Trans­lat­ing ‘chikun­gunya’ for is­land-hop­pers: Don’t let mos­qui­toes give you this bug

The Washington Post Sunday - - TRAVEL - BY AN­DREA SACHS an­drea.sachs@wash­post.com

On a trip to the Caribbean, you wake with a fever and achy, swollen joints that you can’t blame on too many piña co­ladas. You might suf­fer from a headache, mus­cle pain, nau­sea or a rash. All you want to do is crawl back into your ho­tel bed and hide in your her­mit shell.

Based on your symp­toms, you can rule out heat stroke and hang­over. A more likely di­ag­no­sis: the chikun­gunya virus.

“Peo­ple no­tice that they’re well one minute, and then they’re un­well” said Erin Sta­ples, a med­i­cal epi­demi­ol­o­gist at the Cen­ters for Dis­ease Con­trol and Preven­tion.

Last year was rough for is­land lo­cals and vis­i­tors. The mos­quito-borne virus, which first ap­peared in Africa in the 1950s and later spread to Asia, Europe and In­dia, didn’t sur­face in the Caribbean un­til late 2013. Then it made up for lost time. Since the ini­tial find­ings on the French half of the is­land of St. Martin, the Pan Amer­i­can Health Or­ga­ni­za­tion has tracked more than 1.2 mil­lion prob­a­ble cases in 44 coun­tries and ter­ri­to­ries through­out the Amer­i­cas. The CDC lists 25 Caribbean des­ti­na­tions — from An­guilla to the U.S. Vir­gin Is­lands — with in­stances of chikun­gunya.

“It was eas­ier to talk about is­lands that didn’t have cases,” Sta­ples said.

For­tu­nately, the virus has slowed its Carib-wide in­va­sion. Last year, for in­stance, Mar­tinique re­ported 73,000 cases; this year, the num­ber has dropped to 320. (One caveat: Be­cause of lapses in in­for­ma­tion, the counts are not ex­act.) The bug has been shift­ing its course to the west and south. In May, the CDC added Mex­ico, Cen­tral Amer­ica and South Amer­ica to its “Watch Level 1, Prac­tice Usual Pre­cau­tions” cat­e­gory. The Caribbean also made an ap­pear­ance.

De­spite the re­ced­ing fig­ures, chikun­gunya is still a threat, es­pe­cially among in­di­vid­u­als who have never con­tracted the virus. (As with chicken pox, once you have been in­fected, you are im­mune for life.) Vis­i­tors with health is­sues should also be vig­i­lant.

The mos­qui­toes that carry chikun­gunya are most ac­tive dur­ing the day — a de­par­ture from the maxim of dusk and dawn — and breed in coastal re­gions as well as wa­ter-filled con­tain­ers in res­i­den­tial ar­eas. The two species are less preva­lent in forested ar­eas, but hik­ers should still re­main on guard. The in­cu­ba­tion pe­riod lasts a few days, and the symp­toms typ­i­cally re­main for up to two weeks. There is no vac­cine or treat­ment, but to ease the dis­com­fort, Sta­ples rec­om­mends tak­ing ac­etaminophen (such as Tylenol), drink­ing liq­uids and rest­ing. She also stresses pre­ven­tive mea­sures. “Avoid mos­quito bites,” she said sim­ply. The best way to avoid chikun­gunya is to use in­sect re­pel­lent when­ever you are out­doors and to close win­dows and screens when you are in­side. For bug spray, the CDC rec­om­mends prod­ucts reg­is­tered with the En­vi­ron­men­tal Pro­tec­tion Agency, such as brands that con­tain DEET, pi­caridin and lemon eu­ca­lyp­tus oil. Sta­ples said to ap­ply the cream or to spritz it over your sun­screen and reap­ply as needed, based on the con­cen­tra­tion of the ac­tive in­gre­di­ents.

Keep­ing mos­qui­toes away has ad­di­tional ben­e­fits, such as re­duc­ing your risk of con­tract­ing West Nile virus, dengue fever and malaria — in­creas­ing your odds of en­joy­ing an ail­ment-free Caribbean va­ca­tion.

CEN­TERS FOR DIS­EASE CON­TROL AND PREVEN­TION

Chikun­gunya, a mos­quito-borne virus that has emerged in re­cent years in the Caribbean, causes fever and joint pain. Its car­ri­ers are ac­tive dur­ing the day.

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