The key to how quickly chikungunya reaches the continental US is Puerto Rico. In Florida, one of the top areas for imported dengue cases is PR. The road to the US passes through Puerto Rico for chikungunya. My best guess is that we will see locally acquired cases in the Commonwealth by May, and imported cases in Florida by August.
The discovery, in early December of 2012, that chikungunya was causing illnesses on the eastern Caribbean island of St. Martin came as little surprise to public health authorities. The nations of the Western Hemisphere have been expecting the mosquito-borne virus to make the leap to the Americas for several years. The only questions were when, and where.
NYS set up its own website and health insurance exchange. I was able to log in on Oct. 7 and submit an application. Since then, despite tweaks in the data on my part, the site continually tells me that the data it has from other sources does not match my data and I am not eligible to proceed to plan selection until I fix it.
The Department of Veterans Affairs (VA) is the cabinet-level agency responsible for caring for veterans of the United States military. One of the many tasks they are charged with is the provision of medical care, which is done through a network of hospitals, outpatient clinics and veterans centers. The placement of these facilities, especially the hospitals, may serve other interests than those of our veterans.
Dengue on Long Island and in South Texas once again point to my observation that West Nile is an indicator for the potential for other, more serious mosquito borne illnesses. Some of the mosquito species that carry West Nile also carry malaria, yellow fever, dengue and a host of other illnesses that we have yet to experience in our country.