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Chikungunya Confirmed in Dominican Republic

                          - April 6, 2014

The Ministry of Public Health confirmed an outbreak of chikungunya virus [infection] in the Nigua municipality of San Cristobal province.

The Minister of Health, Dr. Freddy Hidalgo Nunez, stated that blood samples from people affected with fever and intensive joint pain were sent to the [USA] CDC and were positive for chikungunya virus. The official issued this information on Friday [4 Apr 2014] and said that Public Health sought laboratory assistance for virus diagnosis from the Centers for Disease Control in the United States in order to confirm the presence of the virus in the country.

Hidalgo Nunez said the Ministry of Health maintains and will intensify preventive measures in all the national territory to contain outbreaks of diseases transmitted by the _Aedes aegypti_ mosquito.

He recommended that the populace get into the habit of elimination of mosquito breeding sites and spread bleach above the water line in [water] tanks and other [water] recipients and cover them correctly. He also reminded people not to self-medicate.

He reiterated that there is no vaccine to prevent chikungunya [virus infection] nor are there specific treatments.

In January [2014], facing the possible introduction into the country, Health issued an epidemiological alert and put into action an inter-sectorial preparatory and response plan.

Communicated by:
Roland Hubner
Superior Health Council

[The confirmation of chikungunya virus infections in the Dominican Republic is not good news. The DR has a population of 9 445 281 (per national statistics, 2010) inhabitants. Dengue virus is endemic, indicating that the population of mosquito vectors is abundant enough to sustain outbreaks. This same vector population can transmit chikungunya virus as well, so the risk of ongoing transmission seems high.

The Ministry of Health Boletin Epidemiologico Semanal for week 12 stated ( that from week 7-12 in Nigua municipality, there were 767 patients with arthralgia and rash compatible with chikungunya virus infection. In the past week (12), there were 488 cases. Occurrence of cases of chikungunya virus infection have now been confirmed. A 1 Apr 2014 ProMED-mail post (archive no. 20140401.2371161) indicated that there were over 1000 suspected cases of chikungunya virus infection in the Dominican Republic as of 25 Mar 2014.

The Dominican Republic outbreak is another example of how the virus has been moving around the Caribbean Basin. The USA CDC considers that the this virus is a risk in the Americas more generally (see

The CDC has ongoing studies to look at different actual regional mosquitoes to assess their competency to transmit this virus, assessing species from the continental United States. In an interview, Dr. Erin Staples of the CDC indicated that "the Asian strain of chikungunya virus circulating in the Caribbean currently is preferentially transmitted by _Aedes aegypti_ mosquitoes. It can go into _Ae. albopictus_, but they are not a very competent vector for that strain currently." There is a map on the CDC website on the vector control fact sheet that depicts where both of those mosquito species are located in the United States currently If _Ae. albopictus_ in the USA becomes an efficient vector of the virus circulating in the Caribbean, the risk of infection would expand substantially. A study cited in the 1 Apr 2014 ProMED-mail post (archive no. 20140401.2371161) indicated that several strains of _Ae. albopictus_ could efficiently transmit the Asian strain of chikungunya virus.

A HealthMap/ProMED-mail map showing the location of the Dominican Republic can be accessed at - Mod.TY]

[1] Dominican Republic
Date: Fri 4 Apr 2014
Source: El Viajero [in Spanish, trans. Mod.TY, edited]

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