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Epidemiological update: autochthonous cases of chikungunya fever in the Caribbean region and South America

05 Jun 2014
​On 6 December 2013, France reported two laboratory-confirmed autochthonous cases of chikungunya in the French part of the Caribbean island of Saint Martin. It is the first time that autochthonous transmission of the virus has been documented in the Americas.
An ECDC risk assessment of the outbreak published on 12 December 2013 concluded that the risk of the disease spreading to other islands in the Caribbean region was high. Since then, local transmission has been confirmed on the majority of the islands in the Caribbean and in South America (French Guiana and Guyana).
As of 4 June 2014, there have been more than 100 000 suspected cases in the region with at least 14 fatalities. Of the suspected cases, 4 182 were confirmed in the Caribbean region and 224 in South America.

Distribution of cases reported by country, 2014, as of 4 June
33 confirmed cases
Antigua and Barbuda
4 cases
1 imported case originating from Sint Maarten
1 817 suspected cases and 122 confirmed cases
Dominican Republic
38 639 suspected, 17 confirmed cases and one death
23 100 suspected and 1 328 confirmed or probable cases, one death
6 confirmed cases and 6312 suspected
29 200 suspected and 1 515 confirmed or probable cases, 9 deaths
Puerto Rico
1 confirmed case
Saint Barthélemy
520 suspected and 135 confirmed or probable cases
Saint Kitts and Nevis
22 confirmed cases
Saint Lucia
5 confirmed cases
Saint Martin (FR)
3 320 suspected and 793 confirmed or probable cases, 3 deaths
Saint Vincent and the Grenadines
110 suspected cases and 57 confirmed cases
Sint Maarten (NL)
325 suspected and 301 confirmed cases
Virgin Islands (UK),
20 confirmed cases
South America
French Guiana
222 confirmed or probable cases 74% of which autochthonous
2 confirmed cases
Outbreak still expanding
In addition to confirmed autochthonous cases, several countries have reported imported cases of chikungunya in patients with travel history to the affected areas: the US (Florida), Barbados, Trinidad, Chile, Panama, France and Italy.
The latest epidemiological data indicate increasing number of cases in most affected countries and that the outbreak is still expanding and reaching new areas. The chikungunya transmission was detected during a concomitant dengue outbreak in the Caribbean. Both arboviruses are transmitted by the same Aedes aegypti mosquito species. The naïve population, the presence of an effective vector in the region and the movement of people in and between islands and territories are factors that make it likely that the outbreak will continue to spread geographically and continue to increase in numbers.
The conclusions and recommendations of the rapid risk assessment published on 12 December 2013 remain valid.
Clinicians and travel medicine clinics should remain vigilant regarding imported dengue and chikungunya cases from the Caribbean, French Guiana and Guyana.

Local chikungunya transmission and imported cases in the islands of the Carribean region, French Guiana and Guyana

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