Caribbean chikungunya outbreak slows; total nears 190,000

Though the number of chikungunya cases in Caribbean countries continued to grow last week, topping 189,000 cases, the pace slowed as officials reported a steady trickle of imported cases in US residents who had traveled to affected areas.

The number of suspected or confirmed cases reached 189,055, reflecting 18,519 more cases than the previous week, according to a Jun 20 update from the Pan American Health Organization (PAHO). That increase is slightly more than half of the 35,139 new cases reported in PAHO's Jun 13 update.

Seven more deaths attributed to the mosquito-borne disease were reported, boosting the outbreak's fatality number to 21.

Latin Caribbean countries are hot spots

As for the past several weeks, the areas reporting most of the recent cases are Latin Caribbean countries, especially the Dominican Republic; suspected and confirmed cases reported in that country grew from 77,320 to 89,738 last week. No new illnesses were reported in neighboring Haiti, however.

More than 5,000 of the new cases were reported in Guadeloupe. Other Latin countries in the Caribbean that reported increases include Saint Barthelemy and the French part of Saint Martin.

No new cases were reported in the countries and territories in the non-Latin part of the Caribbean. Those areas reported most of the cases earlier in the outbreak soon after it began in December.

The European Centre for Disease Prevention and Control (ECDC) said in its latest communicable disease threat outbreak today that most areas continue to report cases, especially Haiti and the Dominican Republic.

The ECDC said Costa Rica reported its first confirmed case, though the report didn't specify if the infection was locally acquired or travel related. Media reports last week said over a thousand chikungunya cases were diagnosed locally in a part of El Salvador. The ECDC, however, said the cases still need to be confirmed.

Imported cases, US developments

In related developments, one more country in the Americas—Suriname—reported an imported case, according to PAHO. The number of imported cases in the region rose last week from 59 to 87, most of them in the United States.

The US Centers for Disease Control and Prevention (CDC) said in a Jun 17 update that the nation's number of imported chikungunya cases jumped to 57, from 38 the week before. The number of states reporting cases rose from 10 to 13 last week. The United States averages about 28 imported chikungunya cases a year.

Destinations for the US travelers sickened by the virus after their return home include Dominica, the Dominican Republic, Haiti, Indonesia, Martinique, and both the French and Dutch parts of Saint Martin.

Puerto Rico reported 23 locally acquired chikungunya cases, up from 1 the week before.

Since the CDC's Jun 17 report, at least three more states have reported their first imported chikungunya cases. A Minnesota pediatrician was sickened in Haiti where she had traveled to provide charitable maternity care, according to a Jun 16 Minneapolis Star Tribune report.

On Jun 19 the Oklahoma State Department of Health (OSDH) reported its first case, in a Tulsa County resident who had recently traveled to Haiti on a mission trip. And on Jun 20 the Georgia Department of Public Health (GDPH) noted its first case in a patient who was infected during a recent trip to a Caribbean nation.

See also:

Jun 20 PAHO update

Jun 23 ECDC weekly communicable disease threat report

Jun 19 CIDRAP News item "US chikungunya cases jump to 80 as Cuba notes first cases"

Jun 16 Star Tribune story

Jun 19 OSDH statement

Jun 20 GDPH statement

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