The case of Marie Therese Lindor helps explain why chikungunya is spreading so widely and rapidly through Haiti.
As she’s done so many times before, Lindor traveled from New York earlier this year to visit relatives in Haiti. But in May, about a week before she was due to return, she got sick.
“The fever lasted for four days,” Lindor says. “I sat down and couldn’t get up. My body and all of my bones hurt. The second day I was bedridden. I needed help to bathe.”
Lindor suspected chikungunya – a virus marauding through the Caribbean this year. Her symptoms were similar to those of many of her neighbors in Port-au-Prince who’d been told they had the disease.
Problem was, neither she nor they really understood how chikungunya spreads. Lindor has since recovered – but she still believes she got it from contact with infected people.
“If there are six people in the home and one person has it,” she argues, “they will infect everyone in the house.”
Wrong. As Jean-Luc Poncelet, a doctor with the Haiti office of the Pan-American Health Organization (PAHO) puts it: “There is no way that chikungunya can be transmitted from one person to [another] person directly.
“You must have a mosquito in between.”
Chikungunya is transmitted only through the bite of an infected mosquito. And the fact that Lindor and so many other Haitians are unaware of that is one of the reasons it’s been so hard to rein in the virus in the western hemisphere’s poorest country.
Florida has registered more than 50 cases of chikungunya. But in the Caribbean, where the outbreak began late last year, 265,000 people are reported to be infected.
Haiti has been ground zero, recording more than 47,000 cases. In the Dominican Republic, which shares the island of Hispaniola with Haiti, the situation is just as bad if not worse.
But containing chikungunya in Haiti presents more difficult obstacles. As Lindor’s case indicates, public information is one of the most urgent. Poncelet says he and groups like PAHO are working to fix that.
“Mostly [we’re doing it] through radio messages, television and [also] through community workers to inform the population as widely as possible,” says Poncelet.
Even so, Haitians like Vladimir St. Jean say Haiti is still too far behind the epidemic. And St. Jean has a certain credibility: He’s both a doctor and a patient who himself contracted chikungunya this year.
St. Jean, who has also recovered, says one of the biggest problems is that there simply aren’t enough resources in Haiti to test every suspected case.
“Public hospitals are treating patients just based on symptoms,” he says.
The most common of those are severe fever, joint and muscle pain and a rash. Chikungunya usually isn’t fatal, but officials have confirmed more than 20 deaths in the Caribbean related to the disease. Infants and the elderly are the most vulnerable.
St. Jean and his colleagues in Port-au-Prince recently tried to form a medical group to get better and faster help to infected communities.
“But unfortunately,” he says, “we couldn’t move forward because we didn’t have enough money. We asked for help from Haitian health officials, and they didn’t come through.”
SPRAYING AND DRAINING
Slowing the spread of chikungunya also means spraying for mosquitoes and draining standing water where they breed. But as St. Jean suggests, that’s not easy for a cash-strapped country like Haiti to do on such a massive scale – especially since it’s still recovering from a massive 2010 earthquake and a cholera epidemic that came soon after.
Though people can’t pass chikungunya to each other, health officials like Poncelet say one important thing to remember is that infected people can infect mosquitoes – here in Florida as well as the Caribbean. That’s why it’s critical, Poncelet adds, that South Florida officials keep people informed and take preventive measures.
“When you reach several thousand cases,” says Poncelet, “there’s nothing really that anyone on earth can do to stop it.”
Perhaps. But Haiti still has a chance to control it – if it does a better job of putting its own preventive measures between man and mosquito.
You can read more of WLRN's Latin America coverage here.