Date: Mon 17 Feb 2014
Source: Caribbean 360 [edited]
<http://www.caribbean360.com/index.php/news/dominica_news/1106753.html#axzz2tgv5ajip>

Health authorities say persons who have contracted the mosquito borne disease, chikungunya, should remain home as Dominica recorded more than 31 cases of the disease so far.

Chikungunya is a viral disease that is spread by the _Aedes aegypti_ mosquito, and the island recorded its 1st case on 16 Jan this year [2014].

"The numbers keep changing on a daily basis. We have a number of suspected cases, and we have a number of confirmed cases. The last count that we have in terms of confirmed cases was 31 cases, and we have other persons who have not been confirmed. We're asking the persons with the disease to remain at home and to use mosquito [bed] nets when they are sleeping and other persons to use mosquito repellents as well," said Chief Medical Officer Dr David Johnson, adding that it was advisable that people take precautionary measures to reduce the risk of spreading the disease.

"We're asking persons to avoid the spreading of the disease or, if they are infected with chikungunya, to ensure that they sleep under a mosquito net that is treated with insecticide," he said, adding that the Ministry of Health would be sourcing treated mosquito nets for distribution.

Health authorities have said the disease has spread to several areas across the island, and Dr. Johnson said most of the cases could "be managed at home without having to admit them to the hospital."

He said there was no cause for alarm about the disease, whose symptoms include fever, headache, fatigue, nausea, vomiting, muscle pain, rash, and joint pain. Acute chikungunya fever typically lasts a few days to a few weeks.
=====================
[The case count on Dominica has increased from 13 cases a few days ago to 31 mentioned above. Although the mortality rate from chikungunya virus infections is very small to nil, morbidity rates can be very high, and the severe, incapacitating arthralgia can persist for weeks, months, or even more than a year.

Maps showing the location of the localities where chikungunya virus is occurring can be accessed at
<http://www.worldatlas.com/webimage/countrys/namerica/caribb/ai.htm 
and http://healthmap.org/r/9NLv>. - ProMed Mod.TY]

[A ProMED-mail HealthMap is available at
<http://healthmap.org/r/4cwR>.]
Date: Fri 17 Feb 2014
Source: Dominica News [edited]
<http://dominicanewsonline.com/news/homepage/news/health/expert-warns-chikungunya-pandemic/>

An expert brought to Dominica in light of a local outbreak of the mosquito-borne disease chikungunya is warning of a pandemic if the disease is not brought under control quickly. "If it doesn't get under control, it is going to be another pandemic, and it is going to be worse than dengue," Yale University entomologist Dr. Durland Fish told Kairi FM's Healthy Environs, Health People.

According to the World Health Organization, a pandemic is the
"worldwide spread of a new disease."

"We need to have emergency measures to try to bring this epidemic under control, and we have only a week or 2 to do that," Fish said. "If we cannot contain this in 2 weeks, we are going to wind up like Martinique and Guadeloupe" [which it did - ProMed Mod.TY].

Officials say there has been a total of 13 confirmed cases of the disease in Dominica. They say it was confined to Bath Estate and Woodfordhill, but Chief Environmental Health Officer Anthony Scotland said it is spreading across the island.

"The disease is spreading to several communities," he told the same program on Kairi FM. "It has moved out of the major areas of Woodfordhill and Bath Estate. We have seen it in Scotts Head, Soufriere and Grandbay and a couple in Marigot." Scotland said there are reported cases in Kingshill, Goodwill, Roseau Central, Mahaut and Massacre. He described Bath Estate as the epicenter of the disease and said there have been some severe cases in a small section of Woodfordhill called Small Farm. "We moved into Bath Estate," he said. "We did a lot of work on the ground, working with the patients and the contacts and wider environment to see how we can stem the flow of that disease."

