Travelers Advice: Chikungunya Fever in Asia

This information is current as of today, July 29, 2009 at 11:19 EDT

Updated: July 29, 2009

Situation Information

Since January 2009, a growing number of cases of chikungunya fever has been reported in parts of Asia, including Thailand, Malaysia, and India. 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.

Thailand

As of July 22, 2009, a large outbreak of chikungunya fever has affected the southern region ofThailand including some tourist destinations, such as Phuket. According to the Ministry of Public Health in Thailand, over 34,200 cases have been documented this year in 50 provinces, with no deaths reported. The most affected areas are the southern provinces of Songula, Narathiwat, Pattani, and Yala.

Recent reports show that Chikungunya virus has now from the southern provinces to all other regions of the country.

Malaysia

As of July 18, 2009, the Ministry of Health in Malaysia has reported over 2,900 cases of chikungunya fever. The most affected areas are the northern provinces of Kedah, followed by Selangor, Kelantan, Perak and Sarawak.

India

As of April 29, 2009, the Directorate of National Vector Borne Disease Control Programme in Indiahas reported over 2,700 suspected cases of chikungunya fever, with no deaths reported. The most affected areas are the Karnataka, followed by Andhra, Goa, and Kerala states.

In response to the growing number of reports, other countries in Asia have increased surveillance for chikungunya fever.

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.

• The best way to avoid Chikungunya fever is to avoid 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 from 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 you could transmit the disease to other people through mosquitoes.

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) can be 2-12 days, but is usually 3-7 days. Chikungunya fever typically lasts a few days to 2 weeks, but some patients feel fatigue lasting several weeks. Most patients have reported severe joint pain or arthritis, which may last for weeks or months. The symptoms are similar to those of dengue fever, but, unlike dengue, people who have chikungunya fever do not usually experience hemorrhage (bleeding) or go into shock. People with chikungunya fever generally get better on their own and rarely die from the disease.

There is no specific drug treatment for chikungunya fever, and medical care 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—

• Chikungunya (CDC Fact Sheet)
• Traveling with Children: Resources (CDC Travelers’ Health website)

Other Mosquito-Related Diseases

In many of the areas where chikungunya is present, there are other diseases spread by mosquito bites, 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.

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