various health centres and hospitals being informed to look out for chikungunya [virus infection] symptoms in patients. The ports of entry were also warned to look out for the disease. We have been very vigilant, the Minister said. He noted that a report was made that there was an increase of cases with the same symptoms as chikungunya [virus infection] in New Amsterdam; as such, samples were taken from those cases and sent to a lab in Trinidad for testing. The Minister disclosed that a total of 84 suspected cases were identified; however, only 30 samples were sent to Trinidad. He added that on Saturday, 8 case reports were returned, and 2 samples were positive for chikungunya [virus infection]. One of the cases is from Cumberland and the other from Canefield, both in Canje. These cases involve a 4-year-old child and a 40-year-old woman. The Health Minister said the team sent to Berbice would be stationed there until the campaign is over. He added that now that the infected area has been identified, his Ministry is working along with the Region Six officials to provide more protection to residents. Dr Ramsaran pointed out that with this disclosure, they have heightened fogging and vector control exercises not only in Berbice but will continue the campaign in Georgetown as well. Meanwhile, Chief Medical Officer Dr Shamdeo Persaud is advising citizens to take the necessary precautions to protect themselves from the disease. He urged residents to make use of nets and get rid of any water-filled containers or pot-holes in yards since they are breeding grounds for mosquitoes. Dr Persaud is encouraging persons who have dengue-fever symptoms to seek immediate medical attention since it might be chikungunya as the symptoms are similar. -- Communicated by: Roland Hubner Superior Health Council Brussels Belgium [Apparently, these are locally acquired cases. If so, Guyana becomes the 2nd country on the mainland of the Americas with ongoing transmission. Further spread to other mainland countries would not be surprising. Maps of Guyana in north eastern South America can be accessed at and . - Mod.TY] ****** [9] PAHO/WHO report Date: Fri 30 May 2014 Source: PAHO/WHO [edited] Country / Week / Susp. cases / Conf. cases / Deaths Latin Caribbean: Dominican Republic / week 21 [ending 25 May 2014] / 38 639 / 17 / 1 French Guiana / week 21 [ending 25 May 2014] / 0 / 222 / 0 Guadeloupe / week 21 [ending 25 May 2014] / 23 100 / 1328 / 1 Haiti / week 21 [ending 25 May 2014] / 6312 / 6 / 0 Martinique / week 21 [ending 25 May 2014] / 29 200 / 1515 / 9 Puerto Rico / week 22 [ending 31 May 2014] / 0 / 1 / 0 St Barthelemy / week 21 [ending 25 May 2014] / 520 / 135 / 0 St Martin / week 20 [ending 17 May 2014] / 3320 / 793 / 3 Non-Latin Caribbean: Anguilla / week 13 [ending 29 Mar 2014] / 0 / 33 / 0 Antigua and Barbuda / week 20 [ending 17 May 2014] / 0 / 4 / 0 Aruba / week 6 [ending 8 Feb 2014] / 0 / 1 / 0 Dominica / week 20 [ending 17 May 2014] / 1817 / 122 / 0 Guyana / week 22 [ending 31 May 2014] / 0 / 2 / 0 St Kitts & Nevis / week 21 [ending 25 May 2014] / 0 / 22 / 0 St Lucia / week 19 [ending 10 May 2014] / 0 / 5 / 0 St Vincent & the Grenadines / week 19 [ending 10 May 2014] / 110 / 57 / 0 St Maarten / week 12 [ending 22 Mar 2014] / 0 / 123 / 0 British Virgin Islands / week 19 [ending 10 May 2014] / 0 / 20 / 0 -- Communicated by: ProMED-mail A map showing the counties and territories with autochthonous transmission of chikungunya in the Americas, as of 17 May 2014, can be seen at . - Mod.TY] ****** [10] French Antilles and Guiana Date: 19-25 May 2014 Source: Institut de Veille Sanitaire, (French Institute for Public Health Surveillance, InVS) no 20 [in French, trans. Mod.TY, edited] Cases since the beginning of the outbreak in December 2013: - St Martin: (susp) 3320 cases; deaths 3; stable and low. - St Barthelemy: (susp) 520 cases; stable and low. - Martinique: (susp) 29 200 cases; deaths 9; increasing steadily over past 5 weeks. - Guadeloupe: (susp) 23 100 cases; deaths 1; increasing strongly. - French Guiana: (susp) not available; (probable or confirmed) 222 cases; 74 per cent locally acquired; increasing, with new clusters but most cases in Cayenne. -- Communicated by: ProMED-mail [Maps of the area can be seen at and . - Mod.TY] ****** [11] Venezuela ex Dominican Republic Date: Thu 29 May 2014 Source: Ultimas Noticias [in Spanish, trans. & summ. Mod.TY, edited] Dr Jesus Toro Landaeta, Director General of Environmental Health, reported last Thursday evening 29 May 2014, a possible imported case of chikungunya [virus infection] detected by epidemiology officials of the health ministry. This case was imported from the Dominican Republic by a woman who had been in this Caribbean nation recently. Landaeta Toro explained that the patient, upon her return, went to an ambulatory [clinic] of the National Public Health System where the physician who treated her suspected the presence of the virus and took a blood sample that was sent to the National Institute of Hygiene Rafael Rangel for diagnostic confirmation of the virus. -- Communicated by: Roland Hubner Superior Health Council Brussels Belgium [The 31 May 2014 edition of El Nacional ( in Spanish) indicated that the tests were negative for the diagnosis of chikungunya virus (CHIKV) infection. The woman became ill 2 weeks before her return to Venezuela, so it would have been unlikely that she would have been viremic upon her arrival in Venezuela had she been infected with CHIKV. Nonetheless, this case illustrates how international travel carries the risk of introduction of pathogens to new countries and ongoing transmission where competent vectors are