Meanwhile, the Public Health Agency of Canada has issued a travel notice to Canadians traveling to several Caribbean islands, including Dominica. "There have been confirmed cases of chikungunya on the Caribbean islands of Saint Martin/St. Maarten, Dominica, Guadeloupe, Martinique, Saint-Barthelemy and the British Virgin Islands. These cases mark the 1st time that locally acquired transmission of chikungunya has been detected in the Region of the Americas," the agency said in the travel notice. The agency recommend that travellers to the islands take precautions, such as protecting themselves from mosquito bites, particularly during peak mosquito biting times in the early morning and late afternoon.

Chikungunya is a viral disease, carried mainly by the _Aedes aegypti_ mosquito, and causes a dengue-like sickness. Symptoms include a sudden high fever, severe pain in the wrists, ankles or knuckles, muscle pain, headache, nausea and rash. Joint pain and stiffness are more common with chikungunya virus infections than with dengue viruses. Persons who have these symptoms are advised to report to the nearest health centre or their personal health care provider.

The type of mosquito that transmits chikungunya virus is also known to transmit dengue fever virus.
--------------------------------
Communicated by:
Roland Hubner
Superior Health Council
Brussels
Belgium
roland.hubner@sante.belgique.be
===================
[Cases of chikungunya virus infection in the Caribbean islands continue to accumulate. However, only Martinique appears to have significantly increasing incidence, and the other localities have stable or decreasing weekly numbers. No transmission on the mainland has been reported, although the risk remains.

Maps showing the location of the islands mentioned can be accessed at
<http://www.worldatlas.com/webimage/countrys/namerica/caribb/ai.htm> and <http://healthmap.org/r/9NLv>. - ProMed Mod.TY]

[Re: "symptoms which can be considered to be lifelong symptoms" is a bit of an exaggeration, although some unfortunate victims may have chronic joint pains persisting for months. - ProMed Mod.JW]
Date: Fri 7 Feb 2014
Source: Dominica News [edited]
<http://dominicanewsonline.com/news/homepage/news/health/thirteen-cases-chikungunya-dominica/>

There are now a total of 13 confirmed cases of the mosquito borne [virus] disease, chikungunya, in Dominica. Senior environmental health officer, Sylvester St Ville, made the announcement on state-owned DBS Radio on Friday [7 Feb 2014] and said the matter is disturbing. "It's a major concern for the health care system, but it's something that we are trying to manage," he said. "As of our latest report, there are 13 confirmed cases." He said the cases are mainly in the Woodfordhill and Bath Estate areas. "They are confined to those 2 communities," he remarked.

St Ville pointed out that the environmental health department is currently undertaking preventative measures to reduce the spread the disease. "Presently we are in Bath Estate doing some source reduction and vector control activities ... this evening (Friday [7 Feb 2014]) we will be doing some fogging operations to reduce the population of adults in these communities," he pointed out.

He said the department will also be removing discarded white goods [stoves, fridges, washing machines and other household appliances] in the Bath Estate area since they provide breeding areas for mosquitos. St Ville is calling on residents to play their part by covering water sources, emptying water containers, among other things, in efforts to control the breeding of mosquitos.

Chikungunya is a viral disease, carried mainly by the _Aedes aegypti_ mosquito, that causes a dengue-like sickness. Symptoms include a sudden high fever, severe pain in the wrists, ankles or knuckles, muscle pain, headache, nausea and rash. Joint pain and stiffness are more common with chikungunya than with dengue. Persons who have these symptoms are advised to report to the nearest health centre or their personal health care provider.
Date: Tue 28 Jan 2014
Source: Dominica News Online [summ., edited]
<http://dominicanewsonline.com/news/homepage/news/health/breaking-news-three-confirmed-cases-chikungunya-disease/>

Health officials have confirmed 3 more cases of chikungunya disease in Dominica. There is now a total of 4 confirmed cases of the disease on the island.

The new confirmed cases are from the Health Districts of Marigot, Castle Bruce and Roseau, health officials said on Tuesday afternoon [28 Jan 2014], adding they are all local transmissions.

The island confirmed its 1st imported case of the disease on 16 Jan 2014. The infected person had a history of traveling to St Martin, according to officials.

