Comments Off on Dominican Republic Chikungunya Virus
Right now if you plan on staying in the Dominican Republic the chances of you getting the Chikungunya Virus is very good. Well over ¾ of the people I know here have gotten the virus. Even after taking all the normal precautions it still gets passed around. If you are here for vacation and you are looking up information on how to treat it, sorry there isn’t much to do but take some pain medicine and wait it out.
However what you do while you are waiting it out can make a big difference on how comfortable you are and how long it lasts. Pushing through and remaining active will just complicate things and may even lead to more serious complication as you will see from the experiences I relate below.
The short answer for treating Chikungunya is: There is no real treatment; you just try to lower the symptoms. If you go to a hospital the first thing they will usually do is connect an IV and try to get you hydrated. With the IV they will often give you pain killers, vitamin B and also an anti-inflammatory.
While Chikungunya usually doesn’t kill, it is a very painful disease. It usually starts with pain in the feet or other joints like the knees although pain in the chest seems to be very common here too. Even for many days or even weeks after you may still have pain while walking. The initial part of the disease also seems to always come with headaches, usually the next day the fever comes. Fevers range from moderately low to dangerously high. If you start to get a high fever see a doctor immediately, usually they will give you an injection to try to lower the fever.
Untreated the fever usually last for 3-5 days. If you fever is relatively low, you can treat it with over the counter medicine. Rest will help keep the disease from getting worse and having further complications.
Emergency rooms usually try to treat the people with the highest fevers first. There have been times that people have flooded the emergency rooms and are crowded around outside waiting to get in. For this reason, it is often a good idea to try to find a clinic where you will have to pay instead of a hospital. The free hospitals are often very crowded, while the clinic emergency rooms which usually only cost $15-$30 to get checked out in remain relatively empty.
Once you get past the first stages there is a wide variance in the severity of the disease. I know of some that after a couple days were back on their feet only suffering from occasional back or other joint pain for the next couple weeks. However, most do not get by as easily.
One victim tried to remain active just knocking the fever down a bit with pills (after being immobile for a day). The fever returned accompanied by kidney infections, severe body and joint pain and skin eruptions.
These skin eruptions seem to be pretty common. Some people just get a rash other get canker sores in their mouth and one victim I know had it going down his throat. These sores can make it very hard to eat or drink. The skin eruptions often appear behind the ears and back of the neck or other warm location. One victim I know had the top of both feet covered with the sores, which lasted several days.
Victims often are bed ridden for several days, for older ones this can last for weeks before they start to gain strength.
Dominican Republic Chikungunya MosquitoThe same mosquito that is responsible for the spread of other diseases and viruses like Dengue Feaver and Yellow Fever also spreads the Chikungunya Virus. While you hear a lot of speculation in the DR about this being spread by human contact, this virus is pretty well documented as a mosquito born disease. That means if someone in your house is carrying the virus, gets bit by a mosquito, and then you get bit by the same mosquito there is a good chance you are going to get the disease.
So, preventing mosquito bites is the best preventative medicine. A common statement in the Dominican Republic is that you can always tell a foreigner lives in a house by the window screens. It seems Dominican just don’t like window screens even if they have the money to afford them (screen costs about 30 pesos a yard). However this is one of the best ways to avoid spreading the disease in your household. However at some point you have to go outside. That requires repellant for protection.
The CDC mentions 4 different types of repellant that works well, products with:
- DEET (Products containing DEET include Off!, Cutter, Sawyer, and Ultrathon)
- Picaridin (also known as KBR 3023, Bayrepel, and icaridin products containing picaridin include Cutter Advanced, Skin So Soft Bug Guard Plus, and Autan [outside the US])
- Oil of lemon eucalyptus (OLE) or PMD (Products containing OLE include Repel and Off! Botanicals)
- IR3535 (Products containing IR3535 include Skin So Soft Bug Guard Plus Expedition and SkinSmart)
If you are planning to also apply sunscreen it is a good idea to apply the sunscreen first and then the mosquito repellant over the sunscreen, this keeps the sunscreen from masking the scent of the repellant. Another alternative is to use a combination sunscreen and repellant like Bullfrog.
Well there isn’t much. If your symptoms are bad, go to the doctor for a shot for the fever and pain or IV for rehydration. Get plenty of rest, getting up too early just increases the chance of much worse complications. Get plenty of water or drinks like Gatorade to rehydrate. You can take various medicines like ibuprofen, naproxen, acetaminophen, or paracetamol, to relieve fever and pain. The doctors just prescribe higher doses of these and if needed other non-steroidal anti-inflammatory drugs (NSAIDs) to relieve acute pain and fever.
The initial fever usually lasts for 3-5 days and the victim is doing pretty well again in about 7. However a persistent joint pain can last for weeks of months after the fever drops. It is best to keep active in this period.
Chikungunya and Dengue
One of the biggest issues with NOT going to the Doctor to get checked out is the possibility that you have the far more dangerous Dengue virus instead of Chikungunya. In many ways the symptoms are the same, however Dengue can cause internal bleeding and even death.
Often when the hospitals are rushed with large numbers of victims they don’t do the blood test, they just assume that it is Chikungunya and usually they are right. However the same mosquito that transmits Chikungunya also transmits Dengue, and dengue is also pretty common here. It is a good idea to push for the blood test to make sure. Less rushed clinics usually will do the test as soon as you are admitted.
Should I cancel my trip to the Dominican Republic?
That is a tough question. If you group includes older ones or young children it might be a good idea to postpone it for a while. It does seem that the disease is on the decline although in my area it seems to be still going pretty strong. Likely in the tourist areas that are a bit cleaner (less water pooling for mosquito breeding), you have a good chance of having a successful and healthy trip if you keep applying the mosquito repellant.