The most common health problem experienced by travelers to the Virgin Islands is sunburn. Nevertheless, the possibility exists for more serious problems, especially if you take risks swimming, diving, boating, driving, drinking or with sexual behavior. Health care in the islands is generally good, although specialist services are limited, and ambulance service may be very slow, especially in remote or outer islands. Mosquito-borne diseases zika, chikungunya and dengue hemorrhagic fever are also something to watch out for.
The U.S. Centers for Disease Control and Prevention (877/FYI-TRIP, www.cdc.gov) maintains up-to-date health information for travel destinations around the world, including the Virgin Islands. This is a good resource for travelers.
Zika, chikungunya and dengue hemorrhagic fever are all spread by the aedes aegypti mosquito. The aedes aegypti mosquito feeds at dawn and dusk, indoors and in shady areas. The Aedes mosquito’s distinctive white markings are visible to the human eye, but if you can get that close you’re probably better off killing the mosquito than studying its legs.
The prevalence of mosquitos in the Virgin Islands increases and decreases in direct proportion to the amount of recent rain. Visit in the traditionally drier months of December-May to minimize the risk of mosquitos. Accommodations that are exposed to lots of wind will generally have fewer mosquitos. Also avoid staying near ponds or other areas of standing water.
You can avoid mosquito bites by using repellent which contains DEET, IR3535, oil of lemon eucalyptus or icaridin; wearing light-colored clothing covering your body; and remaining within mosquito-free areas such as screened or air-conditioned spaces. Avoid being outside at dawn or dusk, and avoid shady areas favored by mosquitos.
Property owners can reduce the number of mosquitos around by removing any standing water and regularly clearing drains. If you are sensitive to mosquitos, ask your hotel or host whether they undertake regular efforts to prevent mosquito breeding.
Zika is a viral infection, spread primarily by the aedes aegypti mosquito. The symptoms of zika include fever, rash, conjunctivitis, malaise and headache, though most people with zika do not develop any symptoms at all. While the symptoms of zika are generally mild and temporary, the risk to pregnant women and babies is significant. An estimated 5-10 per cent of babies born to women who had zika during pregnancy will be born with some kind of zika-related defect, the most serious of which is micocephaly. Zika can also be sexually transmitted.
There have been confirmed case of zika in both the U.S. and British Virgin Islands. However, neither territory has experienced a serious outbreak of the disease and the number of infections has dropped significantly since zika first emerged in the region in 2016. As a result, in October 2018 the World Health Organisation reclassified the entire Caribbean region as no longer having active zika transmission. Nonetheless, the US Centers for Disease Control has maintained its travel warning for the Caribbean, including the Virgin Islands.
As of October 2018 the US Virgin Islands reported two new zika cases for the year, compared to 46 cases in 2017 and 986 cases in 2016. (There were 0 zika cases in 2015.) There have been no public reports of babies born with zika related birth defects in either territory.
Research into zika is ongoing, and many questions remain. The U.S. CDC and the World Health Organisation maintain up-to-date guidance and advice. The CDC advises women who are pregnant to avoid visiting the Virgin Islands (and the 86 other countries and territories where zika is present.) Women who are pregnant or may become pregnant should speak to their doctor and carefully weigh the risks of visiting the Virgin Islands. Men who travel to the Virgin Islands should review and follow CDC guidance on preventing sexual transmission of the virus to a partner after returning to the islands.
Chikungunya and Dengue
The most prominent symptoms of chikungunya, a mosquito-borne virus, are fever and joint pain. Other symptoms include headache, muscle pain, rash, and joint swelling. Chikungunya means “that which bends up” in the Makonde language of Tanzania and Mozambique, where the disease was first identified. The name refers to the terrific joint pain that some sufferers experience, often for months or years. Chikungunya is rarely ever fatal, but well worth trying to avoid. The incubation period for chikungunya is up to 12 days, so if you start to feel sick after a visit to the Virgin Islands, be sure to mention your recent trip to your doctor.
Dengue is a virus characterized by fever, headaches, and joint and muscle pain, sometimes accompanied by nausea, vomiting, and rash. People who have dengue report feeling extremely tired. Symptoms usually appear 4-7 days after the person is bitten by a dengue-carrying mosquito. There is no cure or vaccine for dengue. Treatment is available for the symptoms, which usually run their course in about a week, although in the very old and very young recovery can take longer. In rare cases, dengue can be fatal.
Take precautions against the powerful tropical sun. The best option is to cover up: Wear a wide-brimmed hat and a cover-up at the beach or on the boat, and seek out shade. Avoid going out in the direct sun between 10am and 2pm. Apply reef-safe sunscreen to exposed skin 15-20 minutes before you go out, and reapply regularly. The chemical oxybenzone, commonly used in many sunscreens, has been proven to negatively affect coral reefs, already under stress from disease, rising sea temperatures, pollution, and careless snorkelers and boaters. When you’re stocking up on sunscreen, carefully check the label and look for formulas whose active ingredients are zinc oxide or titanium dioxide instead. These ingredients are better for you too.
