Mosquitos in st. Martin

[Karysa]

Good question. Perhaps when Chikungunya reaches Puerto Rico (if not already there), avoidance might be in order for people at risk of complications (>65 years of age or immune compromised). 400 million people are infected by Dengue each year, sometimes without obvious symptoms. There was a Dengue death in St. Martin in early December, 2013, right about the time the French health folks discovered the first Chikungunya infections there (coincidence? there are several symptoms these viruses have in common). Dengue has occurred in the United States, is endemic to Puerto Rico and tropical areas of South America and worldwide. the CDC advises: "When infected, early recognition and prompt supportive treatment can substantially lower the risk of medical complications and death." The Chikungunya virus is different: this outbreak involves a NEW virus to the Western Hemisphere that has a strong foothold in St. Martin (and likely elsewhere). It is "hot" in St Martin because the population has NOT been exposed to it before. Dengue and Chikungunya are carried by the same mosquito. The native population has not developed natural antibodies to Chikungunya virus. This has the disease control folks from France, Holland and the U.S. so concerned: from the first two cases discovered by the French on Dec 3, Chikungunya has been discovered on several other Caribbean islands in the past few days. Is this virus spreading quickly or has it been there and only recently discovered? - that is the real question. Its only host is primates and the Tiger mosquitoes spread this disease: they are most active during the day rather than dawn or dusk - they usually prefer shade, especially around trees. The CDC advises using strong anti-mosquito protections. The CDC does NOT say that such protections "prevent" the spread of this disease - they just might "reduce the risk" of being bitten by the Tiger mosquito. People over 65 years old, or the immune compromised, are at much higher risk of developing serious and potentially long-term complications from a Chikungunya infection.

 

I know people who had Dengue and they were not 65 or immune compromised and they were knocked off their feet for close to a week with it. Traveller's should be aware of Dengue and use deet to avoid getting bitten by Dengue carrying Mosquitos.

 

The spraying and attention that Chikungunya in St. Maarten has received is ultimately great for those of us who like to visit the island. This issue is being dealt with and not covered up.

[Karysa]

Also. The CDC recommends everyone going to St. Lucia / Barbados / and St, Kitts to get a Hepatitis A shot two to four weeks before traveling, as well as immunization against Typhoid and POLIO.

 

PR has the same alert ( most) traveller's should be vaccinated for Hepatitis A and Typhoid. So along with knowing about the large number of Dengue cases in 2012 (5000) and rising again in 2013 to 7000 reported cases would you be staying on the ship in PR?

 

PS if you check I would bet that most if not all of the Caribbean has the Hepatitis A notification.

Edited January 4, 2014 by Karysa

[InsideCruiser]

Health Canada has issued a Level 2: "Practise Special Precautions" advisory.

[wshaw859]

 

Can you provide the source for this? The CDC advisory still says 27 cases as of December 22, 2013.

 

IC

 

I apologize - my statistics underestimated the more accurate numbers from non-CDC European sources. This might help:

 

http://www.examiner.com/article/chikungunya-spreading-eastern-caribbean

 

"January 3, 2014

At least 131 cases of chikungunya have now been confirmed in patients living in the eastern Caribbean, according to the European Centre for Disease Prevention and Control in their report for the week ending Jan. 4. The mosquito-borne viral illness has been found on both the Dutch and French sides of the island of St. Martin, and on the islands of Guadeloupe, Saint Barthélemy and Martinique. One case, in a traveler from Martinique, has been diagnosed in French Guyana."

[wshaw859]

The spraying and attention that Chikungunya in St. Maarten has received is ultimately great for those of us who like to visit the island. This issue is being dealt with and not covered up.

 

Are any cruise folks returning this week from St Martin receiving warnings from their cruise lines? I wouldn't suggest that the cruise lines are "covering up" anything - it appears they failed to offer any warning (per the CDC) to their passengers on excursions to the hot zone (French side) during the week of December 18, 2013 - when there were eight cruise ships in port. However, I have spoken with Royal Caribbean in Miami this week and they express concern and appear to be acting in a responsible, proactive manner. Also keep in mind: on Dec 18, the Oasis of the Seas tanked up with 600,000 gallons of fuel for about $1.5 million on St Maartin.

[InsideCruiser]

Please don't link to media articles. They are in the business of sensationalizing every situation. Are you a journalist? :D

 

Remember the Carnival Triumph fire? :cool:

 

Please only link to official health websites.

 

The article does indeed state 131 cases in the eastern Caribbean. Yet the ECDC health site that the article links to cites 50 cases, of which 33 are in Saint Martin. You earlier stated 100 cases in Saint Martin.

