I had an inquiry today about the safety of travel to Caribbean destinations on cruises. The person was concerned about Chikungunya and whether a spouse with health problems should risk taking a Caribbean cruise. The answer is that Chikungunya is a risk if you decide to go ashore on most of the Caribbean islands. If you are planning a trip to warm Caribbean waters, don’t necessarily cancel your plans; but you should arm yourself with the information to know the risks.
The Centers for Disease Control still rate travel to the Caribbean at Watch Level 1, which simply means to “Practice normal precautions” (Watch Levels 2 and 3 are “Practice enhanced precautions” and “Avoid unessential travel”). As of mid-August the CDC listed 25 countries (islands) with active cases of Chikungunya. It is not recommending against people traveling to these countries, but urges travelers to the Caribbean to “protect themselves from mosquito bites”.
The CDC adds that some travelers may be more likely to get chikungunya, have severe disease, or be at higher risk for other reasons. If you fall into one of these high-risk groups, you are encouraged to discuss your travel plans with your doctor. Examples of high risk includes people with arthritis, high blood pressure, heart disease, late term pregnancies, people over 65, and others. If you are planning to spend much time outdoors, or sleep in locations without air conditioning or mosquito screens, you should also expect to be at higher risk.
From last December 2013 to August 29th, there were 659,367 cases of Chikungunya in the Americas. The most heavily infected nations include the Dominican Republic, Guadaloupe, Haiti and Martinique. Cases are also present in El Salvador and some other central American countries. Many Caribbean countries have had only very low numbers of cases, so check out this article and graph to see where risk is highest.
Chikungunya is rarely fatal, but is a potentially debilitating and unpleasant mosquito borne disease. Symptoms include fever and joint pain. It is carried by container-breeding Aedes mosquitoes that are especially common in cities. See this link for more information about insect repellents.