Virus Advances Through East Caribbean

By FRANCES ROBLES FEB. 8, 2014

MIAMI — A painful mosquito-borne virus common in Africa and Asia has advanced quickly throughout the eastern Caribbean in the past two months, raising the prospect that a once-distant illness will become entrenched throughout the region, public health experts say.

Chikungunya fever, a viral disease similar to dengue, was first spotted in December on the French side of St. Martin and has now spread to seven other countries, the authorities said. About 3,700 people are confirmed or suspected of having contracted it.

It was the first time the malady was locally acquired in the Western Hemisphere. Experts say conditions are ripe for the illness to spread to Central and South America, but they say it is unlikely to affect the United States.

“It is an important development when disease moves from one continent to another,” said Dr. C. James Hospedales, the executive director of the Caribbean Public Health Agency in Trinidad. “Is it likely here to stay? Probably. That’s the pattern we have observed elsewhere.”

Tracking Outbreaks

Reports of locally acquired Chikungunya virus as of January 2014

Chikungunya fever is particularly troublesome for places such as St. Martin, a French and Dutch island 230 miles east of Puerto Rico, where two million tourists visit annually. In an effort to keep the disease from affecting tourism and crippling the island economy, local governments began islandwide campaigns of insecticide fogging last week and house-to-house cleanups of places where mosquitoes could breed.

The French side of St. Martin to the north has had 476 confirmed cases, the largest cluster in all of the islands, while the Dutch side has had 40 cases, according to the Caribbean Public Health Agency.

Already, the travel search engine Kayak said there was a 75 percent decline in searches for St. Martin in the past three weeks, compared to the same period last year.

Searches for Martinique, which has had 364 confirmed chikungunya cases, were down 18 percent.

“When I read about chikungunya, I thought: ‘There’s a mosquito in St. Martin waiting for me, rubbing its little feet together waiting to get a hold of me,’ ” said Betsy Carter, a New York City novelist who was scheduled to travel to St. Martin with two other couples in January. “So we all decided not to go.”

Ms. Carter was particularly nervous, because she had contracted a different disease from a sand fly a few years ago in Belize, which caused half her hair to fall out. Despite having bought insurance, last month the three couples lost $9,000 they paid to stay at Dreamin Blue, a luxurious villa overlooking Happy Bay.

“The owners said they would spray the house,” Ms. Carter said. “But what if you want to leave the house?”

Public health and tourism officials on the islands are urging visitors to wear long sleeves and insect repellent high in DEET.

“Not a lot of bookings were canceled, but there were a few people not understanding exactly what this was, thinking it was a pandemic on a large scale,” said Kate Richardson, a spokeswoman for the French St. Martin’s tourism board. “People got a bit scared, and a few of them have declined to take their trips.”

She said the hotel association had not reported the number of cancellations.

Chikungunya (pronounced chik-en-GUN-ya) causes high fever and muscle pain, symptoms similar to those caused by dengue fever, which has swept the Caribbean for several years. While dengue can be fatal and chinkungunya rarely is, experts said the effects of chikungunya, such as pain in the small joints, tend to last longer, sometimes for months.

Ann M. Powers, a vector-borne disease specialist at the Centers for Disease Control and Prevention, said past outbreaks in other nations had incapacitated people because the pain in their wrists and ankles was so severe.

“They miss school and work,” she said. “It’s quite a drain on resources and the work force.”

Nora E. Kelly, an Ontario restaurant comptroller, is leaving for St. Martin on Sunday with a group of 28 friends who have tracked the disease closely and loaded up on insect repellent.

“It’s been a miserable winter,” Ms. Kelly said. “Chikungunya is not going to stop me from getting on that plane in a million years.”

The health ministry in Sint Maarten, the Dutch side of the Caribbean island, said no Canadian, European or American tourist at a resort had fallen ill.

“In order to keep the virus under control, various proactive steps have been taken and continue to be taken by both the Dutch and French authorities,” Lorraine Scot, a spokeswoman for the ministry, said in a statement.

Those steps include fogging, surveillance of suspected cases, biological lab investigations and a public-awareness campaign alerting people to the dangers of standing water, where mosquitoes lay their eggs.

The virus has also been detected in the British Virgin Islands, Dominica, French Guiana, Guadeloupe and St. Barthélemy.

“It certainly has the potential to move to a lot of other places in the Western Hemisphere,” Ms. Powers said. “All of Central America and big parts of South America would certainly be susceptible.”

The disease is not likely to spread to the United States, because it is carried by two species of mosquito that prefer warm climates.

Chikungunya was first identified in Tanzania in 1952. The name translates to “that which bends up” in the Kimakonde language of Mozambique.

According to the World Health Organization, since 2005, nearly two million cases have been reported in India, Indonesia, Malvides, Myanmar and Thailand.

An epidemic hit Northern Italy in 2007, and in 2006 thousands were sickened in Réunion, a French island east of Madagascar.

Correction: February 8, 2014
Because of an editing error, an earlier version of a picture caption misstated the name of a species of mosquito that carries Chikungunya fever. It is Aedes aegypti, not aegpyti.