Painful and potentially deadly infections like COVID-19 and dengue fever were far less prevalent in the territory in 2025 than 2024, according to a new report from the Virgin Islands Health Department. A hand, foot, and mouth disease outbreak was quelled within months.
In 2024, the Virgin Islands reported at least 215 cases of bone-grinding dengue fever. Only 47 cases of the mosquito-borne illness were reported in 2025, according to the Epidemiology Division’s 2025 Annual Report published Thursday. Those numbers may be off, however, as only roughly 25% of people infected show noticeable signs of illness, the report said. Five percent will have severe reactions but less than 1% die.
From 770 COVID cases in 2024, the territory saw just 140 cases in 2025 — none fatal, according to the report.
Territorial Epidemiologist Dr. Esther Ellis credited proactive data collection and diligent interpretation with helping quell such outbreaks.
“Disease surveillance remains the cornerstone of effective public health practice. Through systematic data collection, analysis, and interpretation, we can detect emerging threats, monitor disease activity, and guide evidence-based interventions,” Ellis wrote in the report.
The first few months of 2025 were notable for a dramatic insurance of hand, foot, and mouth disease. From February to April, the Health Department identified 247 cases — 243 on St. Thomas and four on St. Croix — at USVI day cares and schools, the report said.
Hand, foot, and mouth disease is a common illness in children under five years old that can spread quickly in social settings, the report said. Symptoms are often mild, lasting for a week to 10 days, and can include fever, sore throat, mouth sores, and rash commonly found on the hands and feet.
It’s spread through direct contact with an infected person’s saliva, mucus, or blisters, respiratory droplets from an infected person’s cough or sneeze, contaminated surfaces, or contact with infected feces, such as changing diapers.
“To reduce the risk of infection, frequent hand washing and cleaning and disinfecting commonly touched surfaces and shared items (e.g., toys) are critical, the report said. “To contain the outbreak and prevent further illness, the VIDOH-EPI provided phone consultations and in-person visits for direct observation and infection control training at affected schools and day cares. Improved hand hygiene protocols and environmental cleaning efforts were recommended for all school and child care settings.”
Other infectious diseases, such as hepatitis, were lower year over year as well. There were four cases of acute hepatitis B and eight of hepatitis C in 2024, but two cases of acute hepatitis B and two of hepatitis C in 2025.
The flu hit the territory hard, however. In 2024, there were 99 confirmed cases of influenza in the Virgin Islands. In 2025, that number spiked to 378 cases. St. Thomas had the vast majority of flu cases, reporting 296 cases — or 78.3% of the territory’s influenza outbreak. St. Croix had 68 cases and St. John had 14 cases.
“This represents the highest case count recorded in the past five years,” the report said.
Another troubling increase was lead levels detected in Virgin Islanders’ blood. Four confirmed cases and one suspected case of abnormally high blood-lead levels were reported in 2024, which rose to nine confirmed, three probable, and three more suspected lead cases in 2025.
There is no safe blood lead level, especially for children. Even low levels of lead in blood are associated with developmental delays, difficulty learning, and behavioral issues, the reports said.
Of the nine confirmed cases, six were on St. Croix and three were on St. Thomas, the report said. Four were adults and five were children under five years old.
“Home assessments identified potential sources of lead exposure to be walls with chipping paint, ceramic/porcelain tiles, cooking pots, and ceramic kitchenware (e.g., plates). Certain businesses were identified to be higher risk of exposure to lead, including indoor shooting ranges,” the report said.
Health Commissioner Justa Encarnacion said the report “reflects our unwavering commitment to safeguarding the health of all Virgin Islanders through evidence-based practice, strategic action, and strong community partnerships.”
Encarnacion highlighted not just infectious disease control, but also community wellness, youth health, and overall emergency preparedness as keys to combating health challenges.
“While we celebrate this progress, we also recognize the ongoing challenges we must address — particularly in chronic disease prevention, equitable access to care, and the expansion of mental health support. I extend my deepest appreciation to our dedicated public health professionals, our partners, and our community members for their resilience and commitment,” she wrote.
