The chikungunya epidemic that began in Dec. 2013 on French St. Martin continues to grow. A headline in the Sept. 28 Denver Post reads “Mosquito-borne virus chikungunya infects 1 million in the Americas.” The total number of cases officially reported is closer to 756,000 but there is a vast under-reporting of illnesses in many Western Hemisphere nations.
The Pan American Health Organization (PAHO) provides the largest amount of data on the chikungunya outbreak in the Americas, with its last report dated Sept. 26. Their report categorizes the illnesses reported from each country as suspected, laboratory confirmed and travel associated. The latest total from the PAHO is 749,136. Most of these cases are suspected chikungunya illnesses.
Laboratory confirmation is not being widely performed. It is expensive for many of the impoverished countries in Latin America. And, with no cure and no vaccine, confirmation is of little use to medical authorities in treating their patients.
There have been several notable local reports adding to the PAHO data. El Salvador has seen over 6,000 more suspected cases. Grenada is reporting 1,655 cases of chikungunya after reporting just five last week. Columbia is also now reporting a more current case total, with 2,300 new cases in the last week, a 350 percent increase in a week.
The Jamaican government is being heavily criticized by citizens, media and opposition parties over its handling of the spread of chikungunya on that island. The Gleaner reported on Sept. 26 that “Health Minister Dr Fenton Ferguson has said that a decision had been made to discontinue the announcement of confirmed cases.” The Jamaican Observer reported on Sept. 26 “Opposition Spokes-man (sic) on Health Dr Kenneth Baugh says that there is now a “full-blown chikungunya epidemic” in Jamaica, as in the rest of the Caribbean.”
The under-reporting of cases is most evident for Haiti. That government has not submitted a report on the number of chikungunya cases in Haiti for 12 weeks. At that time, it submitted a total of 64,709 illnesses.
Social media reports from the late spring and summer suggest that the number of chikungunya illnesses in that nation could be in the millions. A Sept. 12 new item from HaitiLibre quotes an unnamed Haitian government official as suggesting that half of the country’s population could contract the mosquito borne illness.
Martinique and Guadeloupe have seen large numbers of chikungunya cases. Based upon the latest PAHO data, 15.7 percent of the population of Martinique and 16.9 percent of that of Guadeloupe have contracted the illness in the last nine months.
The chikungunya outbreak in Puerto Rico continues to grow, as well. The PAHO shows that the commonwealth has reported 2,165 confirmed cases and has seen an additional 7,306 suspected cases. The illness was first reported in mid-May but large numbers of cases were not sent to the PAHO until early August.
The only locally acquired chikungunya illnesses in the continental United States, 11, have all been in Florida, the CDC report of Sept. 23 states. There have been 1,114 imported or travel-associated cases. New York, as the crossroads of the world, has the greatest number of imported chikungunya illnesses in 2014 with 259. Florida is second with 217. No other state has over 100 cases and five states have not reported any.