A travel advisory issued over the deadly chikungunya virus has been expanded as it continues to spread around the world.
The virus, which is spread by the Aedes mosquito, can cause sudden, agonizing joint pain in the hands and feet that can be so severe it leaves sufferers unable to move normally for months.
Since the beginning of 2025, more than 240,000 chikungunya cases and 90 chikungunya-related deaths have been reported in 16 countries. Cases have been reported in the Americas, Africa, Asia, and Europe.
A severe outbreak of the virus in China totaling more than 10,000 cases prompted the CDC to issue a level 2 travel warning for Guangdong Province in August.
And in the most recent update, which urges Americans to take extra precautions when visiting certain areas, the advisory now includes, Kenya, Madagascar, Somalia and Sri Lanka.
Health officials say that US travelers are also at elevated risk of exposure to chikungunya in Brazil, Colombia, India, Mexico, Nigeria, Pakistan, Philippines, and Thailand.
A Level 2 Advisory for travel viruses from the CDC means travelers should ‘Practice Enhanced Precautions’ for their destination. This indicates a heightened health risk due to specific disease outbreaks, and travelers should take extra measures to protect themselves.
The Pan American Health Organization warns that chikungunya cases are on the rise across the Americas with the hotspots currently being Brazil (with 210,711 cases) and Bolivia (with 5,159 cases). To date, there have been 55 cases reported in the US.
Chikungunya, which is spread by the Aedes mosquito, can cause sudden, agonizing joint pain in the hands and feet that can be so severe that it leaves sufferers unable to move normally for months
Since the beginning of 2025, more than 240,000 chikungunya cases and 90 chikungunya-related deaths have been reported in 16 countries. Cases have been reported in the Americas, Africa, Asia, and Europe
Chikungunya is a ‘nationally notifiable’ condition in the US, meaning health authorities can voluntarily report cases to the agency for national tracking and monitoring.
While a handful of cases pop up in the US every year from people traveling to high-risk areas, it hasn’t experienced local transmission since 2019.
But with more than 4.7 million US passengers flying internationally on any given day, mosquitoes in America could bite an infected traveler and begin transmitting the virus locally to Americans.
China remains a hotbed for the virus and it is currently battling its largest-ever outbreak of the illness with more than 10,000 cases.
The spread of the mosquito-borne disease triggered a roll out of Covid-like restrictions in August, with disinfectant sprayed in streets and patients quarantined in hospitals.
Reports surfaced that Chinese authorities in the city of Foshan cut electricity to some households that were not cooperating with health checks aimed at containing the chikungunya outbreak.
Chinese officials also deployed insecticide-spraying drones, ‘cannibal’ mosquitoes and killer fish to eliminate any insects that could be carrying the virus.
Dr Louisa Messenger, a mosquito researcher in Nevada, previously told DailyMail.com: ‘This outbreak in China is very concerning. It [the virus] could already be here in the US; and really it’s just one plane flight away.’
The outbreak in China remains ongoing.
Along with the CDC, travel agencies and cruise lines also issued warnings about preventing mosquito-borne diseases, including chikungunya, dengue and Lyme disease, all of which have been detected in the US so far this year.
This summer, Norwegian Cruise Line warned guests traveling to Italy to use insect repellent and wear clothing treated with permethrin, which can repel ticks and mosquitoes. Aedes mosquitoes are common in Italy, especially around coastal areas.
Authorities in Italy reported the first locally acquired cases of both dengue and chikungunya, prompting the warnings from Norwegian Cruise Line.
In the US, one town in Massachusetts closed its parks and fields each evening last September after a man in his 80s caught eastern equine encephalitis from a mosquito bite. The rare but serious disease can cause severe inflammation of the brain.
Off the back of rising chikungunya cases, health officials in New Jersey state on the Department of Health website: ‘The best way to prevent chikungunya is to prevent mosquito bites and avoid travel to areas with ongoing chikungunya outbreaks.’
Chikungunya is spread to humans from a bite from the Aedes mosquito, which also spread dengue fever, yellow fever and Zika virus. The infection does not spread from person to person through bodily contact or saliva.
More than 10,000 cases have been detected in China so far, prompting Covid-era protections
The above compares chikungunya symptoms to those from Zika virus and Dengue, which are both also spread by mosquitoes
However, pregnant women who become infected near the time of delivery can pass the virus to their baby during birth, which can result in severe illness in the newborn.
About 15 to 35 percent of people infected with the virus are asymptomatic, the CDC reports.
The mortality rate for chikungunya is generally low, estimated at less than one in 1,000 cases.
The incubation period is typically three to seven days and the most common symptom is a sudden onset of a fever over 102 degrees Fahrenheit (39 degrees Celsius).
Other symptoms of chikungunya virus include headache, nausea, rash, muscle aches, swelling and redness of the conjunctiva (the white part of the eye and inner eyelids) and joint pain that is sometimes severe and debilitating in the hands or feet.
In severe cases, life-threatening complications involving the heart and brain can occur such as inflammation, irregular heartbeats and organ failure.
Symptoms usually last seven to 10 days, but patients may experience lifelong complications such as persistent joint pain.
There is no specific treatment for chikungunya, and doctors mostly focus on easing symptoms like over-the-counter pain and fever medications. However, there are two vaccines available for people visiting an area with an outbreak.
According to the CDC, chikungunya was rarely detected in American travelers before 2006.
But between 2006 and 2013, the US logged around 30 imported cases a year, all in people who had recently visited affected regions in Asia, Africa or the Indian Ocean.
In 2014, a total of 2,799 cases were reported – including 12 that were locally acquired – in states and territories such as Florida, Texas, Puerto Rico and the US Virgin Islands, making it the country’s worst year on record for the virus.
Since then, case numbers have declined and last year, the CDC recorded 199 travel-related chikungunya cases in the US.
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