A medical practitioner who was struck by a new mosquito-borne virus while working in Haiti is warning North Americans about possible long-term joint pain that comes from this virus, which is now quickly spreading throughout the Caribbean.
Dr. Jennifer Halverson, an emergency medicine specialist from Minnesota, spends three or four months a year in Haiti. She became ill last month while working at a maternity care hospital in Port Au Prince.
“My joints my shoulders, hips and knees were incredibly painful,” she says of the symptoms. “The first 48 hours were miserable … Even lifting my arm, lifting the covers on the bed was extremely painful.”
After a fever, Halverson’s mouth became inflamed with sores. Although those acute symptoms lasted only about four to five days, Halverson says she was left with what she calls “persistent arthritis symptoms” -- joint pain that continues to this day.
“Every day when I wake up, I limp,” she says. “I am still taking non-steroidal anti-inflammatories … to keep the symptoms under control.”
Chikungunya -- pronounced “chik-en-gun-ya” -- triggers a very painful illness. According to the World Health Organization, the name is derived from a word in the Kimakonde language of Tanzania, where the virus was first described in 1952. The word means "to become contorted."
The virus is already common in central and southern Africa and southern Asia.
It has recently spread to 17 countries in the Caribbean, including Haiti and Cuba, where the number of chikungunya cases now tops 189,000, according to the Pan American Health Organization. And as of last week, 80 cases of chikungunya have been reported in 13 U.S. states.
While no Canadian cases have yet been reported, doctors say it’s only a matter of time.
There are concerns that travellers returning from the World Cup in Brazil will bring the illness home with them as well.
Government reports indicate some 40,000 people have been infected with chikungunya in Haiti. But some doctors suspect the numbers are far higher -- likely in the millions.
Most cases aren’t counted because the test to distinguish chikunguyna from dengue fever -- another mosquito-borne disease -- isn’t readily available on the island.
Dr. Megan Coffee, an American infectious disease physician who has been living in Haiti since 2010, says she now finds it “surprising” when someone in Port-au-Prince says they haven’t had it.
“It's like in the old days when everyone just expected to get chicken pox … Almost everyone I know has had it,” says Coffee. “It will feel like their feet are broken, their legs are broken and their arms are broken.”
But the real concern is whether the joint pain will last a long time. Some patients recover quickly, but for others, it lingers for months.
There is no specific treatment for the virus, only supportive care like fluids and over-the-counter painkillers. In severe cases, steroids can help relieve joint pain and inflammation.
While chikungunya isn’t considered as deadly as malaria or dengue fever, it can still be fatal in about 1 in 1,000 cases -- mostly in the very young and the very old.
While in Haiti, Halverson cared for some babies infected during birth, noting that one infant developed seizures a few days after birth.
“This can be linked to poor development later in life,” she says.
Halverson says doctors need to be watching for symptoms of chikungunya in travellers returning from areas where the mosquito-borne virus is endemic.
The Public Health Agency of Canada first issued a travel notice about chikungunya in December, recommending that travellers protect themselves from mosquito bites when travelling to affected countries.
