Chikungunya in the Region of the Indian Ocean

Level 4 - Avoid All Travel
Level 3 - Reconsider Nonessential Travel
Level 2 - Practice Enhanced Precautions
Level 1 - Practice Usual Precautions
Map: Réunion, Mayotte, Mauritius, and Sri Lanka
Map: Mauritius, Mayotte, Réunion, Somalia, and Sri Lanka (see larger map)
What is chikungunya?

Chikungunya disease is caused by the chikungunya virus and is spread to humans through mosquito bites. Outbreaks have occurred in countries in Africa, Americas, Asia, Europe, the Caribbean, and Indian and Pacific Oceans.

Most people infected with chikungunya virus develop some symptoms. Symptoms of chikungunya usually begin 3–7 days after a bite by an infected mosquito. The most common symptoms are fever and joint pain. Other symptoms may include headache, muscle pain, joint swelling, or rash. Most people get better within a week; however, some can have severe joint pain for months to years following acute illness.

People at risk for more severe disease include newborns infected around the time of birth, older adults (65 years or older), and people with medical conditions such as diabetes or heart disease. Death from chikungunya is rare.

There is no specific treatment for chikungunya.

Key points

  • There are outbreaks of chikungunya in Mauritius, Mayotte, Réunion, Somalia, and Sri Lanka (see map).
  • Mosquitoes spread the virus that causes chikungunya.
  • You can protect yourself by preventing mosquito bites, which includes using insect repellent; wearing long-sleeved shirts and pants; and staying in places with air conditioning or that have screens on the windows and doors.
  • Vaccination is recommended for travelers who are visiting an area with a chikungunya outbreak. Two chikungunya vaccines are approved for use in the United States.
  • If you are pregnant, reconsider travel to the affected areas, particularly if you are close to delivering your baby. Mothers infected around the time of delivery can pass the virus to their baby before or during delivery. Newborns infected in this way or by a mosquito bite are at risk for severe illness, including poor long-term outcomes.
    • In general, vaccination against chikungunya should be deferred until after delivery. However, when the risk of infection is high and exposure cannot be avoided, pregnant travelers should discuss with their healthcare provider the potential risks (to themselves and their babies) of chikungunya virus infection and the potential benefits and risks of vaccination so that vaccination can be considered.
  • Seek medical care if you develop fever, joint pain, headache, muscle pain, joint swelling, or rash, during or after travel.

For Clinicians

  • Two chikungunya vaccines are licensed in the United States:
    • A live-attenuated vaccine (IXCHIQ) was licensed in November 2023 for use in adults aged ≥18 years
    • A virus-like particle vaccine (VIMKUNYA) was licensed in February 2025 for use in adolescents and adults aged ≥12 years
  • Healthcare providers should refer to the vaccine package inserts for contraindications for use of each vaccine.
  • In addition, CDC and FDA recently investigated five hospitalizations for cardiac or neurologic events following vaccination with IXCHIQ among older people. This topic was discussed at the April 16th Advisory Committee on Immunization Practices (ACIP) meeting. We have also become aware of additional reports of serious adverse events among people aged 62 to 89 years from the use of the vaccine in other countries. Until these additional reports can be further investigated, the live-attenuated vaccine should not be used among people 60 years and older.
  • Healthcare providers should discuss the benefits and risks of vaccination with individual travelers based on their age, underlying health conditions, destination, trip duration, and planned activities.

Traveler Information

Clinician Information