CARIBBEAN-PAHO urges increased surveillance amid chikungunya outbreaks and ongoing Oropouche cases

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Caribbean PAHO chikungunya Oropouche health alert
Health agency warns on chikungunya and Oropouche cases

WASHINGTON, CMC – The Pan American Health Organization (PAHO) on Friday called for reinforcing surveillance, clinical management, and vector control to address what it described as localized chikungunya outbreaks and the ongoing circulation of the Oropouche virus (OROV) in countries across the Americas, including the Caribbean.

PAHO said that the simultaneous presence of these and other arboviruses increases the risk of outbreaks, severe complications, and fatalities among vulnerable populations.

According to a new epidemiological alert from PAHO, the most significant chikungunya outbreaks in 2025 have been concentrated in South America, particularly in Bolivia, Brazil, and Paraguay, as well as in parts of the Caribbean.

It said that these are associated with the Asian and East/Central/South African (ECSA) genotypes, marking a shift in the pattern observed since 2014.

“Cases reported in the Indian Ocean region, Europe, and Asia also raise the risk of reintroduction and further spread into new areas with conditions conducive to transmission,” PAHO said, noting that as of August 9, this year, 14 countries in the region reported a total of 212,029 suspected chikungunya cases and 110 deaths.

In comparison, 2024 saw 431,417 reported cases and 245 deaths, indicating a decline this year, though localized outbreaks remain active.

Meanwhile, in the first seven months of this year, over 12,700 confirmed Oropouche cases have been reported in 11 countries.

PAHO stated that globally, chikungunya has been circulating for decades in Africa, Asia, and the Indian subcontinent. It was first detected in Europe in 2007 and arrived in the Americas in 2013.

Regionally, the Asian genotype predominated between 2014 and 2017. However, the presence of the ECSA genotype in at least four countries is concerning, as its cocirculation with the Asian type could enhance viral adaptation.

“Understanding chikungunya’s genetic lineages is essential to predict transmission dynamics and tailor public health responses,” PAHO said, noting that chikungunya follows a seasonal pattern with cases in the Southern Hemisphere typically rising in the first half of the year during the rainy season, while in Central America, Mexico, and the Caribbean, they usually increase in the second half.

In 2025, however, those regions have contributed minimally so far.

PAHO stated that traditionally, Oropouche transmission was mainly confined to parts of the Amazon; however, in 2024 and 2025, its spread has extended to previously unaffected areas, highlighting the need to bolster surveillance, particularly through the integration of spatial and temporal analysis and the use of geospatial tools to detect shifts in vector and case distribution.

Chikungunya is a viral disease primarily transmitted by the Aedes aegypti mosquito. Symptoms include high fever, rash, and intense muscle and joint pain, which can persist for months or even years, causing long-term disability.

Severe cases may progress to shock, meningoencephalitis, or Guillain–Barré syndrome. Young children, older adults, pregnant individuals, and persons with underlying health conditions are most at risk. There is no specific treatment, so prevention focuses on avoiding mosquito bites.

The midge Culicoides paraensis primarily transmits Oropouche virus, although the mosquito Culex quinquefasciatus may also play a role. It causes fever, headache, muscle aches, and sometimes neurological symptoms. There is no vaccine or specific antiviral treatment for this virus; care is symptomatic.

PAHO recommends enhancing early case detection and eliminating mosquito breeding sites in high-risk locations, such as schools and health facilities.

It also advises improving diagnosis using molecular methods, such as PCR, especially within the first five days of symptoms, and training healthcare workers in managing both acute and chronic cases.

For Oropouche, PAHO advised clinicians to include it in the differential diagnosis of dengue during the first week of symptoms and remain alert to possible neurological complications, such as meningitis and encephalitis, in later stages. Up to 60 per cent of patients may experience relapses. Therefore, ongoing monitoring and investigation of fatal cases are strongly recommended.

“Community engagement is essential for reducing mosquito populations. Promoting the use of repellents and window screens, alongside multisectoral approaches, is crucial. “Controlling Culicoides paraensis also calls for specific measures, such as draining temporary water bodies, removing stagnant pools, and clearing vegetation around homes to reduce breeding and resting grounds for the vector,” PAHO added.

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