Vector-Borne Diseases in the US Virgin Islands

Disease Overview

The US Virgin Islands have several endemic diseases, including dengue fever, chikungunya, and Zika virus, all transmitted by Aedes mosquitoes that breed in household water storage systems like cisterns 1
Dengue fever is transmitted by day-biting Aedes mosquitoes, particularly Aedes aegypti, and can progress to dengue hemorrhagic fever in severe cases, with management including supportive care, avoiding aspirin, and monitoring platelet counts and hematocrit 1, 2
Chikungunya is transmitted by Aedes mosquitoes, with an incubation period of 2-3 days, and clinical presentation including fever, severe joint pain, headache, and myalgia, with higher incidence observed among women and individuals aged 55-64 years 1
Zika virus is associated with microcephaly in newborns and Guillain-Barré syndrome, with clinical presentation including mild fever, rash, conjunctivitis, and muscle and joint pain, and management including supportive care 3
African Tick Bite Fever (Rickettsia africae) is endemic in the eastern Caribbean, transmitted by cattle ticks, with clinical presentation including fever, headache, myalgia, eschar at bite site, and regional lymphadenopathy, and treatment including doxycycline as the first-line therapy 1

The Centers for Disease Control and Prevention (CDC) recommends using insecticide-treated bed nets, applying insect repellents containing DEET, wearing protective clothing, and properly maintaining water storage systems to control vector-borne diseases 4
Travelers to the US Virgin Islands should take preventive measures against mosquito bites, consider appropriate prophylaxis if indicated, and be aware of symptoms and seek prompt medical attention if they develop, as advised by the World Health Organization (WHO) 5

For travelers returning from the US Virgin Islands with fever, a detailed travel history, including specific islands visited, activities, and duration, should be obtained, and laboratory testing should include complete blood count, dengue PCR, serology for dengue, chikungunya, and Zika, and consideration of thick and thin blood smears to rule out malaria if clinically indicated, as recommended by the CDC 1, 2, 5
All cases of dengue, chikungunya, Zika virus, and other notifiable diseases diagnosed in travelers returning from the US Virgin Islands should be reported to local health departments as per CDC guidelines, with a strength of evidence level of high 6