By Frank Martínez, Arleen Rodríguez Derivet, Claudia Fonseca Sosa, Yilena Héctor Rodríguez, Frank Martínez Rivero on November 21, 2025 from Havana
At the start of the nightly Round Table on the impact of arboviruses on the health of the Cuban population, Dr. Ileana Morales Suárez, National Director of Science and Technological Innovation at the Ministry of Public Health (Minsap), reported that chikungunya presents a dynamic picture in 2025, with very high transmission rates in 40 countries worldwide.
The director pointed out that this disease, like COVID-19, shares a common factor: a vector that produces “a significant number of serious cases and, in some cases, deaths.” She explained that its appearance and spread in Cuba are due to global triggers.
Among these factors, she identified, first of all, climate change. “High temperatures directly influence the vector. The hotter it is, of course… the heat, the humidity,” she said. Secondly, she mentioned the high level of urbanization that exists both globally and in Cuba. As a third element, she highlighted the high population mobility, citing the example of COVID-19: “it started in one place in China and within days and then months it was all over the world.” The fourth factor is the presence of “a vector capable of transmitting the disease with a high presence in many countries.”
Dr. Morales Suárez explained that specific conditions in Cuba added to the global factors. The country had “a high level of susceptibility. We were all susceptible because we had not been exposed to the vector.” She explained that the epidemic is caused by a “coalition” where the vector and a particularly vulnerable population converge.
This vulnerability, she added, is due to “a highly aged population, where practically one in four Cubans is 60 years of age or older. Generally, older adults have one, two, or three diseases.” Added to this, she said, are environmental problems that facilitate the reproduction of the vector: “poor hygiene… accumulated garbage, standing water… and other practices.”
“When these four factors come together, they produce a collision,” he summarized. “So, here we found this highly susceptible population and, obviously… we have high numbers of disease incidence.”
However, he pointed out that they are facing a known pathology for which there is a protocol for action, similar to the strategy followed with COVID-19.
Following the working model implemented during the COVID-19 pandemic, the Innovation Committee was reactivated.
“From here, the committee is activated… with tremendous frequency and tremendous speed, just as with COVID,” said the director. This mechanism guarantees “scientific rationality” for intervention and study proposals, always respecting ethical and regulatory components.
Showing a record, she reported that “five new research projects were approved this week and we have new research in preparation.” These include “new product development, clinical studies, clinical trials already proposed, complex health interventions,” and research to better characterize the behavior of the virus in Cuba.
The first health interventions will focus on older adults and will begin in Havana, stratified by the epidemiological situation in each municipality. An immediate intervention will be “the application of Biomodulina T to older adults between 70 and 74 years of age.”
At the same time, flu vaccination will begin for those over 75 in the capital, as well as for residents of social and health institutions. “We decided that we would cover the 70 to 74 age group with Biomodulina,” she explained.
Another planned intervention is with the product Curmeric, which “will be given to a population group in Havana… aged 60 to 69.”
All these interventions will be accompanied by studies to collect data on their effectiveness.
Dr. Morales Suárez called on the population to avoid self-medication and to seek health services. “Medical evaluation is irreplaceable,” she stressed. “You can read a leaflet, medical information, but the doctor’s eyes, the doctor’s examination… not all patients are the same. So, not everyone has the same risk.”
She warned of the dangers of self-medication based on information from social media: “That has its risks and can even be life-threatening… there are people at high risk who are staying at home and their lives are in danger.”
Regarding the protocols for action, he reported that an improved version (protocol 1.2) is now available, incorporating the knowledge accumulated in recent months, including strengthened sections for pediatric and neonatal care. Current work is focused on strengthening the management of the chronic phase of the disease. “The rehabilitation section, the chronic part, is the one that will undergo the most change. Because that is where we are focusing most of our efforts on what we can do for the number of patients who may reach that phase,” he concluded.
At another point in the Round Table, Dr. Osvaldo Castro Peraza, an expert from the Pedro Kourí Institute of Tropical Medicine (IPK), explained that chikungunya has more visible and widespread symptoms than other arboviruses. “For every 10 or 15 cases infected with dengue, one has symptoms; in chikungunya, for every 10 cases infected, nine manifest the disease,” he said. That difference, he insisted, causes “a significant number of cases” and increases the magnitude of outbreaks, which can occur in multiple forms, including severe ones.
The specialist emphasized that this is not a disease that ends in seven or fifteen days, but rather continues its inflammatory course, affecting the joints and potentially compromising multiple organs.
Among the characteristic symptoms, he mentioned that chikungunya fever “is one of the highest among arboviruses,” may be preceded by joint pain, and is accompanied by incapacitating arthritis “that symmetrically affects virtually all joints.” Added to this are skin rashes, conjunctivitis, and lymphadenopathy in some cases.
As part of the most serious manifestations, the doctor warned that neurological problems such as meningoencephalitis, myelitis, and Guillain-Barré syndrome may also appear, as well as cardiovascular complications.
