Caribbean - Chikungunya Virus

Introduction

Club correspondents Steers/Cariconsult International, Bridgetown, Barbados have advised the Club of an ongoing outbreak of Chikungunya virus in the Caribbean.

The Chikungunya virus is transmitted by two types of infected mosquito, aedes aegypti and aedes albopictus, which are easily identified by white bands on their legs. Chikungunya is not fatal, but the symptoms can be severe and debilitating. There is no vaccine, therefore treatment is aimed at relieving the symptoms.

The World Health Organisation reports that between December 2013 and March 2014 there were 8,000 suspected cases of Chikungunya in the Caribbean region. The islands affected are Anguilla, Antigua and Barbuda, British Virgin Islands, Dominica, Dominican Republic, Grenada, Guadeloupe, Haiti, Martinique, Puerto Rico, Saint Barthélemy, Saint Kitts and Nevis, Saint Lucia, Saint Martin, Saint Vincent and the Grenadines, Sint Maarten and the Turks and Caicos Islands.

Symptoms

Symptoms are similar those of Dengue Fever and usually appear between four and eight days after being bitten by an infected mosquito. Typical signs include fever and joint pain, sometimes accompanied by muscle pain, headache, nausea, fatigue and a rash. The symptoms usually last a few days but in some cases may last for weeks. Subject to medical advice, sufferers are generally advised to drink plenty water to prevent dehydration and take medicines such as paracetamol to relieve fever and pain.

Precautionary Measures

Mosquitoes tend to bite between dawn and dusk, with possible peaks of biting activity in the early morning and late afternoon.

Mosquitoes breed in water; therefore higher concentrations of mosquitoes may be expected in and around still water areas, even small puddles of rainwater. To discourage mosquito activity, containers such as buckets holding standing water should be emptied, covered or removed, and any areas of standing water on deck should be brushed away.

When going outside during daylight hours bare skin, particularly arms and legs, should be covered with light coloured, loose fitting apparel; mosquitoes are attracted to dark clothing and can in some cases bite through tight clothing. A suitable insect repellent containing DEET should be applied to any exposed skin, following the manufacturer’s instructions and re-applying it regularly as sweat will reduce its effectiveness over time. If sun screen is also being used, this should be applied first.

Vessels visiting ports in the affected islands should ensure that the air conditioning is in use and close all external doors, windows and ports including any mesh screens. Where practicable, air vents in the accommodation should also be shut. Any mosquitoes spotted inside the accommodation should be eradicated, ideally using a knockdown insecticide spray.

On ships not equipped with air conditioning, external doors and all open windows and ports should be fitted with mesh screens. Bed nets should also be used, ensuring that they are well tucked in and there are no mosquitoes inside before going to sleep. Bed nets should be soaked in a suitable insecticide every six months and regularly inspected for holes and tears. As an additional precaution, indoor residual insecticide may be sprayed over internal areas as its effectiveness can last for over 3 months depending on the insecticide used and the type of surface on which it is sprayed. However, checks should be made to confirm that aedes aegypti and aedes albopictus mosquitoes are not resistant to the proposed product.

Further information on the Chikungunya virus may be found on the World Health Organisation’s website. Members requiring any further guidance should contact the Loss Prevention department.