Chickungunya

Chickungunya is a mosquito born viral disease that arrived in St. Martin in 2013 and has swept through the Caribbean in a major epidemic. You do not want it, infection results in a high fever and joint pain often headache, and sometime a really itchy rash. Most people will feel better in a week but in some, especially the elderly, the infection seems to manage to stay somewhat active and give joint pains that last months or years, and can be debilitating.

It is spread by Aedes Aegypti  and aedes Albopictus mosquitos. In the open these mosquitos bite by day especially at dawn and dusk, and are not usually a problem at night.  If they are living indoors however, they can bite at night also. Their flying range is limited about 400 meters for Aedes Aegypti   and 200 meters for aedes Albopictus. They need water to breed in but are adept at using water in old tires, tin cans, and bird baths. The primary way of dealing with this in a community is to clean up all small lying water sources. We have not really started that yet.

The mosquitos live for about a month. Unlike dengue, which needs humans for transmission, ChickV can also use rodents, which is unfortunate as rodents breed fast and may provide a stable reservoir for the virus even when a large part of the population is immune.  This could mean we may not get rid of this little scourge until either a vaccination is developed, or communities get very proactive at removing small sources of standing water.

Prevention consists of not getting bitten. The way to do this is to use plenty of mosquito repellent and follow the directions for when to reapply.  Also buy Permethrin and spray it on clothes and mosquito nets if you are using them.  It is effective for about a month and half even through half a dozen washings. It seems pretty safe, but follow directions!

There is no cure, though symptoms can be alleviated with acetaminophen, or paracetamol. Also for fever plenty of fluids with some salt and sugar. If joint pain continues you can consult a doctor about steroids. Infection does provide immunity.

Some people claim taking the juice made from crushing Papaya leaves helps (people also claim it cures cancer).  There is no scientific evidence of any of this, and on the face of it, it seems unlikely, however absence of evidence, is not evidence that it does not work. More troubling is that, although quite a few people use it, its toxicity to humans has not been tested, though mice can tolerate it. You should be aware Papaya leaves contain papain, a meat tenderizer. While most people can tolerate this is small quantities, some people can be very allergic to papain and it should not be taken by pregnant women as it may damage the fetus.  It should be avoided during breast feeding also. It may also interact with blood thinners to make them more active, which could be dangerous if you are taking these and mistake ChickV for dengue.

Dengue fever is spread by the same mosquitos, Dengue can be worse, especially if you catch it more than once (there are several strains). It seems something with your immune reaction from the first infection makes the dangerous hemorrhagic fever more likely in later infections. However, dengue tends to happen in much smaller outbreaks, and does not so often affect visitors.