Be especially careful when you are swimming or sailing, since the coolness of the water and breeze may make you forget how strong the sun is. Wear a T-shirt and shorts when snorkeling for long periods to protect your back, and be sure to apply sunscreen to the back of your legs. Quick-drying surf shorts and tops are stylish way to protect your skin.
Do not overestimate your swimming, snorkeling, diving, or sailing abilities. The ocean can be powerful, unpredictable, and deadly. Pay attention to weather forecasts. Yes, you are on vacation, but terrible things can still happen.
Swimming-related deaths occur annually in the Virgin Islands, usually when someone overestimates their ability or underestimates the physical challenge involved. If you have had heart trouble or are at risk for a heart attack, be especially careful. The only beaches with lifeguards are Magen’s Bay on St. Thomas and Trunk Bay on St. John. (Cane Garden Bay and Josiah’s Bay, Tortola, and The Baths, Virgin Gorda, sometimes have lifeguards but don’t count on it.) All the rest are swim at your own risk.
The British Virgin Islands use a system of flags on popular beaches. If you see a red flag flying, don’t get in. A yellow flag means to swim with caution.
If you are susceptible to motion sickness and plan to sail or ride in a boat, bring Sea-Bands, the wristbands that help prevent motion sickness. Ginger is also a proven remedy. You could also pack an over-the-counter motion sickness medicine like Dramamine.
Sharks live in Virgin Islands waters, but they mostly stay in deep water well offshore. It is unlikely you will encounter a shark at all. You will, however, see barracudas if you snorkel. Barracudas tend to stay still in the water; do not bother them and they will not bother you. Moray eels live inside dark caves and crevices—don’t reach into one of these unless you have checked it out with your light first. Learn to recognize sea urchins—their long, black spines are a giveaway. Step on one and you will be in a lot of pain. The West Indian sea egg looks like a pincushion and is not a nice thing to step on either.
Tropical Fish Poisoning
One of the most mysterious and worst tropical maladies is fish poisoning, a severe illness caused when you eat a fish containing ciguatera toxins. Symptoms of fish poisoning are severe nausea, diarrhea, vomiting, and weakness. In addition, there are neurological symptoms such as tingling feet and hands, itchiness, and the sensation of hot things feeling cold and cold things feeling hot. Muscle weakness and pain in the bones and joints are also common.
Depending on the severity of the case, symptoms can range from mild to completely debilitating. If you experience any of the symptoms, think of whether you have eaten fish in the last 24 hours. In many cases, hospitalization is required to prevent dehydration.
Pelagic fish such as tuna, wahoo, swordfish generally pose no risk. Fish poisoning arises only when fish eat algae containing ciguatera toxins: Large game fish do not eat algae and are far enough up the food chain that any exposure to the toxin via another fish in their diet is too small to matter. Smaller fish that live directly on the coral reefs around the islands are more susceptible to poisoning although a great deal of local knowledge exists among fishers about which fishing grounds are more and less likely to produce fish that poison.
Unless you swear off tropical fish all together, there is no sure way to avoid fish poisoning, but restaurants, groceries, and reputable fishers use testing kits and local knowledge to determine if fish contain poison and cases are few and far between.
Sexually Transmitted Diseases
The Caribbean has the second highest prevalence rate for HIV/AIDS in the world, behind sub-Saharan Africa. The Virgin Islands have relatively low rates of infection, although AIDS advocates say that much more needs to be done to arrest the spread of the disease. They emphasize that, due to the tight-knit society, many persons choose not to disclose their status, causing official statistics to be misleading.
Condoms are widely available at gas stations, convenient stores, drug stores and pharmacies.
Both the U.S. and British Virgin Islands have a higher crime rate than many U.S. or U.K. cities of a similar population. Recent statistics from the U.S. Virgin Islands show a homicide rate some six times the national average.
Most crime is contained to the local populations. The overwhelming majority of victims are young men, and police say that poverty, gangs, and drugs are the cause of most of the violence. A myriad of community organizations work to combat violence through intervention, police-community outreach, and rehabilitation.
Tourists are rarely the target of crime, but it is important to take common-sense measure to avoid becoming a target. The most common crime against tourists is theft, so be sure to lock your hotel room, car, or villa and don’t bringing valuables with you in the first place. If you are walking in town after dark, do so in a group, stick to well-lit areas, and keep your wits about you. Better yet, take a taxi to your destination, especially if you’ve had too much to drink.
Both the U.S. and British Virgin Islands have stiff drug laws. Marijuana, cocaine, and other drugs are illegal here. The islands are also a major drug transshipment point—for your own safety and health, don’t get mixed up with drugs while you are in the islands.