Outbreak Notice
Chikungunya Fever in Asia and the Indian Ocean
This information is current as of today, February 09, 2010 at 22:49 EST
Updated: October 28, 2009
Situation Information
Since 2006, parts of Asia and the Indian Ocean have reported chikungunya fever activity. Several countries have increased surveillance for this disease, and cases continue to be reported throughout this region.
Chikungunya fever is a disease caused by a virus that is spread to people through the bite of infected mosquitoes. Symptoms can include sudden fever, joint pain with or without swelling, chills, headache, nausea, vomiting, lower back pain, and a rash. Chikungunya mainly occurs in areas of Africa and Asia. In 2007, limited transmission of chikungunya virus occurred in Italy.
The following examples highlight some recent chikungunya activity in Asia and the Indian Ocean region:
Thailand
As of September, 29, 2009, a large outbreak of chikungunya fever has affected the country, particularly the southern region including some tourist destinations, such as Phuket. According to the Ministry of Public Health in Thailand, over 42,300 cases have been documented this year in 50 provinces. Reports from Thailand show that chikungunya virus continues to circulate throughout the country.
Malaysia
As of September 26, 2009, the Ministry of Health in Malaysia has reported over 3,185 cases of chikungunya fever. The most affected areas are the northern provinces of Kedah, followed by Kelantan, Selangor, Perak, and Sarawak.
Réunion
As of August 28, 2009, the French government has reported 3 confirmed cases of chikungunya fever on the island of Réunion. No deaths have been reported. All cases occurred in the Saint-Gilles-Les-Bains area, on the western side of the island. However, mosquito activity reports show that the virus is circulating throughout Réunion.
Advice for Travelers
No medications or vaccines are available to prevent a person from getting sick with chikungunya fever. CDC recommends that people traveling to areas where chikungunya fever has been reported take the following steps to protect themselves from mosquito bites.
- When outdoors during the day and at night, use insect repellent on exposed skin.
- Look for a repellent that contains one of the following active ingredients: DEET, picaridin (KBR 3023), Oil of Lemon Eucalyptus/PMD, or IR3535. Always follow the instructions on the label when you use the repellent.
- In general, repellents protect longer against mosquito bites when they have a higher concentration (%) of any of these active ingredients. However, concentrations above 50% do not offer a distinct increase in protection time. Products with less than 10% of an active ingredient may offer only limited protection, often only 1–2 hours.
- The American Academy of Pediatrics approves the use of repellents with up to 30% DEET on children over 2 months of age.
If you get sick with a fever and think you may have chikungunya fever, you should seek medical care. Although there is no specific treatment for the disease, a doctor may be able to help treat your symptoms. Avoid getting any other mosquito bites, because if you are sick and a mosquito bites you, it can spread the disease to other people.
For more travel health information, see the destinations section and search for the country you are planning to visit.
More Information
The incubation period for chikungunya (time from infection to illness) is usually 3–7 days, but it can range from 2 to 12 days. Chikungunya fever typically lasts a few days to 2 weeks, but some patients feel fatigue lasting several weeks. Most patients report severe joint pain or arthritis, which may last for weeks or months. The symptoms are similar to those of dengue fever, but, unlike some types of dengue, people who have chikungunya fever do not experience hemorrhage (bleeding) or go into shock. People with chikungunya fever generally get better on their own and rarely die from the disease.
Medical care for chikungunya fever is usually focused on treating the symptoms of the disease. Bed rest, fluids, and mild pain medications such as ibuprofen, naproxen, or acetaminophen (paracetamol) may relieve symptoms of fever and aching, provided there are no medical contraindications for using these medications. Most people are not sick enough to need to stay in the hospital. All people who become sick with chikungunya fever should be protected against additional mosquito bites to reduce the risk of further transmission of the virus.
For more information, see—
Other Mosquito-Related Diseases
In many of the areas where chikungunya is present, mosquito bites spread other diseases, such as dengue, malaria, Japanese encephalitis, and yellow fever. If you are traveling to any tropical and subtropical areas of the world, you should take steps to avoid mosquito bites.
