Rapidly Evolving Outbreak of a Febrile Illness in Rural Haiti: The Importance of a Field Diagnosis of Chikungunya Virus in Remote Locations
Vector Borne and Zoonotic Diseases
Although rarely fatal, Chikungunya virus (CHIKV) infection can lead to chronic debilitating sequelae. We describe the outbreak of suspected CHIKV in 93 subjects who presented voluntarily over 2 months to a remote rural Haitian general medical clinic staffed by international healthcare providers. Diagnosis was made on clinical signs and symptoms, as no serum analysis was available in this remote rural site. The subjects were 18.0 ± 16.2 (median±standard deviation) years of age and were of
... and were of similar gender distribution. The presenting vital signs included a temperature of 102.3°± 0.6F with fever lasting for 3.0 ± 0.7 days. Symptoms mainly consisted of symmetrical polyarthralgia in 82.8%, headache in 28.0%, abdominal pain in 17.2%, cough in 8.6%, maculopapular rash in 30.0%, and extremity bullae in 12.9%. In 84.9% of subjects, symptoms persisted for 7.1 ± 8.3 days with 16.1% having ongoing disability due to persistent pain (≥14 day's duration). There were no deaths. In Haiti, especially in remote, rural regions, the risk for CHIKV spread is high given the shortage of detection methods and treatment in this tropical climate. Preventative efforts are similarly lacking. Implications for a global public health impact are likely with outbreak extension and spread to neighboring countries.