Above: Malagasy plague specialists perform an autopsy on a potential plague rat.
We went to Madagascar in the fall of 2013 because the village of Beranimbo had been an epicenter of a black plague outbreak that resulted in nearly 600 cases and more than 90 deaths across the country. Madagascar reports the most instances of the disease in the world.
Read: The Hot Zone – Black Death Returns to Madagascar
Meet Chikungunya, a Highly Infectious Disease Slated to Hit the American South
In the southern United States, it’s that time of year again: Birds are chirping, the sun is shining, and thousands of baby mosquitoes are hatching in your weird uncle’s neglected swimming pool.
But this year there’s a new problem child: Aedes aegypti, otherwise known as the yellow fever mosquito. Typically brown with white markings, this mosquito is a highly aggressive biter, generally found in hot, humid areas like Mexico and Central America, and sometimes the American south. But this year, mosquito control managers were concerned to find a bunch of Aedes aegyptias as far west as southern California, and they’re multiplying quickly. The female of the species lays up to 200 eggs several times a season, just above the water line in containers of standing water.
Aedes aegypti is the perfect vector for a handful of frightening tropical diseases, including yellow fever, West Nile virus, and dengue fever. But they’re also a great transmitter of a little known virus that’s been popping up in the Caribbean this year: Chikungunya.
Chikungunya is an acute virus transmitted from the bite of an infected mosquito. It’s not usually fatal, but it causes acute fever, joint pain, and rash. What’s scary is that it has a strikingly high rate of epidemic—up to 50% of potential human hosts will contract the disease when bitten. And of those, around 10% will have persistent arthritis in the smaller joints for up to three years. There’s currently no vaccine to prevent or medicine to treat the disease—the best thing we’ve got is bug spray.
In late 2013, the virus was found for the first time in the Americas, on islands in the Caribbean. More than 5,900 suspected cases of chikungunya have been reported in the Caribbean and South America since December 6. The Public Health Ministry of the Dominican Republic recently reported 3,690 suspected cases in the San Cristobal province alone. Although this may not sound as bad as a disease like Ebola (which kills you through internal hemorrhaging in your gastrointestinal tract), a full-blown outbreak of chikungunya, replete with hundreds of southerners experiencing long-term arthritic symptoms and fever, would take a serious economic toll on the isolated rural areas of the deep south.
So, on to the question: How worried should we be about this particular disease? I called up Dr. Tim Brooks at the Rare and Imported Pathogens Department of Public Health England (PHE). He’s been helping to run the main UK referral center for the disease out of the PHE office, so I figured he’d be able to tell me whether or not you should cancel your upcoming vacation to New Mexico.
Health workers identifying chikungunya in a patient after the disease traveled to the south of France via a tourist. Photo courtesy Valentin Pezet, Jules Foulongne, and Nicolas Gueniot
VICE: So what exactly is Chikungunya? What is it named for?
Dr. Tim Brooks: Chikungunya is a disease that’s pretty much had its day, but it comes around every so often. Its name translates to “that which bends up,” because the biggest problem with the disease is the arthritic debilitation that follows the infection. It’s also got a fascinating history: Chikungunya was first pinned down in Tanzania in 1952, but historical accounts appear across Asia and Africa as early as 1779. Historically, outbreaks began in the Indian Ocean Basin, and it’s been able to travel very successfully since then.
What are the symptoms exactly?
Normally chikungunya presents with joint pains, a rash, and acute fever, followed by all the other symptoms you associate with high fever: headache, diarrhea, back pain. The main problem is the arthritic pain, which does not go away for maybe 10% of patients. It can persist for up to three years, and is very debilitating. It tends to affect the smaller joints, causing local swelling and pain. Once you’ve got it, you’ve got a lifelong immunity to it, but it will generally infect a large portion of the population, move on, and then disappear until the next generation comes up.
Meet the Guy Who Accidentally Shot Himself in the Heart with a Nail Gun
Getting a two-inch splinter while sanding plywood is a drag. Smashing your thumb into gooey pulp with a hammer is also a drag. But accidentally shooting yourself directly in the heart with a fucking nail gun is the sort of thing that makes you stop and wonder what the hell you’re doing with your life, and why you’re anywhere near a situation where that’s even possible.
Eugene Rakow is a 58-year-old self-employed carpenter living in St. Bonifacious, Minnesota. Don’t feel bad if you’ve never heard of it—a 2010 census set the town at just 2,283 people. This past Friday, Eugene was helping his neighbor build a deck when he made a little mistake, and accidently fired a three-and-a-half inch galvanized framing nail directly into his heart. Worse still, Eugene doesn’t have health insurance, and he’s got seven kids, all home-schooled. Luckily, his daughter Naomi has set up a Paypal accountwhere people can donate to help him pay the bills.
The whole thing became a bit of a local story, and I’m fascinated with the macabre, so what the hell. I hit up Naomi on Twitter and she actually got back to me, and was really, really nice, especially considering that her dad just went through the scariest thing that could happen in professional carpentry. I wanted to know what it felt like to fire a nail into your own heart, so I gave Eugene a quick call. He turned out to have more bravery in one little punctured chamber than I probably have in my whole body.
VICE: Hi Eugene. So I read in the Minnesota Star Tribune that you’re the guy who shot himself in the heart with a nail gun.
Eugene Rakow: Yes. Well, I was building a deck for a neighbor, and I was driving in nails at about chest-level. I was pushing the nail gun up, and my arms were in the air. Then the gun bounced and hit me, and just sort of shot a nail right into my chest.
I don’t understand. Did it bounce out of your hands?
No, not quite. It bounced up in the air and I caught hold of it. When the weight of the gun came back down it hit me in the chest, but I still had my finger on the trigger.