Date: Fri 14 Feb 2014
Source: Examiner [edited]
<http://www.examiner.com/article/chikungunya-cases-now-over-2-100-eastern-caribbean>

The outbreak of chikungunya illnesses in the Caribbean continued to grow, according to the weekly report by the European Centre for Disease Prevention and Control (ECDC) released 14 Feb [2014].

Combined with local media reports quoting government sources, the total number of confirmed and probable cases of this mosquito-borne illness has reached 2115. That is an increase of 662 illnesses (30 per cent) in the last week.

The French islands of the Antilles continue to be the centre of the chikungunya epidemic. Martinique is especially hard hit, with 844 cases and a 63 percent increase in illnesses in the last week.

The French side of St. Martin has now reported 653 cases and the smaller island of St. Barts [Barthelemy] 270. Guadeloupe has reported 253 chikungunya cases. The Dutch side of St. Martin [St. Maarten] has reported 65 cases, while English-speaking Dominica has 13. Aruba, Anguilla, and French Guyana are seeing imported cases thus far. The British Virgin islands reported no new cases this week and 6 for the entire outbreak. There have been no confirmed locally acquired chikungunya cases on the [central or south American] mainland.

Chikungunya (CHIKV) is a viral illness spread human-to-human through the bite of a mosquito. Until early December 2013, it had never been locally acquired in the Western Hemisphere. The illness was 1st discovered in French St. Martin and has spread from there.

Fox News discussed the potential for chikungunya to spread to the United States in an article on 11 Feb [2014]. Dr. Laura Harrington, a professor of entomology at Cornell University, told Fox: "We definitely should be concerned." The mosquitoes that carry the virus, _Aedes aegypti_ and _Aedes albopictus_, are already found in the United States. There is no vaccine for chikungunya [virus] and no cure.

Winter vacations, Caribbean cruises and upcoming spring break trips will be affected by the chikungunya outbreak to some extent. The Centers for Disease Control updated its watch for CHIKV on 6 Feb [2014]. The Public Health Agency of Canada updated its travel health notice on 12 Feb [2014]. Neither agency is urging travel restrictions at this time. Both suggest that preventing mosquito bites is the best strategy for preventing chikungunya [virus infections]. Mosquito repellents and the use of screens and netting in buildings are among their suggestions.  [Byline: Charles Simmins]
====================
[The economies of many, perhaps most, of these islands depend on tourism. If it becomes common knowledge that there is an exotic disease circulating in these localities, tourists may opt for other destinations, with unfortunate consequences for the affected islands. - ProMed Mod.TY]
Date: Mon 27 Jan 2014
From: Denis Malvy <denis.malvy@chu-bordeaux.fr> [edited]

A 28-year-old female residing in Chateauboeuf quarter, Fort de France, Martinique, from August 2012 to 28 Dec 2013 experienced an abrupt algo-eruptive fever on 2 Nov 2013 (week 44). Additional symptoms occurred on 4 Nov [2013] with incapacitating joint pain in knees, ankles, toes, wrists, fingers, and the left shoulder.

Fever and extensive cutaneous rash lasted for 4 days, but joint manifestations persisted over time. 10 weeks later, on 10 Jan 2014, she was admitted to our clinics because of persistent long standing severe limiting arthralgia located on similar joints. Laboratory investigation of the condition ruled out dengue virus infection whereas ELISA testing was positive for chikungunya fever specific IgM and IgG.

The serological features were consistent with a recent chikungunya [virus] infection and with the recent clinical history experienced by the patient. Of note, she denied any previous travel in Africa or Asia, nor in any other places in the Caribbean region, especially during the 2 weeks preceding the initial acute phase of sickness. Indeed the patient stayed in Martinique, mainly in Fort de France (mostly Chateauboeuf and Redoute, and sparsely Dillon, Centre-Ville and Sainte-Therese quarters), with sparse, short outings in the Lamentin and Trinite locations.

The spread of chikungunya in the Caribbean had been noticed in mid-October 2013 on St Martin island with the 1st 2 confirmed cases and accounts for the 1st known outbreak of chikungunya virus in the western hemisphere. Subsequently, 3 locally-acquired cases from Martinique have been noticed during week 50 2013 (mid-December). Thus, the case above, laboratory-confirmed from late serum sample analysis, is ascertained to be the 1st documented indigenous case of chikungunya occurring in Martinique.

The case has been reported to the regional health agency and local and national health authorities have been informed.
----------------------------------
Dr Denis Malvy, Dr Marie-Catherine Receveur, Dr Matthieu Mechain
Travel clinics and Division of Tropical Medicine - Clinical
International Health
Department of Infectious and Tropical Medicine
University Hospital Center
Bordeaux
France
<matthieu.mechain@chu-bordeaux.fr>
and
Dr Isabelle Leparc-Goffart, Dr Christine Prat, Dr Olivier Flusin
Arbovirus National Reference Center
IRBA (Biomedical Research Institute of the French Armed Forces)
Marseille, France
isabelle.leparcgoffart@gmail.com
====================
[ProMED-mail thanks Dr Denis Malvy and colleagues for this 1st hand report of the index case on Martinique.

A map showing the location of Martinique at can be accessed at
<http://healthmap.org/r/9Pud>. - ProMed Mod.TY]
Date: Mon 20 Jan 2014
From: ProMED-mail <promedmail.org>

The number of cases (7) listed for Martinique in the ProMED-mail post of 18 Jan 2014 (archive no 20140118.2181292) is incorrect. The case numbers (340 suspected, 127 confirmed) in the post of 20 Jan 2014 (archive no. 20140120.2184116) are correct.

ProMED-mail regrets the error and any inconvenience it may have
caused. - ProMed Mod.TY]

[A HealthMap/ProMED-mail map can be accessed at:
<http://healthmap.org/r/9Pud>.]
Date: Thu 19 Dec 2013
Source: Martinique 1 [in French, transl. ProMed CopyEd.MLI, edited]
<http://martinique.la1ere.fr/2013/12/19/2-cas-confirmes-de-en-martinique-95585.html>

On 19 Dec [2013], 2 cases of chikungunya were confirmed in Martinique, the 1st 2 cases reported in the department. The ARS [regional health agency] does not want to report which part of Martinique the 2 cases of chikungunya are from but advised people to protect themselves against mosquito bites and consult their doctor if they suffer from severe headaches, fever and joint pains.

On 6 Dec [2013], 115 and 145 cases, both [localities] in St Martin, were suspected [they did not say where in St Martin], of which 38 cases were confirmed.
-----------------------------------
communicated by:
Roland Hubner
Superior Health Council
Brussels
Belgium
<roland.hubner@sante.belgique.be>
Date: Sat 1 Jun 2013
Source: DOMactu [mach. trans., edited]
<http://www.domactu.com/actualite/135312243345124/martinique-cas-confirme-de-cholera-en-martinique/>

A man, aged 63 from Haiti, presented on Thursday, 30 May 2013, night at the emergency department of the CHU of Fort-de-France, in a state of dehydration. The tests quickly confirmed that he was suffering from cholera. So far, this does not imply the risk of an epidemic, according to the regional health agency.

The man was immediately placed in isolation room and was seriously ill as judged by doctors. The clinical signs appeared several hours after his aircraft landed from Port-au-Prince. Any contamination of other passengers on the flight is therefore excluded, according to the doctor.

Health authorities remain on alert for the people that would have been in contact with the patient upon his arrival in Martinique. But, for the moment, no disturbing symptoms have been reported.  [byline: Philippe Daniel]
=========================
[A HealthMap/ProMED map can be accessed at
<http://healthmap.org/r/3EpV>]
More ...