A rash crawls up junior Molly Manske’s legs. It spans her stomach, her arms – almost her entire body. As the Dominican sun sets, she realizes this isn’t another false alarm. The limp in her left leg hasn’t gone away since the day before. At first she chalked it up to soreness from walking and hiking, but the feeling has only gotten more painful. Walking has become a challenge. This is what she has been afraid of since she arrived in La Lista, Dominican Republic, five weeks before.
Chikungunya, a viral disease transmitted by mosquitoes, is expanding itself within her bloodstream. For three days, Manske will be in bed with a fever and painful joint soreness, trademarks of the virus.
Manske is one of three East students who contracted the Chikungunya virus over the summer while volunteering in the Dominican Republic. The virus is quickly spreading throughout the Caribbean and the Central America. Upon their return home they were asked to be involved in a Centers For Disease Control (CDC) study in order to gain more information about the virus.
Juniors Will Bledsoe and Brittanie Whitney also contracted the virus.The three volunteers were working with the organization Amigos De Las Americas. Each volunteer lived with one host family for periods of four to eight weeks. The organization sends students to work in communities and start initiatives that offer improvement to the area. For example, Whitney started music programs for the youth of her community as well as put on day camps throughout her time there.
When Whitney arrived back on US soil at the Miami airport, a group of CDC officials met her and the other Amigos volunteers at customs and ushered them into a separate room. They were instructed to fill out a fifteen-page packet. Within the packet were questions regarding their use of insect repellent as well as the conditions they were living in. The CDC also took each volunteer’s blood so they could officially confirm each volunteer had contracted the virus.
While Whitney was living in her assigned community there was no official way to tell she had actually been infected with Chikungunya, since the CDC is the only agency that has the ability to test for it. Although she will not know for two more weeks if the virus was actually Chikungunya, she exhibited fever, rash and soreness, which the locals classified as Chikungunya.
Although Whitney believes that her Dominican community’s limited medical resources did not have an impact on her condition, she admitted that she was surprised at the reaction to Chikungunya in the states.
“It wasn’t a huge deal there,” Whitney said. “Here, it’s a lot bigger deal. But since everyone had it and everyone has it down there it just wasn’t a [big deal.]”
Upon arriving in the US both Manske and Whitney were surprised at the reaction of CDC officials. The packet, the blood test, it all seemed quite intense. Manske’s mom, Amy Schuman, immediately took her to the doctor since she was still having joint pain in both her hands and ankles.
“It got really bad almost a week after I got home,” Manske said. “Then it got noticeably bad, I couldn’t walk in the hallways.”
Her doctor suggested that she take multiple anti-inflammatories and the pain has since gone away. However, the CDC cautioned that each person infected with Chikungunya could experience joint pain for up to two years.
Sick or not, the volunteers were not permitted to communicate with their parents more than once during their stay in community with Amigos. Schuman said that when Manske called her, she had not yet gotten the virus, but she was aware of the threat.
“I knew a little bit about it, but it wasn’t really on my radar at that time,” Schuman said. “But it received a lot of press while she was down there, and so I read more and more about it…I worried every single day about her and her health.”
The Amigos organization isn’t the only group keeping close eye on the Chikungunya virus. University of Kansas infectious diseases doctor Lisa Clough said that although there are many more serious viruses across the world, Chikungunya has caught the medical community’s attention. The virus has, according to the CDC’s website, shown up on multiple continents, but was first detected in the Americas in late 2013. As of August 1, the Pan American Health Organization (PAHO) reported 508,122 suspected cases throughout the region, including 4,732 confirmed cases.
“Right now we’re impressed by the fact that it was only introduced to the Caribbean and Central and South America in December and how rapidly it spread,” Clough said.
According to her, climate change and less control of mosquito population compared to the United States were both contributing factors to the spread. In warmer, longer summers, mosquitos can grow and populate at a faster rate, increasing the chances of people contracting certain mosquito-borne illnesses. Whitney also noted that the medical knowledge within the community was low. Many of the people she was around did not believe that it was spread from mosquitos.
“They thought Africa started it to stop overpopulation,” Whitney said.
In addition, Whitney said local community lore regarding how the virus began included a theory that Chikungunya was started by neighboring country Haiti, or by the Japanese government. None of these theories are supported by the CDC.
Since it’s known that mosquitoes spread the illness both Clough and the CDC noted that there was a likelihood, especially in Southern states like Louisiana and Florida, the virus could spread further. As of August 26, 696 cases have been reported from the US. All but four of these cases have been from travellers like Bledsoe, Whitney and Manske returning home with the virus. However, the virus is only transmitted from human-to-mosquito rather than human-to-human contact. Clough said the reaction of the general public would be smaller than to something like Ebola or Middle East Respiratory Syndrome (MERS). Chikungunya is almost never fatal compared to some of the other infectious diseases spreading around the world today.
“I think that anytime there’s an infectious disease that’s new and introduced,” Clough said. “And has the potential to make people ill, it certainly raises level awareness and there is heightened anxiety because it makes us aware of how vulnerable we are as a population.”
Both Manske and Whitney knew about Chikungunya when they began their projects, and took precautions to avoid it. Amigos had addressed the virus in both emails and the briefing stages before they went on into their communities. The organization mainly focused on mosquito prevention in order to avoid contracting Chikungunya.
“Wear long-sleeved shirts and long trousers,” an email from Amigos read. “Use mosquito repellent…Reapply frequently, always sleep under your bed nets (we recommend ones pre-treated with insecticides).”
However, once both students arrived in their communities they realized that Chikungunya would be hard to avoid. While they slept under bug nets and applied insect repellent, both saw how it was affecting a majority of the communities. They began to see that it was only a matter of time before they contracted the virus. The blood the CDC took from them will soon confirm whether or not they were infected with the official strand of Chikungunya and will be used as research in the global health study of the virus.