La Chikungunya, la chiku...what?

Have you heard of this nasty illness that recently jumped the Atlantic and is spreading like wild fire through the Caribbean? CHIKUNGUNYA, aka, CHIKV. It is now spreading through the Americas.  In other words, it will arrive in your town at some point if you live in an area where the Aedes aegypti mosquito dwells.

This is mosquito is the same mosquito that carries dengue fever and urban yellow fever.  A significant portion of Southeast Asia, Africa, Central and South America, and all of the Caribbean are home to this little beast.  This mosquito is also found in the southeast United States.

The Dominican Republic, like the rest of the Caribbean, has faced the threat of dengue for centuries.  There is no vaccine, although scientists are working hard to develop one. But the medical community is very experienced in treating the fever in these areas.  ChikV is entirely new.  There has been a public information campaign and the medical community has guidelines for treating patients. Mosquito 

So what is this terrible new infection and how do you pronounce it?  In English, it is pronounced "chik-en-gun-ye."  Here in the DR it is pronounced "Cheek-oon-goo-ya."  Don't ask me what happened to the "N" when it got here.  It probably went the same way as half the Spanish "S's" "D's" on the island, caught by a tropical breeze and now floating somewhere over the ocean.

The scientific details of the illness are readily available at www.cdc.gov and www.who.int.  Here is what I have observed as I have watched ChikV rip through the villages where I work and knock down many of my friends in Jarabacoa.  After the first case in a neighborhood, people start dropping like flies.  The whole family may become infected within a week or so and on it goes from house to house.  So many people become ill that there is doubt that it is from a mosquito.  Surely it must be in the water or be spread like the cold, people tell me.  It is well known that the mosquito carries dengue.  But the outbreaks don't sicken the majority of an area like ChikV.  Why?  Because many people have had one or more types of dengue and are immune to the type in the current outbreak.  No one has immunity to ChikV.

Typically, people are sicken rapidly with chills, high fever, and joint pains. One friend left my house feeling fine and by the time she arrived home, 15 minutes later, she went straight to her bed with chills and pains.  She stayed there for 3 days straight.  The rest of the week she continued to be ill.  There is a nasty rash that arrives to further torment the sufferer.  The initial infection seems resolve after a week.  There are no medications that speed healing.  Acetaminophen is the only medicine prescribed or recommended here.  Patients are urged to see a doctor and have a blood test to rule out dengue, as many of the symptoms are the same.  It is a great blessing that very few people die from ChikV, even a 91 year old woman, Dona Maria, in El Montaña survived by spending several days in the hospital receiving palliative care.

Woe to anyone who has a chronic illness, especially arthritis, or anyone beyond the mid-forties.  They will suffer from joint pain and swelling for a month to years after they recover.  It is truly miserable and no one can predict how long it will last.  

I have sat with many of my friends or their family members and heard the tale of their illness and subsequent arthralgia.  I can relate as I have inflammatory arthritis.  This is essentially what ChikV sufferers face.  I have even heard people say that old surgery sites and injuries are particularly painful and swollen.

So we pray together for endurance, relief of suffering, and that ChikV would subside in the Dominican Republic and elsewhere.  Privately I pray earnestly that I will not fall victim as I already live with these symptoms.  So far our family has not been stricken.  We are vigilant about using DEET and thankful for screened windows!  Ultimately it is God's mercy that has spared us.