including at least one case on the Dutch half of the island, and more than 180 suspected cases. The virus had also spread to Martinique (3 cases) and Guadeloupe (1 case) by the end of the year. In Saint Barthélemy, there were 21 suspected cases. Previously, chikungunya had not been found in the Americas. Although it had never previously been found, it was considered an emerging threat and preparations for its spread were underway by 2012. In July 2013, a Caribbean-wide virtual meeting was held to educate high-ranking medical personnel on how to detect the virus. It is unclear how the virus first spread to the Americas' mosquito population. Spread of the chikungunya virus By January 21, 2014, cases had been St. Barthelemy and the British Virgin Islands. Dominica and French Guiana both had one reported case due to travel in the affected islands. At the start of April, chikungunya was confirmed in the Dominican Republic. On 24 April, Saint Vincent and the Grenadines announced the island had three confirmed cases of chikungunya and an outbreak was officially declared. Two days later, Antigua and Barbuda announced its first confirmed case, on the island of Antigua. Four other cases were suspected. At the end of April, there were more than 4,100 probable cases of chikungunya across fourteen different Caribbean countries. In addition to thirteen island nations, the virus had been confirmed in French Guiana. Martinique, Guadeloupe, and St. Martin had the most reported cases. During the week of April 27, 2014, health officials from multiple agencies met in the Dominican Republic to discuss the outbreak. On May 1, the Caribbean Public Health Agency (CARPHA) declared a Caribbean-wide epidemic of the virus. The United States-based Centers for Disease Control and Prevention said it was "working with state health departments to increase awareness about chikungunya and to facilitate diagnostic testing" in preparation for possible introduction into South Florida. As of May 19, 2014, the Dominican Republic had over 32,000 reported cases of chikungunya, representing 68% of the total cases registered to date. By the end of May, four cases had been confirmed in Florida. Over 50,000 people were suspected to have contracted the virus in total. As of late September 2014, Health Minister Nancy Pérez of Venezuela stated that only 400 Venezuelans were infected with chikungunya while the Central University of Venezuela stated that there could be between 65,000 and 117,000 Venezuelans infected.