title: [Chikungunya: a challenge for the Dominican Republic's health services].
abstract: The Region of the Americas has been affected since December 2013 by a chikungunya epidemic for the first time. Although the first cases were recorded in the French Caribbean, the epidemic quickly spread to the Dominican Republic due to trade and people movements. The Dominican Republic, which shares the island of Hispaniola with Haiti, has a population of 10 million. This article contains information from a range of different publications and official documents about the chikungunya virus infection and epidemic. These papers were extremely helpful for guiding the response to the epidemic in the Dominican Republic and may also be useful for enhancing knowledge of the virus and responses among health workers elsewhere in the region. Particular attention is drawn to the important research undertaken in countries and territories affected by the epidemic in the Indian Ocean area. This is the case, for example, of the island of La Réunion, where the epidemic had an attack rate of more than 30% between 2005 and 2007. Researchers were able to identify risk groups, severe and atypical forms of the infection, cases of vertical transmission, chronic disease causing recurrent pain over three years, and directly- or indirectly-related deaths from the virus. Given its high attack rate, the chikungunya virus has emerged as an exceptional challenge for health ministries and calls for appropriate organized responses from the health services, prioritization of care for risk groups and patients exhibiting severe forms of the disease, and effective social communication and intersectoral actions.
authors.affiliation: Organización Panamericana de la Salud, Santo Domingo, República Dominicana, moyajose@paho.org.
authors.forename: José
authors.initials: J
authors.lastname: Moya
authors.affiliation: Dirección General de Epidemiología, Ministerio de Salud Pública, Santo Domingo, República Dominicana.
authors.forename: Raquel
authors.initials: R
authors.lastname: Pimentel
authors.affiliation: Centro Nacional para el Control de Enfermedades Tropicales (CENCET), Ministerio de Salud Pública, Santo Domingo, República Dominicana.
authors.forename: José
authors.initials: J
authors.lastname: Puello
mesh_terms: D000330:Aedes / Q000821:virology; D000818:Animals; D065632:Chikungunya Fever / Q000453:epidemiology* / Q000635:transmission; D004196:Disease Outbreaks; D018450:Disease Progression; D004293:Dominican Republic / Q000453:epidemiology; D006301:Health Services Needs and Demand; D006306:Health Surveys; D006801:Humans; D007303:Insect Vectors / Q000821:virology; D011159:Population Surveillance