CDC Message about virus on St Martin

[dcrow72]

Received alert email from CDC regarding virus carried by mosquitoes on St Martin. Never even heard of this one. Will post content. Doesn't sound fatal unless preexisting conditions made you compromised.

 

 

The following CDC Health Alert Network (HAN) Health Advisory Message was issued December 13, 2013. You are receiving this information because you subscribe to COCA E-mail Updates. If you have any questions on this or other clinical issues, please e-mail coca@cdc.gov.

 

 

 

On behalf of the Clinician Outreach and Communication Activity (COCA)

 

Centers for Disease Control and Prevention (CDC)

 

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This is an official

 

CDC HEALTH ADVISORY

 

 

 

Distributed via the CDC Health Alert Network

 

December 13, 2013, 1400:00 (2:00 PM ET)

 

CDCHAN-00358

 

 

 

Notice to Public Health Officials and Clinicians: Recognizing, Managing, and Reporting Chikungunya Virus Infections in Travelers Returning from the Caribbean

 

 

 

Summary

 

On December 7, 2013, the World Health Organization (WHO) reported the first local (autochthonous) transmission of chikungunya virus in the Americas. As of December 12th, 10 cases of chikungunya have been confirmed in patients who reside on the French side of St. Martin in the Caribbean. Laboratory testing is pending on additional suspected cases. Onset of illness for confirmed cases was between October 15 and December 4. At this time, there are no reports of other suspected chikungunya cases outside St. Martin. However, further spread to other countries in the region is possible.

 

 

 

Chikungunya virus infection should be considered in patients with acute onset of fever and polyarthralgia, especially those who have recently traveled to the Caribbean. Healthcare providers are encouraged to report suspected chikungunya cases to their state or local health department to facilitate diagnosis and to mitigate the risk of local transmission.

 

 

 

Background

 

Chikungunya virus is a mosquito-borne alphavirus transmitted primarily by Aedes aegypti and Aedes albopictus mosquitoes. Humans are the primary reservoir during epidemics. Outbreaks have been documented in Africa, Southern Europe, Southeast Asia, the Indian subcontinent, and islands in the Indian and Pacific Oceans. Prior to the cases on St. Martin, the only chikungunya cases identified in the Americas were in travelers returning from endemic areas.

 

 

 

Clinical Disease

 

A majority of people infected with chikungunya virus become symptomatic. The incubation period is typically 3–7 days (range, 2–12 days). The most common clinical findings are acute onset of fever and polyarthralgia. Joint pains are often severe and debilitating. Other symptoms may include headache, myalgia, arthritis, or rash. Persons at risk for more severe disease include neonates (aged <1 month) exposed intrapartum, older adults (e.g., > 65 years), and persons with underlying medical conditions (e.g., hypertension, diabetes, or cardiovascular disease).

 

 

 

Diagnosis

 

Chikungunya virus infection should be considered in patients with acute onset of fever and polyarthralgia who recently returned from the Caribbean. Laboratory diagnosis is generally accomplished by testing serum to detect virus, viral nucleic acid, or virus-specific immunoglobulin M (IgM) and neutralizing antibodies. During the first week of illness, chikungunya virus infection can often be diagnosed by using viral culture or nucleic acid amplification on serum. Virus-specific IgM and neutralizing antibodies normally develop toward the end of the first week of illness. To definitively rule out the diagnosis, convalescent-phase samples should be obtained from patients whose acute-phase samples test negative.

 

 

 

Chikungunya virus diagnostic testing is performed at CDC, two state health departments (California and New York), and one commercial laboratory (Focus Diagnostics). Healthcare providers should contact their state or local health department to facilitate testing.

 

 

 

 

 

 

 

Treatment

 

No specific antiviral treatment is available for chikungunya fever. Treatment is generally palliative and can include rest, fluids, and use of analgesics and antipyretics. Because of similar geographic distribution and symptoms, patients with suspected chikungunya virus infections also should be evaluated and managed for possible dengue virus infection. People infected with chikungunya or dengue virus should be protected from further mosquito exposure during the first few days of illness to prevent other mosquitoes from becoming infected and reduce the risk of local transmission.

 

 

 

Prevention

 

No vaccine or preventive drug is available. The best way to prevent chikungunya virus infection is to avoid mosquito bites. Use air conditioning or screens when indoors. Use insect repellents and wear long sleeves and pants when outdoors. People at increased risk for severe disease should consider not traveling to areas with ongoing chikungunya outbreaks.

 

 

 

Recommendations for Health Care Providers and Public Health Practitioners

 

· Chikungunya virus infection should be considered in patients with acute onset of fever and polyarthralgia, especially those who have recently traveled to the Caribbean.

