Chikungunya in the Caribbean: What travelers should know

Published on Sep 30, 2025, 3:54 pm CDT

7 min read

The CDC has issued a Level 2 travel health notice for Cuba due to an outbreak of chikungunya, a mosquito-borne viral disease that causes high fever and severe joint pain. While most travelers' risk remains low, outbreaks across the Caribbean and other regions can raise exposure, especially during rainy seasons and in urban areas with Aedes mosquitoes. This briefing explains what chikungunya does to the body, the likelihood of contracting it, historic Caribbean trends, and what the latest Cuba alert means for travel plans.

Key points

Why it matters: Chikungunya can cause debilitating joint pain that may linger for months.
Travel impact: Level 2 alert for Cuba; enhanced precautions and targeted vaccination guidance apply.
What's next: Health agencies are tracking 2025 spikes while advising bite prevention and selective vaccination.
Regional context: Cases are elevated globally in 2025, with notable activity in the Americas.
Vaccine update: A live vaccine is suspended in the U.S.; a newer VLP vaccine remains available.

Snapshot

Chikungunya is transmitted by Aedes aegypti and Aedes albopictus mosquitoes, which bite primarily during the day. Symptoms generally begin three to seven days after a bite and include sudden fever and intense, often symmetric joint pain; rash, headache, and muscle aches are common. Most patients improve within a week, but joint pain can persist for months, occasionally longer. Severe disease and death are rare, yet risks are higher for newborns infected around birth, older adults, and those with conditions like hypertension or diabetes. The CDC rates the current Cuba situation as Level 2, meaning travelers should practice enhanced precautions such as wearing repellent and long sleeves, using screened or air-conditioned lodging, and eliminating standing water around accommodations. Vaccination may be recommended depending on destination and traveler profile.

Background

Chikungunya first established local transmission in the Americas in December 2013 on Saint Martin, then swept across the Caribbean and into South and Central America through 2014-2015. Puerto Rico, the Dominican Republic, Martinique, Guadeloupe, and Haiti experienced substantial waves, with Puerto Rico reporting more than 10,000 suspected cases by August 2014 and evidence that roughly one third of residents may have been infected during the peak period. Attack rates in some island outbreaks elsewhere have reached 35 percent or more, underscoring how quickly transmission can climb in favorable mosquito conditions. Since then, the virus has persisted in seasonal cycles in tropical and subtropical regions worldwide, producing localized surges tied to rainfall, temperature, urban density, and vector control performance.

Latest developments

Cuba's Level 2 alert: What it means for your trip

On September 26, 2025, the CDC posted a Level 2 notice for chikungunya in Cuba, advising "enhanced precautions" against mosquito bites and recommending vaccination for travelers to outbreak areas. The advisory does not ban travel, but it does raise the bar for prevention: use an EPA-registered repellent, wear long sleeves and pants, choose screened or air-conditioned lodging, and minimize outdoor exposure at dawn and dusk when Aedes are active locally. Travelers who are pregnant, nearing delivery, or who have significant medical conditions should discuss the trip with a clinician; in some scenarios, postponement or vaccination may be advised. Always check itinerary specifics, since risk can vary by locality and season.

How common is chikungunya in 2025 across the Americas and beyond?

As of August 2025, the European Centre for Disease Prevention and Control estimates about 317,000 cases and 135 deaths globally this year, spanning the Americas, Africa, Asia, and Europe. In the Pan American region alone, countries reported more than 212,000 suspected cases and over 100 deaths through early August, with the majority in South America and localized events elsewhere. U.S. surveillance shows travel-associated cases in 2025 but no confirmed local transmission to date; health authorities in New York are investigating a possible locally acquired case on Long Island with overall risk described as very low. These figures point to elevated but uneven activity, reinforcing that traveler risk is highly dependent on destination and season.

What the disease does and who is most at risk

For symptomatic patients, chikungunya's incubation period is typically three to seven days. The hallmark is abrupt fever accompanied by severe, often disabling joint pain in the hands and feet; other symptoms can include rash, headache, myalgia, and swelling. Most recover within a week, but post-viral arthralgia may persist for months. Severe complications are uncommon but can involve neurologic or cardiac issues. Higher-risk groups include newborns exposed around delivery, adults 65 and older, and people with chronic conditions. The CDC notes that for most U.S. travelers, overall risk is low, though it increases during outbreaks or with prolonged stays.

Likelihood of contracting chikungunya on a Caribbean trip

Traveler risk hinges on four variables: local transmission intensity, time of year, length of stay, and bite exposure. During major Caribbean waves in 2014-2015, surveillance in Puerto Rico suggested large community exposure, and scientific reviews document that island outbreaks elsewhere have reached attack rates on the order of 35 percent of the population. That level reflects community transmission, not a typical traveler's short-term risk. For most visitors using repellent, covering up, and lodging with screens or air-conditioning, the individual probability of infection on a short trip remains low even during alerts. Risk rises for longer stays in outbreak districts, outdoor-heavy itineraries, and for travelers who forgo bite prevention.

Vaccines and 2025 safety updates

The U.S. currently has two FDA-approved chikungunya vaccines, but with important caveats. The live-attenuated vaccine (Ixchiq) received accelerated approval in November 2023 for adults 18 and older at increased risk; the FDA suspended its U.S. license on August 22, 2025, over safety concerns. A second, virus-like particle vaccine (Vimkunya) was approved on February 14, 2025, for persons 12 and older and remains available. CDC guidance recommends vaccination for travelers going to outbreak areas and allows case-by-case consideration for extended stays in elevated-risk countries without an active outbreak. Clinicians should weigh age, medical conditions, pregnancy status, itinerary, and current product advisories when counseling travelers.

Analysis

For travelers, chikungunya risk management is about layering controls. First, destination intelligence: Level 2 does not bar travel, but it signals sustained local transmission, warranting strict bite prevention and a vaccine discussion. Second, itinerary design: urban day-time exposure, outdoor dining, and lodging without screens or air-conditioning raise risk because Aedes mosquitoes thrive in container habitats and bite during daylight. Third, traveler profile: pregnancy, older age, and cardiometabolic conditions increase the stakes from an otherwise self-limited illness. Fourth, vaccine availability and safety: with the live vaccine on FDA suspension, clinicians will increasingly rely on the virus-like particle vaccine for eligible travelers, especially adolescents and adults heading to outbreak zones. Finally, historical context matters. Caribbean experience in 2013-2015 showed how quickly cases can escalate and how long joint symptoms can persist, affecting trip quality and post-trip function. Practical steps-repellent, coverage, screens, and itinerary tweaks-remain the most dependable tools, with vaccination as an added layer for specific scenarios.

Final thoughts

Chikungunya is seldom life-threatening, but its prolonged joint pain can turn a vacation into months of discomfort. The Cuba Level 2 alert is a reminder to tune itineraries to local conditions, especially in the wetter months, and to use bite prevention everywhere Aedes mosquitoes thrive. For higher-risk travelers or those heading into outbreak districts, talk with a clinician about vaccination timing, product selection, and any age- or condition-specific precautions. With layered controls and informed planning, most trips can proceed safely, even during periods of elevated transmission of chikungunya in the Caribbean.