“A chikungunya patient must rest because their organs are damaged. If they engage in physical activity, they are at risk of arrhythmia or other cardiovascular events,” he said.
Other possible complications include liver and kidney damage, hemorrhagic episodes, and severe skin lesions.
Castro Peraza insisted that self-care begins with individual responsibility: seeing a doctor and avoiding physical activity during the acute phase. “When joint symptoms are less debilitating, we tend to be more daring with our activities. And that should not be the case,” he warned.
Regarding clinical progression, he explained that the acute phase lasts from the first day to the third week. This is a period of active inflammation, so the patient requires close monitoring and, in many cases, home care.
Older adults who live alone or have comorbidities, infants under one year of age, pregnant women, and those with a high fever lasting more than three days, moderate or severe dehydration, decompensation of comorbidities, behavioral disorders, disorientation, or inability to care for themselves should be hospitalized.
The sub acute stage, lasting from three weeks to three months, maintains joint inflammation without severe symptoms. “Most people will improve within three months,” said the doctor, although he acknowledged that a small group may become chronic, with persistent pain or synovial fluid effusion.
Regarding treatment, he specified that the acute phase requires complete rest, hydration, and relief of fever and pain. Paracetamol and dipyrone are the first-line analgesics, while tramadol is reserved for second-line treatment. He noted that aspirin is contraindicated and that ibuprofen or other similar drugs are not recommended during this stage.
In the sub acute phase, nonsteroidal anti-inflammatory drugs—such as ibuprofen—can be used for a period of seven to ten days. Prednisone may be indicated for five days at low doses, although “not all patients need it.”
For the chronic stage, she noted that care should be provided by multidisciplinary teams and rheumatology specialists, focusing on the management of persistent pain. She added that the virus compromises the peripheral nerves, so “B vitamins help alleviate these phenomena.”
Dr. Lissette López González, head of the National Pediatrics Group, warned of the need to remain alert to any symptoms in children under five years of age, describing the disease as “highly symptomatic.” She explained that the current protocol establishes mandatory hospitalization for all patients under two years of age.
For children older than that age, the decision to admit them is based on a “pediatric evaluation,” a clinical tool that allows for the detection of warning signs. “These are everyday medical practices that do not require any supplies or health technology, only a physical examination,” said the specialist.
Dr. López González pointed out that newborns, and among them those under three months of age, bear a “significant burden” in terms of morbidity and severity of the disease, due to their immunological immaturity, physiology, and anatomy. “This is a virus that affects all organs and systems, is very symptomatic, and has a very long duration,” she emphasized.
Among the most frequent atypical cases in neonatal and pediatric wards, she identified difficult-to-manage seizures and central nervous system infections. In view of this, Dr. Lissette López González made an urgent call not to self-medicate children and to prioritize hydration, as this “influences temperature control” and “has a significant impact on reducing inflammation and lubricating the joints.”
She also clarified that “there is no documented evidence that breastfeeding is a route of transmission of the virus,” and therefore advised against discontinuing it.
She emphasized that the pediatric age range is from birth to 18 years of age, and “that gives us a wide range of clinical variables. Adolescents have many similarities with adults, but we have seen that young children have very peculiar characteristics.“
”The golden rule in pediatrics is to be able to clearly distinguish between the usual symptoms described in most patients and those patients who have risks, warning signs, or severe symptoms,” the specialist stressed.
Why are newborns such a group of concern? “Logically, because of their immaturity, because of their limited tools when it comes to dealing with a viral disease that has a significant systemic impact,” she said.
For her part, Dr. María del Carmen Domínguez Horta, a researcher at the Center for Genetic Engineering and Biotechnology (CIGB), explained the potential of Jusvinza, a drug originally created for rheumatoid arthritis and later used in more than 15,000 patients with COVID-19, with a recovery rate of over 85%.
Domínguez Horta indicated that, given that chikungunya is characterized by severe joint pain, Jusvinza—whose active ingredient is an immunomodulatory peptide—could be useful. However, she emphasized the ethical responsibility of not using a drug without prior studies for that specific indication.
“Clinical trials and studies with this drug are currently being conducted […] at the Justino Pérez Hospital in Matanzas,” he confirmed. “As scientists, we believe that Jusvinza can help reduce pain, but this is a hypothesis that needs to be corroborated by studies. If so, Jusvinza will be incorporated into the protocols.”
At the end of the program, Dr. Ileana Morales Suárez, National Director of Science and Technological Innovation at MINSAP, specified that the national protocol for dealing with this arbovirus is structured in three scenarios, as was done with COVID-19: preventive, therapeutic, and rehabilitation.
It was also emphasized that vector control, through outdoor sanitation and family responsibility, is a fundamental pillar of primary prevention, especially to protect infants, who are identified as a highly vulnerable group.
Source: Cuba en Resumen translation Resumen Latinoamericano – English