Cruise Season Concerns Over Outbreak

Before you head to the beautiful tropics for vacation this year, be aware of a recent report from the Centers for Disease Control and Prevention regarding transmissions in the Western Hemisphere of a little-known mosquito-borne virus called chikungunya.

The virus has now been identified in 17 countries or territories in the Caribbean and South America. The regions most affected are the Dominican Republic, Martinique, Guadeloupe, Haiti and St. Martin. From within the 17 jurisdictions, there were 4,400 laboratory-confirmed cases and 103,000 suspected cases as of late May—with the count almost doubling in the preceding two weeks.

So far, 28 cases have been reported in the U.S., and they are likely to increase. All but one were among travelers returning from affected areas, which ultimately means stateside transmission of the virus, which has no cure or vaccine, may also become an increasing concern. The virus cannot be spread directly from person to person, but if an infected person is bitten by a mosquito or mosquitoes, these “vectors” can easily transmit the virus to others.

Acute fever onset is a major symptom of chikungunya virus, as are chills, headache, sensitivity to light, rash, vomiting and severe joint pain. Treatment of the malaria-like virus includes rest, liquids and analgesics. The virus rarely leads to death; most patients see an improvement in symptoms in one week, though joint pain can last several months.

The best defense against the virus is to avoid mosquito bites. Chikungunya virus is a mosquito-borne alphavirus transmitted primarily by Aedes aegypti and Aedes albopictus mosquitoes, which also transmit dengue virus and are found throughout much of the Americas, including parts of the U.S. The CDC notes that, “Humans are the primary amplifying host for chikungunya virus.”

Though more than 95% of the cases have been reported from one of the five jurisdictions mentioned above, if you are traveling to the Caribbean or South America, use air conditioning or screens when indoors; outdoors use insect repellents or wear long sleeves and pants. The regions affected include Anguilla, Antigua and Barbuda, the British Virgin Islands, Dominica, the Dominican Republic, French Guiana, Guadeloupe, Guyana, Haiti, Martinique, Puerto Rico, Saint Barthelemy, Saint Kitts and Nevis, Saint Lucia, Saint Martin, Saint Vincent and the Grenadines, and Sint Maarten.

The World Health organization reports that chikungunya was first described in 1952 during an outbreak in the east African country of Tanzania. Since then it has been detected in about 40 countries across several continents.

Though hiking, snorkeling and various other outdoor activities, tours and specialty excursions are a big part of any island adventure, if you’re sole purpose is to get a little cardio in before hitting the buffet you may wish to workout indoors, where feasible. The hotel gym is a vector-free option, and many cruise ships have semi-enclosed running/walking tracks that will offer more protection than a trail run through the rainforest.

CDC Morbidity and Mortality Weekly Report, June 6, 2014, Vol. 63 No. 22, pp. 500-501, http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6322a5.htm

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