 

· Healthcare providers are encouraged to report suspected chikungunya cases to their state or local health department to facilitate diagnosis and to mitigate the risk of local transmission.

 

· Health departments should perform surveillance for chikungunya cases in returning travelers and be aware of the risk of possible local transmission in areas where Aedes species mosquitoes are currently active.

 

· State health departments are encouraged to report laboratory-confirmed chikungunya virus infections to ArboNET, the national surveillance system for arthropod-borne viruses.

 

 

 

For More Information

 

· General information about chikungunya virus and disease: http://www.cdc.gov/chikungunya/

 

· Chikungunya information for clinicians: http://www.cdc.gov/chikungunya/pdfs/CHIKV_Clinicians.pdf

 

· Protection against mosquitoes: http://wwwnc.cdc.gov/travel/yellowbook/2014/chapter-2-the-pre-travel-consultation/protection-against-mosquitoes-ticks-and-other-insects-and-arthropods

 

· Travel notices related to chikungunya virus: http://wwwnc.cdc.gov/travel/notices

 

· Information about chikungunya for travelers and travel health providers: http://wwwnc.cdc.gov/travel/yellowbook/2014/chapter-3-infectious-diseases-related-to-travel/chikungunya

 

· Chikungunya preparedness and response guidelines: http://new.paho.org/hq/index.php?option=com_docman&task=doc_download&gid=16984&Itemid

 

· Dengue clinical management guidelines: http://whqlibdoc.who.int/publications/2009/9789241547871_eng.pdf

 

 

 

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[spidybabe]

Wow Interesting read. Thanks for the info

Safe sailing

 

 

Sent from my iPad using Forums mobile app

[gtaylor]

I don't know about the French side, but I do know that the Dutch side has been conducting evening and early morning Fogging Operations to eradicate mosquitos.

 

I have to assume that the French side is taking similar precautions.

 

gary

[mollyeilis]

I don't know about the French side, but I do know that the Dutch side has been conducting evening and early morning Fogging Operations to eradicate mosquitos.

 

I have to assume that the French side is taking similar precautions.

 

gary

 

Oh gracious. The chemicals in that are probably far worse for people than a self-limiting illness consisting of fever and joint pains.

[OCruisers]

Yuck! Thanks for posting this warning.

 

LuLu

~~~~

[VIRGINIA ARTIE]

Thanks so much for posting. We're cruising there next month, and I'm not getting off the ship. No sense taking chances .

[spidybabe]

Added bug spray to our packing list .....although I hate the stuff. We live right by "ground zero" where west Nile was located, and we often...often get aerial sprayed at night, and it works great controlling the little buggers. Haven't heard any complaints from past cruisers - So don't worry....be happy.......

As always in life an ounce of prevention.......

Safe sailing

[wallslo]

will be there next week on the Royal Princess. Would Princess pass on stopping at St Maarten due to this risk?

[perfect match]

Our friends are on the Royal Princess right now, heading for St Maarten tomorrow. I know they have a pretty extensive medical supply kit they always take with them. I sure hope it has bug spray!

[gtaylor]

Thanks so much for posting. We're cruising there next month, and I'm not getting off the ship. No sense taking chances .

Perhaps you should stay onboard in every port.

 

From the local paper:

 

Dear Editor,

Last week the Daily Herald reported that two cases of chikungunya virus CHIKV were laboratory confirmed on St. Martin. The article stated that CHIKV is in the Pacific Islands, Asia and India, but until now not in the Caribbean islands.

 

While it is true that these are the first laboratory confirmed cases of CHIKV in the Caribbean, it is highly probable that the virus has been circulating in the Caribbean for some time. Not documenting the virus sooner probably results from a failure to invest in public health research and infrastructure

 

<snip>

 

s/ Dr. Teresa E. Leslie

President and Founder

Eastern Caribbean Public Health Foundation, St. Eustatius.

 

The two reported cases have been limited to the French side, and these are mosquitos, that are normally a problem around twilight here.

 

Personally, I don't have a problem as proceding as usual, bug spray in the evening.

 

gary

[springfire]

Wow, hadn't heard about this.

[satbeachbill]

A good bug repellent would be sensible, or stay on the Dutch side. I understand these are French mosquitos. They are not allowed to cross the border. :D

[bouhunter]

Thanks so much for posting. We're cruising there next month, and I'm not getting off the ship. No sense taking chances .

 

Seriously??? There will probably be 100,000+ cruise passengers getting off there in the next month and odds are none of them will get this virus............ :rolleyes:

Edited December 19, 2013 by bouhunter

[eandj]

Well, I'm sure the doctors would rather "treat" cases of this onboard rather than noro which is soooo contagious.

Bug spray will be in our bag as usual when cruising the Carib. in late Jan.