[Karysa]

Are any cruise folks returning this week from St Martin receiving warnings from their cruise lines? I wouldn't suggest that the cruise lines are "covering up" anything - it appears they failed to offer any warning (per the CDC) to their passengers on excursions to the hot zone (French side) during the week of December 18, 2013 - when there were eight cruise ships in port. However, I have spoken with Royal Caribbean in Miami this week and they express concern and appear to be acting in a responsible, proactive manner. Also keep in mind: on Dec 18, the Oasis of the Seas tanked up with 600,000 gallons of fuel for about $1.5 million on St Maartin.

 

I will answer your questions once you answer mine regarding Dengue and PR.

[wshaw859]

Please don't link to media articles. They are in the business of sensationalizing every situation.

Please only link to official health websites.

 

The article does indeed state 131 cases in the eastern Caribbean. Yet the ECDC health site that the article links to cites 50 cases, of which 33 are in Saint Martin. You earlier stated 100 cases in Saint Martin.

 

I would suspect that you would then argue what an "official health website" actually was. No matter. Nitpick all you like - but you're NOT going to like the "sensationalism" as you read the statistical projections from previous Chikungunya epidemics from the "official health website" CDC publication: Preparedness and Response for Chikungunya Virus Introduction in the Americas". It states on page 14: "The attack rates in communities that have been affected in the recent epidemics ranged from 38%−63%." Given a population of over 74,000 (oops - not from an official health website), one can project the infection will occur in (about) 28,000 to 64,000 persons on St. Martin (not including the cruise ship passengers who bring home the bug). I would bet the CDC et al would lean towards the higher number of infections given the "virgin" nature of this population that has not been exposed to - and has no antibodies for - this virus until now. Now, is that sensational enough for you? Happy cruising!

[VIRGINIA ARTIE]

Why are posters after those submitting cautionary articles , and ridiculing those who don't want to get off the ship ?

We have been on the islands many times. We now cruise to be on the ship, not visit the islands. We don't cower in our suite when docked. I'm not getting off in PR because I've been there, done that.

I appreciate the news updates from wshaw859.

When people buy a lottery ticket they think that they will be the one out of millions that will win. Now people think that out of thousands getting off the ships, they will be the one NOT to get bitten.

Edited January 4, 2014 by VIRGINIA ARTIE

[wshaw859]

PR has the same alert ( most) traveller's should be vaccinated for Hepatitis A and Typhoid. So along with knowing about the large number of Dengue cases in 2012 (5000) and rising again in 2013 to 7000 reported cases would you be staying on the ship in PR?

 

Since you are asking (and insisting) on my answer, here it is: Dengue is endemic to PR. If Dengue had just arrived in PR in December and it was new to the Western Hemisphere - there is NO WAY I would go there. That's much different than the appearance of a virus that is new to the Western Hemisphere and is "hot" in St Martin. By "hot" I don't mean "sexy". Hot means this virus is burning its way through the "fresh meat", that is the local population that has no antibody protection against it. The CDC reports from other epidemics of the Chikungunya virus: "attack rates in communities that have been affected in the recent epidemics ranged from 38%−63%." Given a population of more than 74,000, how many people do you think might be attacked by this virus?

[Karysa]

Please don't link to media articles. They are in the business of sensationalizing every situation. Are you a journalist? :D

 

Remember the Carnival Triumph fire? :cool:

 

Please only link to official health websites.

 

The article does indeed state 131 cases in the eastern Caribbean. Yet the ECDC health site that the article links to cites 50 cases, of which 33 are in Saint Martin. You earlier stated 100 cases in Saint Martin.

 

Hey it hasn't been on CNN this morning so if they aren't sensationalizing it that is saying something!

[Karysa]

Since you are asking (and insisting) on my answer, here it is: Dengue is endemic to PR. If Dengue had just arrived in PR in December and it was new to the Western Hemisphere - there is NO WAY I would go there. That's much different than the appearance of a virus that is new to the Western Hemisphere and is "hot" in St Martin. By "hot" I don't mean "sexy". Hot means this virus is burning its way through the "fresh meat", that is the local population that has no antibody protection against it. The CDC reports from other epidemics of the Chikungunya virus: "attack rates in communities that have been affected in the recent epidemics ranged from 38%−63%." Given a population of more than 74,000, how many people do you think might be attacked by this virus?

 

With the pesticide bombing I have no idea now what that number will be. My guess is way less than it would have been without all of this publicity about the virus affecting St. Martin. Again, I think that this publicity is a good thing and not a bad thing. Time will tell though. If the numbers from one year to the next increase nearly 50% like they have with Dengue Fever in PR from 2012 to 2013 then I will be more concerned.

[58Piano]

I have a cruise in April with Royal Princess. They sent a notice saying there was a fever thru mosquitos. It starts with Cher something. So it is a fact.

Be careful if you are going to St Maarten anytime soon!

[Snow cat]

I would think that cruisers are responsible for arming themselves with information on their destinations, whether its for weather, diseases, and safety and security. I certainly don't think its the cruise lines responsibility to make sure I am adequately informed.

