Knowledge and use of prevention measures for chikungunya virus among visitors - Virgin Islands National Park, 2015.
BACKGROUND
In June 2014, the mosquito-borne chikungunya virus (CHIKV) emerged in the U.S. Virgin Islands (USVI), a location where tourists comprise the majority of the population during peak season (January-April). Limited information is available concerning visitors' CHIKV awareness and prevention measures.


METHODS
We surveyed a convenience sample of Virgin Islands National Park visitors aged ≥18 years. Respondents completed a questionnaire assessing CHIKV knowledge, attitudes, and practices; health information-seeking practices; and demographics.


RESULTS
Of 783 persons contacted, 443 (57%) completed the survey. Fewer than half (208/441 [47%]) were aware of CHIKV. During trip preparation, 28% of respondents (126/443) investigated USVI-specific health concerns. Compared with persons unaware of CHIKV, CHIKV-aware persons were more likely to apply insect repellent (134/207 [65%] versus 111/231 [48%]; p < 0.001), wear long-sleeves and long pants (84/203 [41%] versus 57/227 [25%]; p < 0.001), and wear insect repellent-treated clothing (36/204 [18%] versus 22/227 [10%]; p = 0.02).


CONCLUSIONS
The majority of visitors surveyed did not research destination-related health concerns and were unaware of CHIKV. However, CHIKV awareness was associated with using multiple prevention measures to reduce disease risk. These findings underscore the importance of providing tourists with disease education upon destination arrival.
Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Center for Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, USA; Office of Public Health and Wildlife Health Branch, Biological Resources Division, National Park Service, 1201 Oakridge Drive, Fort Collins, CO, USA. Electronic address: ccherry@cdc.gov.
Cara C
CC
Cherry
Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Center for Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, USA; Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road NE CDC, Atlanta, GA, USA.
Karlyn D
KD
Beer
Epidemiology Elective Program, Division of Scientific Education and Professional Development, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA, USA; Arboviral Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, 3156 Rampart Rd, Fort Collins, CO, USA.
Corey
C
Fulton
Office of Public Health, National Park Service, 4030 Mackland Ave NE, Albuquerque, NM, USA.
David
D
Wong
Office of Public Health and Wildlife Health Branch, Biological Resources Division, National Park Service, 1201 Oakridge Drive, Fort Collins, CO, USA.
Danielle
D
Buttke
Arboviral Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, 3156 Rampart Rd, Fort Collins, CO, USA.
J Erin
JE
Staples
Virgin Islands Department of Health, 3500 Estate Richmond Christiansted, U.S. Virgin Islands.
Esther M
EM
Ellis
D000328:Adult; D000818:Animals; D065632:Chikungunya Fever / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission / Q000821:virology*; D002646:Chikungunya virus / Q000502:physiology; D009033:Culicidae / Q000821:virology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007303:Insect Vectors / Q000821:virology; D008297:Male; D000068316:Parks, Recreational; D011795:Surveys and Questionnaires; D014195:Travel; D014767:United States Virgin Islands / Q000453:epidemiology; D055815:Young Adult
Chikungunya virus; Health knowledge, attitudes, practice; Preventive measures; Travel; United States Virgin Islands