Chikungunya is a viral disease that is spread by _Aedes aegypti_, which also transmits dengue virus, and the _Aedes albopictus_ mosquitos.
====================
[Since these 3 new cases are locally acquired, it indicates that transmission of chikungunya virus is occurring with a high risk of on-going spread.

A HealthMap/ProMED-mail interactive map showing the location of Dominica can be accessed at <http://healthmap.org/r/4cwR>. - ProMed Mod.TY]
Date: Thu 16 Jan 2014
Source: The Sun [edited]
<http://sundominica.com/news/chikungunya-comes-854/>

Officials of the [Dominica] Ministry of Health revealed today [16 Jan 2014] that those blood sucking mosquitoes, especially _Aedes aegypti_, are responsible for Dominica's 1st case of chikungunya fever. "We can confirm now as we speak ... that we have the 1st locally occurring case of chikungunya [virus infection] in Dominica," said Dr David Johnson, Dominica's chief medical officer at a press conference this afternoon. "It's a female with a travel history from St Marten."

Chikungunya [fever] is a viral illness that resembles dengue fever and it is spread by the bite of infected mosquitoes. The fever is characterized by severe, sometimes persistent, joint pain (arthritis), as well as fever and rash. The main difference between dengue and chikungunya [virus infections] is joint pain.

Chikungunya virus was 1st isolated from the blood of a febrile patient in Tanzania in 1953. Since then it has caused several human epidemics in many areas of Africa and Asia and most recently in limited areas of Europe. At the moment it has been discovered in the French Islands and in St Marten, among other countries of the Caribbean. However, it is not a life threatening disease. But the widespread occurrence of the fever causes substantial morbidity and economic loss.

"Most cases of chikungunya [virus infection] are going to be mild and the patient will recover without any major problems," Dr Paul Ricketts, Dominica's epidemiologist. "However, occasionally some patients can have a chronic form of the disease which involves continuing joint pains and listlessness that can go on for several months."

Since the person infected with chikungunya virus lives in Good Hope, the Environment Health Department has mounted a campaign against the _Aedes aegypti_ mosquito there, starting with fogging in the village tonight [16 Jan 2014] and on-going house inspection to destroy the breeding places of the mosquito.

Chief environmental health officer, Joseph Scotland, said another mosquito species named _Aedes albopictus_ is found to be a carrier of the disease, but that mosquito has not been found in Dominica.

Symptoms of chikungunya virus infection [include] fever, headache, fatigue, nausea, vomiting, muscle pain, rash and joint pain. The best precaution for chikungunya [virus infection] is the prevention of mosquito bites by using insect repellent and the wearing of long sleeves and pants. Preventative measures also include getting rid of mosquito sources in and around the house by emptying standing water from flower pots, buckets and barrels.

Though Ministry of Health officials are concerned about the possible spread, Dr Johnson said at the moment there is no need for persons to panic or to be scared. "There is no need for any alarm at this time," he said. "The person who was affected with the chikungunya disease has recovered and is at home doing well. We want to establish whether there are any cases of chikungunya [virus infections] in Dominica or whether the infected case has been transmitting the disease in Dominica."
====================
[This is a case where the infection was acquired on Saint Martin. So far, there have been no locally acquired chikungunya virus infections detected on Dominica yet. However, it does illustrate how the virus can more around easily, and does not bode well for the virus being contained on the islands where cases have been confirmed so far.

In an additional report published in the 17 Jan 2014 issue of the Jamaica Observer, Trinidad-based Caribbean Public Health Agency executive director, Dr James Hospedales, told the Caribbean Media Corporation (CMC), "the Caribbean is at risk; exactly what will happen in the weeks and months ahead we don't know because it has not been here before, but we are at risk"  (<http://www.jamaicaobserver.com/latestnews/Dominica-records-first-case-of-chikungunya>).

A map showing the location of Dominica can be accessed at
<http://www.worldatlas.com/webimage/countrys/namerica/caribb/dm.htm>. - ProMed Mod.TY]
More ...