The number of chikungunya infections in an ongoing outbreak in the Caribbean region saw another steep rise last week, with the Dominican Republic again accounting for much of the new activity, along with Guadeloupe and Martinique, according to the latest update from the Pan American Health Organization (PAHO).
The total number of suspected and confirmed cases rose to 355,617, an increase of 48,780 from the week before, according to PAHO's Jul 11 update. Nearly 28,000 of the new cases were reported from the Dominican Republic, while new case numbers were not listed from neighboring Haiti, another outbreak hotspot.
Other areas that contributed sizable parts of last week's increase are Guadeloupe with 11,600 new cases and Martinique with 8,550, according to the PAHO report.
The European Centre for Disease Prevention and Control (ECDC) said in its communicable disease threat update today that most of the affected outbreak areas continue to report cases, "but the situation is particularly severe in the island of Hispaniola (Haiti and the Dominican Republic)."
Elsewhere, the first locally acquired chikungunya cases have been detected in Trinidad and Tobago, according to a Jul 13 report from the Trinidad Express newspaper. James Hospedales, MD, executive director of the Caribbean Public Health Agency, said the outbreak appears to be spreading to one new country per week, according to the report.
PAHO said the only US territory that saw a notable increase was Puerto Rico, which reported 177 more suspected or confirmed cases for a total of 405 so far.
The number of deaths held steady at 21.
Cases in Central and South America
In Central America, 96 more suspected or confirmed cases were reported, raising the area's total to 1,616, PAHO reported. All of those cases were reported in El Salvador. The country recently declared a national emergency to grapple with its spike in suspected cases.
Some South American countries with coastlines on the Caribbean Sea have also reported cases: Guyana, Suriname, and French Guiana. However, the only one reporting new cases is French Guiana, with 211 more than the previous week, pushing its total to 601, according to PAHO's report.
Some other areas of Central and South America are reporting suspected cases, and it's still unclear if the disease is confirmed or if the illnesses reflect local or travel-related transmission, the ECDC said.
Costa Rica has a confirmed case, but health officials still aren't sure if it's local or imported. Honduras is reporting suspected cases, and Venezuela is reporting 28 cases, but authorities haven't determined if all are imported.
In related developments, the number of imported cases in the PAHO region grew by 43 to 205, with Nicaragua and Paraguay on the case list for the first time. Most of the travel-related cases have been reported by the United States.
The US Centers for Disease Control and Prevention (CDC) said in a Jul 8 update that 138 imported cases have been reported in travelers so far. In typical year, the agency averages only 28 cases.
Jul 11 PAHO update
Jul 13 Trinidad Express story
Jul 14 ECDC communicable disease threat update
Jul 9 CIDRAP News story "US imported chikungunya cases climb to 138"