Chikungunya outbreak spreads to major destinations

Published on Aug 8, 2025, 11:51 am CDT

6 min read

China is battling its largest recorded chikungunya outbreak, centered in Foshan, Guangdong, with weekly tallies pushing the provincial total well past 7,000 cases by early August. Health agencies in Hong Kong and Taiwan have flagged imported infections, and France and Italy have reported locally acquired cases during Europe's peak travel season. The Centers for Disease Control and Prevention now urges enhanced precautions for travelers to Guangdong, and recommends considering vaccination for at-risk adults. Here is what you need to know about the virus, its history in the Caribbean, and how the risk compares to dengue and malaria.

Key Points

Why it matters: Guangdong's surge and Europe's local cases raise summertime travel risk.
Travel impact: CDC advises enhanced precautions for Guangdong, with vaccine options for some adults.
What's next: Continued monitoring in southern China and southern Europe through late summer.
Surveillance notes: Hong Kong and Taiwan are reporting imported cases tied to regional spread.
Perspective: Deaths are rare in chikungunya, far lower than dengue and malaria.

Snapshot

Chikungunya is a mosquito-borne viral illness spread by Aedes aegypti and Aedes albopictus. Incubation typically runs three to seven days. Sudden fever and severe, sometimes disabling joint pain are hallmark symptoms, with headache, muscle aches, rash, and fatigue also common. Most people recover within a week, although joint pain can persist for months, sometimes years, especially in older adults. Severe disease and death are uncommon, but risk rises for newborns infected around birth, adults over 65, and people with conditions like hypertension, diabetes, or heart disease. Two chikungunya vaccines are approved in the United States for adults, though one carries age-related cautions. Learn more from the WHO chikungunya fact sheet: https://www.who.int/news-room/fact-sheets/detail/chikungunya?utm_source=adept.travel

Background

First identified in Africa in the 1950s, chikungunya reached the Caribbean in December 2013, when Saint Martin reported the Western Hemisphere's first local transmission. By 2014 the virus had spread through the Caribbean and into South America, infecting well over a million people across the Americas. That wave seeded long-term travel-related risk between tropical regions and temperate areas where Aedes mosquitoes are established. Since then, autochthonous clusters have appeared periodically in southern Europe, including France and Italy, when warm weather aligns with vector activity and imported cases. Review the early Caribbean timeline here: https://www.ecdc.europa.eu/en/chikungunya/threats-and-outbreaks/outbreak-caribbean?utm_source=adept.travel

Latest Developments

Guangdong chikungunya outbreak surpasses 7,000 cases

Provincial surveillance in Guangdong documented 4,824 locally acquired cases through July 26, followed by 2,892 additional cases reported the week of July 27 to August 2, pushing the cumulative total beyond 7,000. Officials report most cases in Foshan, with activity across multiple Pearl River Delta cities. No human-to-human spread occurs, so control focuses on mosquito suppression and bite prevention. The U.S. CDC issued a Level 2 Travel Health Notice for Guangdong, advising enhanced precautions and vaccination consideration for at-risk adults. See the Guangdong CDC weekly bulletin: https://cdcp.gd.gov.cn/xw/zhxw/content/post_4342752.html?utm_source=adept.travel

France and Italy report locally acquired cases

France's national surveillance logged multiple transmission clusters beginning in June, an unusually early start, with cases across Provence-Alpes-Côte d'Azur, Corsica, Occitanie, Auvergne-Rhône-Alpes, and, for the first time, Grand Est and Nouvelle-Aquitaine. Italy has reported sporadic locally acquired infections this summer as well, consistent with previous seasons when Aedes albopictus is active. Vector control and door-to-door awareness campaigns are underway. France's July surveillance summary: https://www.santepubliquefrance.fr/maladies-et-traumatismes/maladies-a-transmission-vectorielle/chikungunya/documents/bulletin-national/chikungunya-dengue-et-zika-en-france-hexagonale.-bulletin-de-la-surveillance-renforcee-du-9-juillet-2025?utm_source=adept.travel

Hong Kong and Taiwan tighten traveler surveillance

Hong Kong's Centre for Health Protection confirmed its first imported chikungunya case of 2025 on August 2, followed by additional imported infections in the first week of August, and activated an expert vector-borne panel to update prevention guidance. Taiwan's National Infectious Disease Statistics System shows 16 imported chikungunya cases year-to-date, with zero local transmission this year. Both jurisdictions emphasize mosquito control and rapid detection of travelers with fever and arthralgia. Hong Kong's case update: https://www.info.gov.hk/gia/general/202508/02/P2025080200897.htm?utm_source=adept.travel

Analysis

How risky is the current chikungunya outbreak for travelers, and how deadly is the disease compared with other mosquito-borne threats? Globally in 2025 to early July, health authorities counted about 240,000 chikungunya cases and around 90 deaths, a case-fatality ratio near 0.04 percent. That is far lower than malaria, which caused an estimated 597,000 deaths in 2023, and lower than severe dengue, which produced thousands of deaths during 2024's record year. The bigger chikungunya burden is not mortality, it is prolonged, sometimes debilitating joint pain that can last months. Risk is highest for older adults, newborns infected near delivery, and people with cardiovascular or metabolic disease. Two U.S.-approved vaccines can reduce risk for adults traveling to outbreak zones, but clinicians should review age-specific safety and timing, since peak protection is needed before exposure. For situational awareness of global case counts and recent deaths, see ECDC's worldwide overview: https://www.ecdc.europa.eu/en/chikungunya/monthly?utm_source=adept.travel

Final Thoughts

Chikungunya is unlikely to upend most trips the way malaria or severe dengue can, but it can ruin an itinerary with fever and weeks of joint pain. If you are headed to Guangdong or southern Europe, pack and use repellent with DEET or picaridin, wear long sleeves, and book air-conditioned stays or well-screened rooms. Talk to a travel-medicine clinician four to six weeks before departure about whether vaccination makes sense for you, particularly if you are older or have chronic conditions. Vigilance now helps you avoid becoming part of the next cluster in this chikungunya outbreak.