ANTIGUA & BARBUDA HOTELS & TOURISM ASSOCIATION

Chikungunya Guidelines For Travellers Coming To The Caribbean

This document provides information on Chikungunya virus (CHIKV) prevention and preparedness for travellers coming to the Caribbean. This information is based on currently available scientific evidence and has been adapted and prepared for the Caribbean situation. Click here to view General Information on Chikungunya.

Background
Chikungunya is a mosquito-borne viral infection. Outbreaks have previously occurred in Africa, Asia, Europe, and the Indian and Pacific Oceans. Local transmission of the infection was found for the first time in the Caribbean in December 2013. Since CHIKV is new to the Caribbean, almost everyone in the Caribbean is susceptible to the infection and, as a result, CHIKV has now reached epidemic levels in many countries throughout the Caribbean. As of November 7, 2014 a total of 16,280 confirmed/probable cases and 760,791 suspect cases of CHIKV have been reported across the Caribbean region. CARPHA CHIKV updates can be found on the CARPHA website at: http://carpha.org/What-We-Do/Public-Health-Activities/Chikungunya

What is Chikungunya?
In the Caribbean CHIKV is transmitted through the bite of an infected Aedes aegypti mosquito. This is the same mosquito that transmits dengue virus. This mosquito prefers to feed during the daytime, but will feed indoors in the evening if the lights are on.

Symptoms of CHIKV may appear from 1-12 days (average 3-7 days) after being bitten by an infected mosquito. Primary symptoms may include an abrupt onset of fever frequently accompanied by joint pain. Other common signs and symptoms may include: muscle pain, headache, nausea, fatigue and rash. Joint pain usually only lasts for a few days, but the pain may occur intermittently for weeks, and in some cases, several month or years. Symptoms in many individuals are mild and may go unrecognized. In areas where dengue is endemic, CHIKV may be misdiagnosed as dengue.

CHIKV can NOT be transmitted by close or casual contact with an infected person (i.e., not person to person) or through the air, food or water. Infection with CHIKV is thought to provide lifelong immunity, so reinfection is unlikely. However, symptom relapse can occur in some individuals, most often 2-3 months after the initial infection.

Prevention Messages for Travellers coming to the Caribbean
There is no vaccine or treatment available for CHIKV, so prevention measures are essential.
All travellers are advised to:

• Stay informed about the CHIKV situation in countries they are travelling to.
• Prevent mosquito bites:
  • Use insect repellents on exposed skin. Insect repellents that contain DEET, Picaridin (also known as icaridin), oil of lemon eucalyptus (OLE) or IR3535 are the most effective and safe when used according to the label. If also using sunscreen, apply sunscreen first and insect repellent second.
  • Where possible, wear light coloured long-sleeved shirts and long pants, socks and shoes to minimize exposed skin.
  • When indoors use air conditioning and keep the doors and windows closed, unless they are screened, to keep out mosquitoes. If this is not possible sleep under mosquito nets to prevent bites.

What should you do if you feel sick and think you may have Chikungunya?

• Consult a healthcare professional if you are feeling ill, especially if you have a fever. If you have returned home, make sure to tell them about your travel to the Caribbean.
• Use acetaminophen or paracetamol to treat fever and pain.
• Get lots of rest and drink plenty of liquids.
• A person infected with CHIKV will have the virus in their blood for the first week of infection. The virus can be passed on to other mosquitoes if they bite you while you are carrying the virus. Therefore, be especially careful to prevent mosquito bites during the first week to avoid spreading the disease.

Note: CARPHA will continue to evaluate new information as it becomes available, and will update this guidance as needed.