found. Fortunately, in this instance, although the vectors of CHIKV are present in Venezuela, the virus was not introduced into the country this time. Maps of Venezuela can be accessed at and . - Mod.TY] ****** [12] USA (Florida) ex Caribbean Date: Thu 29 May 2014 Source: The Global Dispatch [summ. & edited] Chikungunya virus, which made its presence known in the Western hemisphere with the 1st autochthonous cases in early December [2013] on the French side of St Martin in the Caribbean, has been reported recently in the Sunshine State [Florida] as imported cases linked to travel to the Caribbean. The FLDOH [Florida Department of Health] has reported 10 imported chikungunya cases in 2014 according to the surveillance report. All individuals with a travel history to a chikungunya endemic country or area experiencing an outbreak in the 2 weeks prior to onset. The countries of origin were: Dominica, Dominican Republic, Haiti (6), and Martinique (2). Counties reporting cases were: Broward, Hillsborough (2), Miami-Dade (5), Palm Beach, and Pasco. -- Communicated by: ProMED-mail from HealthMap Alerts [Roland Hubner is thanked for also providing a report containing the same information that was issued by Florida Health Arbovirus Surveillance for week 21, 18-24 May 2014 (). Maps of the state of Florida, in the south eastern USA, can be accessed at and . - Mod.TY] ****** [13] Chile ex Dominican Republic Date: Fri 30 May 2014 From: Cecilia Perret [edited] The 1st case of chikungunya fever was diagnosed in a Chilean traveler coming from Dominican Republic on 20 May [2014]. A woman, 49 years old, visited Dominican Republic between 29 Apr and 6 May [2014]. She visited several places including Santo Domingo, Punta Cana, Bavaro Beach, Bayahibe. She refers to having had many mosquito bites in a sector called Cuevas de las Maravillas located between Bayahibe and Santo Domingo. On 9 May [2014] she presented with a low degree fever and intense arthralgia in wrists, interphlangeal joints, ankles, and knees lasting up to today [30 May 2014]. In addition to these symptoms, she also presented with a rash mainly in limbs that lasted 2 days. The diagnosis was made by a seroconversion of CHIKV [chikungunya virus] IgM by indirect immunofluorescence assay on day 6 of symptoms. The 1st sample on day 2 was negative for CHIKV. Dengue was ruled out by negative IgM tests performed on both samples. CHIKV infection diagnosis was performed in the virology laboratory of the Pontificia Universidad Catolica de Chile. This case was notified to Chilean MOH and represents the 1st Chilean case of chikungunya [virus infection] diagnosed in travelers, highlighting the need to suspect this infection in travelers not only where CHIKV has been described but also where _Aedes aegypti_ is present because of the high risk of rapid dissemination of this arbovirus in Latin America. -- Cecilia Perret, MD Pediatrician and infectious diseases specialist Associate Professor, Infectious Diseases and Virology Laboratory School of Medicine Pontificia Universidad Catolica de Chile Santiago, Chile [This is yet another example of movement of pathogens to new geographic areas. Fortunately, there is no risk of ongoing transmission of CHIKV in Chile. Dr Cecilia Perret is thanked for this 1st-hand report. Maps of Chile can be accessed at and . - Mod.TY] ****** [14] France ex Caribbean Date: Mon 26 May 2014 Source: Institut de Veille Sanitaire, (French Institute for Public Health Surveillance, InVS) [in French, trans. Mod.TY, edited] 16 confirmed chikungunya cases imported into France from the Caribbean, 1-23 May 2014. Cases by region: - Bouches-du-Rhone, Var, Alpes-Maritimes: 6 - Languedoc-Roussillon: 5 - Midi-Pyrenees: 1 - Rhone-Alpes: 3 - Aquitaine: 1 -- Communicated by: ProMED-mail from HealthMap Alerts [Southern France has populations of _Aedes albopictus_, so the need for active surveillance is real. Maps of France can be accessed at and . - Mod.TY] ****** [15] Italy (Livorno province, Tuscany region) ex Caribbean Date: Mon 12 May 2014 Source: Corriere Etrusco [in Italian, machine trans., edited] On the evening of 9 May [2014], the hygiene service ASL [azienda sanitaria locale; local health unit] informed the municipality of Campiglia Marittima, that a resident of Venturina Terme, suffering from [a] chikungunya [virus infection], had been admitted in the department of infectious diseases of the hospital in Livorno. The patient remained in his home only a few hours after returning from abroad, where he contracted the infection, on 7 May 2014, and was hospitalized the next day. Immediately after the communication and with the instructions of ASL, the municipality of Campiglia conducted the disinfection [probably mosquito vector control] of the area as a precaution to avoid any danger to the public. -- Communicated by: Roland Hubner Superior Health Council Brussels Belgium [Rapid mosquito vector control in this situation is prudent. The 1st outbreak of autochthonously transmitted chikungunya virus (CHIKV) in Europe, occurred in the province of Ravenna in north eastern Italy in 2007. CHIKV was imported by a viremic individual who contracted his infection in India, traveled to Italy, and initiated a small outbreak there, transmitted by _Aedes albopictus_ that had become established in the area. That vector has become established in many localities in the Mediterranean Basin (see ProMED-mail archive no 20071210.3980). This is why there is legitimate concern about CHIKV being introduced into this region again. Maps of Italy can be accessed at and . - Mod.TY
Posted on: Tue, 03 Jun 2014 05:53:01 +0000
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