[wshaw859]

I have a cruise in April with Royal Princess. They sent a notice saying there was a fever thru mosquitos. It starts with Cher something. So it is a fact.

Be careful if you are going to St Maarten anytime soon!

 

This cruise line is acting responsibly. Go or don't go - at least you now have the information you need to make a rational choice to protect yourself.

[Froufie]

Thanks for the info on what happens if you do get the virus - I agree it is good to be 'informed' - however it is still probably a rarity if in fact you are bitten - so those that do wish to visit the island should at least be armed with DEET insect repellent and avoid times (dusk and dawn) and areas (standing water) where mosquitoes may gather.

 

I think cruise ships should also be advising their passengers but of course it is a personal choice, once taking into account the risk/benefit for YOUR particular situation,whether or not you wish to disembark and visit the island.

[wshaw859]

Thanks for the info on what happens if you do get the virus - I agree it is good to be 'informed' - however it is still probably a rarity if in fact you are bitten - so those that do wish to visit the island should at least be armed with DEET insect repellent and avoid times (dusk and dawn) and areas (standing water) where mosquitoes may gather.

 

I think cruise ships should also be advising their passengers but of course it is a personal choice, once taking into account the risk/benefit for YOUR particular situation,whether or not you wish to disembark and visit the island.

 

Actually, the Tiger mosquito is active during the day. The other mosquito that spreads Chikungunya virus is busy from dusk to dawn. This goes 24/7. Meanwhile this virus is already established in rodents, birds and other small mammals inhabiting the island. They're not going away either.

 

As to the "rarity", you might have missed the part where up to 63% of the island population is likely to be "attacked" by this virus. If you include the ever-changing cruise passengers who also populate the island, well … the numbers are in the tens of thousands (a very low estimate).

 

And guess what happens when the infected passengers return home to the US and elsewhere where their local Tiger mosquito is ready and willing to help spread this nasty bug?

 

Anyway, that's what the CDC says.

[Froufie]

I do hope your friend is okay - any news on his diagnosis/prognosis?

[wshaw859]

I do hope your friend is okay - any news on his diagnosis/prognosis?

 

He says his ankles are still inflamed and painful (still) and walking is a problem (stiff ankles). He also says he feels like crap, has headaches and is going to see an Ophthalmologist this week for the eye issues. More medical appointments are in progress. Oddly enough, his asthma has stopped and he has strange neurological issues with taste, smell and a "burning tongue". How bizarre. The research reveals that the increase of interferons in the body due to this virus attack may have something to do with the asthma going away.

[wshaw859]

With the pesticide bombing I have no idea now what that number will be.

 

Those infection rates of up to 63% of the population were observed while pesticide bombing was being undertaken.

[wshaw859]

It's not really a disaster until Wolf Blitzer covers it.:)

 

Or until you are infected after a mosquito bite.

[wshaw859]

I was on the Oasis of the Seas last month. The outdoor garden on the Oasis' Central Park is open to the outside and boasts a huge number of plants (thousands).

 

Has anyone noticed if RCCL is spraying their outdoor jungle when in ports like St. Martin where mosquitos are carrying diseases like Chikungunya and Dengue?

 

Just asking - I would suspect the likelihood of spreading these vectors to the ships is low given the fact that no standing water is in Central Park. But these bugs do love trees.

[wshaw859]

Elderly and pregnant women need to use caution:

 

"when intrapartum transmission occurs, it can result in complications for the baby, including neurologic disease, hemorrhagic symptoms, and myocardial disease. There are also rare reports of spontaneous abortions after maternal CHIKV infection."

 

http://wwwnc.cdc.gov/travel/yellowbook/2014/chapter-3-infectious-diseases-related-to-travel/chikungunya

[Karysa]

Let's look at the good news here folks:) We only have one poster posting that they believe that a cruiseship passenger contracted this virus from St. Martin and this was back on December 18th according to the poster. So therefore in the past 19 days we have not read that another cc member has been affected or knows of another cruiser or even vacationer who travelled to St. Maarten over this exceptionally busy holiday season that has become ill from a mosquito bite. CC members are known to share the positives as well as the negatives so to me the fact that we have only one cc member posting about such an experience is indeed comforting.

Edited January 6, 2014 by Karysa

[kbset]

Elderly and pregnant women need to use caution:

 

"when intrapartum transmission occurs, it can result in complications for the baby, including neurologic disease, hemorrhagic symptoms, and myocardial disease. There are also rare reports of spontaneous abortions after maternal CHIKV infection."

 

http://wwwnc.cdc.gov/travel/yellowbook/2014/chapter-3-infectious-diseases-related-to-travel/chikungunya

 

 

Oh great! :( we were planning on getting off the ship at the port, but now I think we'll probably just stay on since I am pregnant...I really hope this issue gets resolved soon! :mad: