.png)
Blood and Bone: The Battle Against Chikungunya
- Heather McSharry, PhD
- Aug 13
- 22 min read
Chikungunya is sweeping through southern China in its largest recorded outbreak—and it’s not just a local problem. In this episode of Infectious Dose, I take you inside Foshan’s summer surge, unpack how this mosquito-borne virus travels the globe, and explore why its painful symptoms can linger for months or even years. You’ll hear how two species of mosquitoes are redrawing the map of where chikungunya can strike, why genetic changes have made it more adaptable, and what public health responses—from targeted mosquito control to controversial government overreach—look like on the ground. Whether you’re a traveler, a science enthusiast, or just someone who hates mosquito bites, this is your deep dive into the past, present, and future of a virus that won’t stay put.
Listen here or scroll down to read full episode.
Full Episode
Shout out to my Tweeps who voted for this episode. This one's for you!
Imagine being so wracked with joint pain that walking feels like broken glass grinding in your knees. You stand, you wince, you take a step… and it feels like your body is turning against you. Now imagine that pain lasting for weeks—or even months—long after the fever is gone.
That’s not a rare autoimmune disease. It’s a virus. With over 240,000 cases across 16 countries this year so far, with 90 deaths. it’s spreading in ways that put millions more people in its path.
This is Blood and Bone: The Battle Against Chikungunya
All right, so right now chikungunya is a global story.
In an outbreak reminiscent of a record-breaking one in 2005-2006, the French overseas region of Réunion, has reported more than 54,000 cases since the start of the year. Every single municipality on the island has been affected. The outbreak has eased slightly—officials recently downgraded the ORSEC Arboviruses alert system to Level 2, which signals a moderate-intensity epidemic—but transmission is still ongoing.
Just FYI, ORSEC is France’s emergency response system—kind of like a playbook for crises—and the Arboviruses plan is the version they activate for mosquito-borne diseases like chikungunya, dengue, and Zika. Different levels mark how intense the outbreak is, from small clusters at Level 1 to widespread, high-intensity transmission at Level 3.
And also FYI, the word ‘arbovirus’ isn’t just random—it’s a syllabic abbreviation, made by blending parts of the words in the phrase arthropod-borne virus. We do this a lot in science because it’s faster to say and easier to remember than the full mouthful. And mosquitoes and ticks are arthropods. Now you know.
OK, so nearby in Mayotte, the situation is even more intense. FYI, Mayotte is an archipelago in the Indian Ocean between Madagascar and Mozambique. It’s a region or department of France. Since late May, the island has been in Phase 3 of its epidemic response, indicating widespread transmission across the territory. More than 1,090 locally acquired cases have been confirmed this year alone.
And you wouldn't know it, but the Americas have recorded the highest case counts in the world for 2025 so far—and, tragically, nearly all of this year’s 90 recorded chikungunya deaths. Brazil leads with over 185,000 cases, and the vast majority of fatalities, concentrated in northeastern states where outbreaks have been especially intense. And Bolivia has reported more than 4,700 cases and several deaths, Argentina has seen nearly 2,840 cases with a smaller number of fatalities, and Peru has reported over 50 cases. Dozens of other countries across the region, from the Caribbean to the southern cone, have also detected infections — all tracked by The Pan American Health Organization (PAHO)’s regional surveillance network. For those who don't know, PAHO is the specialized international health agency for the Americas. It works with countries throughout the region to improve and protect people's health.
Now, in Asia, more than 34,000 cases have been reported this year from India, Sri Lanka, Mauritius, Pakistan—and China. In Africa, Senegal and Kenya have confirmed outbreaks, and imported cases detected in EU/EEA countries from Madagascar and the Seychelles suggest chikungunya may be circulating more widely in the Indian Ocean region than official numbers show.
And it’s here, in southern China, that one of 2025’s most striking outbreaks is unfolding. In the city of Foshan, in Guangdong Province, a small cluster of chikungunya cases detected in June has exploded into the largest outbreak China has ever seen.
Inside China’s Largest Chikungunya Outbreak — Foshan, July 2025
Currently, the city of Foshan in Guangdong Province, China, is at the center of a public health storm. It began quietly—the first known patient developed symptoms on June 16. Fever, joint pain, and rash, the telltale signs of chikungunya fever, a mosquito-borne viral illness that had caused outbreaks in parts of Asia and Africa before, but never on this scale in China.
By July 9, local health authorities had detected a small cluster of cases. But the situation escalated rapidly. By the end of July, there were 4,824 confirmed infections across 12 prefecture-level cities in Guangdong. Nearly every case—98.5% of them—came from Foshan itself. And within Foshan, one district, Shunde, was the undeniable epicenter, with over 4,200 cases. In a matter of weeks, this normally bustling district had become the largest recorded hotspot for chikungunya in China’s history.
OK, so chikungunya virus is abbreviated CHIKV and the disease is CHIKVD. In this episode, sometimes I'll refer to it as CHIK.
So, the outbreak reached its peak on July 19, when 681 people were diagnosed in a single day. Most patients were working-age adults between 15 and 64 years old, though older adults, school-aged children, and even toddlers were affected. The gender split was almost perfectly even. Thankfully, every case reported so far has been mild—no deaths in that outbreak, no severe complications—but the symptoms were still debilitating. In Shunde’s early case investigations, nearly 87% of patients had fever, over 81% experienced painful joints, and two-thirds developed a rash. Half of them had all three symptoms at once.
The public health response was both intense and targeted. Health workers actively searched for new cases, while also screening for dengue, which shares similar symptoms. CHIK testing was added to routine diagnostics in Foshan’s clinics and hospitals.
For those who tested positive, vector control teams moved quickly—within a week of symptom onset—to reduce the chance of the patient passing the virus to mosquitoes, and then on to other people. They installed insecticide-treated window screens and bed nets in homes, and treated living spaces with long-lasting repellents.
At the same time, community-level mosquito control rolled out on a massive scale: spraying for adult mosquitoes, clearing standing water, and removing breeding sites in at least a 100-meter radius around patients’ homes, workplaces, and other frequented spots. Real-time surveillance of mosquito populations helped the teams adapt their approach day by day.
This outbreak is a textbook example of how fast chikungunya can move—and how much work it takes to fight back. Even in Guangdong, a province used to battling mosquito-borne diseases like dengue, the sudden arrival of CHIK at this scale tested the limits of their surveillance and response systems. The fact that no severe cases or deaths have been reported is a testament to how quickly they mobilized.
The CDC has issued a Level 2 Travel Health Notice for Guangdong Province because of this outbreak — meaning travelers should take extra precautions to avoid mosquito bites.
Virology, Structure & Genetic Adaptability
All right — before we get into how this virus has traveled the globe and the mosquitoes that spread it, let’s look at what chikungunya actually is.
At its core, chikungunya is an alphavirus, part of the Togaviridae family. That means it’s a
positive-sense, single-stranded RNA virus wrapped in a lipid envelope — an outer shell that’s generally more sensitive to heat, drying, and disinfectants than the protein shells of some other viruses. But chikungunya’s envelope is tougher than you might expect: it can withstand brief exposures up to around 55 °C (131 °F) with only partial loss of infectivity, and you need sustained heating above 70 °C (158 °F) to fully inactivate it. Like other enveloped viruses, it’s still easily destroyed by alcohol-based hand sanitizers—though for a virus spread only by mosquitoes, that’s not a practical prevention tool.
OK, so there are three main genetic lineages: the Asian genotype, the West African genotype, and the East-Central-South African genotype, or ECSA. The outbreak in Foshan? That’s ECSA — specifically from the Central African clade.
The ECSA genotype has a well-traveled history. It’s the same one that left coastal Kenya in 2004, swept across the Indian Ocean islands, and reached India in a matter of months. During a massive 2005–2006 outbreak on Réunion Island, it picked up a single genetic change —a E1-A226V mutation — that allowed it to spread far more efficiently via Aedes albopictus, the cooler-climate, invasive mosquito that had not previously been good at transmitting CHIK. That one mutation was a game-changer, opening the door for chikungunya to move into temperate regions — from southern Europe to parts of the Americas — where Aedes aegypti can’t survive year-round.
In Foshan, scientists sequenced virus samples from 190 different patients, reading the genetic code letter by letter. Every single sample was almost identical, pointing to a single introduction of the virus into the region. All belonged to the Central African clade of the ECSA genotype — the same lineage that has proven, time and again, that once it reaches a region with competent mosquito vectors, it can settle in for the long haul.
In other words, chikungunya is a shapeshifter—a microscopic opportunist that evolves to match its vector’s strengths. The bottom line? Mosquito maps are being redrawn, and chikungunya’s genetic adaptability means it’s ready to follow wherever its mosquitoes go. And those boundaries now stretch far beyond the tropics.
But having the genetic blueprint is one thing. How it actually make us sick is another story.
Let's get into CHIK pathogenesis.
I should add here, that transmission isn’t only through mosquitoes. Evidence suggests that mother-to-child transmission can occur, particularly when the mother is infected around the time of delivery—and in newborns, this can have devastating consequences, including severe neurological disease.
Once the virus is in the body, it starts with a very specific target list. It readily infects skin cells at the bite site—especially epithelial and endothelial cells—along with primary fibroblasts and monocyte-derived macrophages. From there, it moves into the lymph nodes, and then into the bloodstream—the viremic phase. The virus is present in very high levels in the blood during this period, which is why mosquito bites at this stage can so easily pass it on.
Now, lab testing during the acute stage often reveals lymphopenia—a drop in lymphocyte counts below 1,000 per microliter—along with occasional leukopenia, elevated liver enzymes, anemia, or markers of muscle injury.
The immune system reacts quickly to the infection. CHIK triggers type I interferon production, largely through the activation of fibroblasts, which is crucial for clearing the virus. In adults, two key signaling proteins—interferon regulatory factors IRF3 and IRF7—can back each other up. In newborns, though, losing even one of these pathways can mean a much more severe infection.
In the skin, CD8+ T-cells dominate early, while in the joints of chronic sufferers, CD4+ T-cells are more common. The immune response isn’t just about clearing the virus—it can also create long-term damage. Inflammatory signals like TNF-α, IL-6, and IL-1 promote the activity of osteoclasts—those are the cells that break down bone tissue. Over time, this could help explain why some people develop lingering joint pain and arthritis-like symptoms long after the virus is gone.
And even the brain can be a battleground with CHIK. While neurological symptoms are rare, they’re serious when they occur, especially in newborns. In lab models, brain cells respond differently depending on their type: astrocytes and oligodendrocytes can be infected and driven to apoptosis, or programmed cell death, while microglia tend to resist infection but release waves of inflammatory molecules in response.
The takeaway? CHIK isn’t just a quick-hit fever. It’s a virus that exploits two global mosquito species, can adapt genetically to new environments, and leaves behind an immune and inflammatory footprint that can alter the body for months—or years—after the initial bite.
Chikungunya’s Past, Its Mosquito Vectors, and the Expanding Danger Zone
Understanding how the virus works inside the body is only half the story. The other half is the mosquitoes that carry it—and how they’ve helped CHIK spread across the world. And we should start with CHIK's two very different transmission cycles.
One is called the urban cycle and refers to transmission from human → mosquito → human.
When a mosquito bites an infected person during their first week of illness—the viremic phase, when the virus is circulating in the blood—it picks up the virus, (which the person got from a mosquito). About a week later, that mosquito becomes infectious, and every bite it takes can pass chikungunya to someone new.
The sylvatic cycle is older and wilder—a loop between forest mosquitoes and non-human primates, with only occasional spillover to humans. This is more common in parts of sub-Saharan Africa, where small outbreaks have been documented in countries like South Africa, Zimbabwe, Cameroon, Uganda, and Senegal.
Historically, when sylvatic spillover happens, Aedes aegypti—the classic yellow fever mosquito—has been the main driver of urban outbreaks in African cities. But in recent years, another mosquito has joined the cast: Aedes albopictus, the Asian tiger mosquito, a versatile species that thrives in cooler climates and in more suburban or rural areas. Where both mosquitoes are present, the dominant vector often depends on the virus’s strain: the Indian Ocean lineage (IOL) is well adapted to A. albopictus, while the older Asian lineage isn’t.
CHIK’s modern recorded history begins with a 1952 outbreak in what’s now Tanzania—but it may have left Africa much earlier, hitching rides on sailing ships alongside humans and mosquitoes, breeding in barrels of stored water. The real acceleration came in the late 20th and early 21st centuries, when global air travel, trade, and rapid urbanization brought the two main mosquito vectors into the same places.
The turning point was that 2005–2006 outbreak on Réunion Island, when the genetic change I mentioned made the virus far better at spreading through Aedes albopictus. In just months, about a third of the island’s population was infected, and travelers carried it to India, southern Europe, and eventually the Americas. Today, both A. aegypti and A. albopictus are entrenched across the tropics and subtropics—and A. albopictus is steadily creeping into temperate zones of Europe and North America.
These two mosquitoes are now central to the CHIK story—and they have very different personalities.
Aedes aegypti is the city dweller. It prefers human blood, breeds in containers close to homes, and thrives in warm, dense urban environments.
Aedes albopictus is the adaptable opportunist. It feeds on both humans and animals, tolerates cooler temperatures, and can live comfortably in rural gardens, suburban neighborhoods, or urban edges.
Both species are aggressive day biters, and both can carry not just chikungunya, but dengue and Zika—sometimes at the same time. They don’t need swamps or ponds to thrive; a bottle cap of water, a clogged gutter, or a plant saucer is enough. If you live somewhere without day-biters, count yourself lucky. Here on the Gulf Coast? They’re relentless. And yes—they suck. Literally. Fun fact: only female mosquitoes feed on blood and transmit diseases. They need those blood meals to produce eggs. Males? They’re just hanging out with the flowers, sipping nectar. Now, with disease-carrying mosquitoes, the process is even more interesting—and a little unsettling. When they bite an infected host, the pathogen has to travel through their body and make its way to the salivary glands before it can be injected into the next victim. That whole journey inside the mosquito is fascinating, and maybe I’ll do a future episode on it—ticks included. But for now, let’s get back to CHIK.
OK, so over the past few decades, global trade, travel, and warming climates have been steadily pushing the range of these two Aedes species into new territories. Aedes albopictus, once native to Southeast Asia, has now established itself across the Americas, southern Europe, parts of the Middle East, and temperate zones of North America. It’s now found seasonally as far north as New York, Chicago, and even southern Canada. Climate projections suggest that by mid-century, much of Europe and large swaths of the United States could have conditions suitable for seasonal or even year-round transmission.
Aedes aegypti — the more urban-adapted of the two — has also been expanding. Native to Africa, it’s now firmly entrenched across most of the tropical and subtropical world and has been steadily moving northward and southward from its traditional range. In the United States, it’s a permanent resident in Florida, the Gulf Coast, parts of the Southwest, and increasingly in pockets of California. In recent decades, A. aegypti has re-established itself in areas where it had previously been eliminated, aided by rising temperatures, urbanization, and water storage practices that create ideal breeding sites close to human homes.
In the Americas, the expansion has been relentless since CHIK first appeared in St. Martin in 2013. Both A. aegypti and A. albopictus have been implicated in outbreaks:
Florida, 2014 — Dozens of locally acquired cases in Miami-Dade, Palm Beach, St. Lucie, and Broward counties.
Texas, 2015 — A confirmed local case in Cameron County along the Mexico border.
Puerto Rico & U.S. Territories, 2014–2015 — Tens of thousands of cases during major outbreaks in Puerto Rico, the U.S. Virgin Islands, and American Samoa.
Before CHIK ever reached the Americas in 2013, Texas saw only a handful of cases — fewer than five in total, all in travelers returning from abroad. But that changed fast. In 2014 alone, the state reported 114 travel-related infections. The following year, there were 54 travel-associated cases… and one that was different. It was the first locally acquired chikungunya case ever confirmed in Texas — proof that the right mosquito was waiting. Follow-up mosquito surveillance showed no chikungunya circulation in the local mosquitos so control efforts work.
In most of those cases mentioned in the Americas, A. aegypti was the primary vector, but A. albopictus was also present in some regions.
Urbanization, inadequate water infrastructure, and the spread of peri-urban communities all create perfect breeding grounds. When the two mosquito species overlap, the risk is layered — A. aegypti can drive intense urban outbreaks, while A. albopictus sustains transmission in surrounding suburban and rural zones.
For countries and cities that have never seen CHIK before, this expanding frontier means they’re entering the danger zone for the first time. For places already battling dengue or Zika, CHIK adds yet another challenge — one with no specific treatment and a risk of long-term disability from post-viral joint pain.
So here's the bottom line when it comes to risk for areas that don't currently have local sustained circulation in mosquitoes, like in the US: if chikungunya enters the local mosquito population through biting a traveler, it’s unlikely to persist silently year-round. Aedes mosquitoes live only two to four weeks in the wild, so the virus disappears without a constant supply of infected humans. Many vector control programs, including in the US, already test mosquito pools for CHIK, and most human cases are symptomatic enough to be detected.
So the bigger risk isn’t silent, year-round circulation—it’s seasonal reintroduction. Every summer especially, infected travelers returning from outbreak regions could spark new chains of local transmission in areas where Aedes aegypti or Aedes albopictus are established. That’s exactly how it’s happened before, and with global travel and warming climates, it’s a pattern we should expect to see again and likely not just in summer.
And if there’s one takeaway here, it’s this: mosquito surveillance matters. That means actively collecting mosquitoes, identifying the species, and testing them for the viruses they might be carrying. It’s our early warning system—and without it, outbreaks can blindside us. If funding for these programs gets slashed, we’re flying without radar. Based on some of RFK’s past statements, it’s not hard to imagine him dismissing the science entirely, or claiming mosquitoes don’t spread disease and should be left alone. That kind of thinking could be catastrophic. The truth is, we need the data. We need the surveillance. And no matter what any politician says, you should protect yourself: use repellents, eliminate standing water, and keep mosquitoes out of your home. Chikungunya is just one of many mosquito-borne diseases you do not want to get. So vote people. Vote.
Symptoms & Clinical Presentation
So let's talk about how you feel after a mosquito infects you with CHIK.
The incubation period—the time from mosquito bite to first symptoms—is usually four to seven days. Then, almost out of nowhere, it hits: sudden high fever, often over 102F (39°C), paired with severe joint pain. This isn’t just a dull ache. It’s typically bilateral and symmetrical—in other words both wrists, both ankles, both knees—and it can be so intense that patients describe their joints as “locked” or “on fire.”
What makes CHIK stand out among mosquito-borne viruses is how often it causes symptoms. In outbreaks, between 50% and 97% of infected people develop a clear clinical illness—far higher than with dengue or Zika. That means in an affected community, you’re not just looking at a silent spread; you’re looking at whole households, even whole neighborhoods, getting sick at once.
Alongside the fever and joint pain, about half of patients will develop a rash—flat or slightly raised, reddish, and often spreading across the trunk, arms, and legs. Headaches, muscle aches, and crushing fatigue are common companions. In the acute phase, the illness can be debilitating—people may be confined to bed for days, unable to move without pain.
Certain groups are at much higher risk of severe outcomes. In newborns, CHIK can cause encephalitis - the medical term for inflammation of the brain. And pregnant women and people with underlying health conditions face greater risks of complications.
And then there’s the long game. For most, symptoms fade within a week or two. But in up to 40–50% of patients, the joint pain doesn’t just linger—it becomes chronic. Studies from past outbreaks, like the massive one I mentioned on Réunion Island, show that months or even years later, many people are still dealing with pain, stiffness, rheumatism, and fatigue. One report found that three-quarters of patients still had symptoms one month after infection; after two years, up to 75% were still affected. In some, the virus seems to leave a lasting mark on bone and joint tissues, triggering conditions like rheumatoid arthritis or ankylosing spondylitis.
New research is helping to explain why. Studies have found that viral RNA and proteins can persist in joint tissue long after the acute illness, likely hiding in immune cells like macrophages. This lingering viral material keeps the immune system in a state of low-grade inflammation — and over time, that inflammation can damage cartilage and bone, much like autoimmune diseases.
I hope I am conveying the seriousness of this. 40-50% of people with chronic severe pain because of this virus is such a high number! The name, Chikungunya really tells you all you need to know. It comes from the Kimakonde language of southern Tanzania. It means “that which bends up”, which is a reference to the hunched, contorted posture people take on when the virus’s severe joint pain makes it hard to stand or walk upright.
And it turns out that certain risk factors: older age, high viral load in the acute phase, and certain immune gene variants, all appear to make chronic disease more likely.
Though CHIK is generally considered to have low mortality but high morbidity, fatal outcomes do occur—and some researchers believe its true death toll may be underestimated. During that first Réunion outbreak, the official case-fatality rate was about 1 in 1,000, but deaths spiked during major epidemics in the mid-2000s, hitting the elderly hardest. For those over 65, the mortality risk can be five times higher than in younger adults, often because the infection tips the balance in people already living with other health conditions.
And the impact of CHIK goes beyond the health effects, there’s the economic toll. Missed work, medical costs, and long recovery times can ripple through entire communities. In places where outbreaks happen often, this virus leaves a lasting mark long after the headlines fade.
Which is why stopping it—or at least slowing it down—is so important.
Diagnosis & Differential Diagnosis
If chikungunya sounds like something you could spot from across the room—fever, joint pain, rash—here’s the catch: dengue and Zika can look almost identical. Even malaria, yellow fever, leptospirosis, and certain autoimmune conditions can overlap with the same symptoms.
That’s why lab confirmation is key. In the first week of illness, the gold standard is RT-PCR — a molecular test that looks for the virus’s RNA in the blood. After that first week, when the virus is no longer detectable in high amounts, blood tests for antibodies — IgM for recent infection, IgG for past infection — can confirm the diagnosis.
The World Health Organization actually recommends triple testing for dengue, Zika, and CHIKV in regions where all three circulate. That’s not just to be thorough—it’s because co-infections are real, and they complicate treatment and recovery.
Treatment & Management
There’s no antiviral drug for CHIK. No pill or shot that clears it from your system. Like for most viruses we talk about here, and despite what RFK might say, treatment is supportive—meaning it focuses on relieving symptoms and preventing complications.
In the acute phase (the early phase), that means rest, plenty of fluids, and pain relief. Acetaminophen is preferred until dengue is ruled out, because NSAIDs like ibuprofen can worsen bleeding in severe dengue cases. For lingering joint pain, doctors may recommend anti-inflammatory drugs, low-dose corticosteroids, or in chronic cases, disease-modifying antirheumatic drugs — the same kinds used for rheumatoid arthritis.
Physical therapy can help restore mobility and reduce stiffness in long-hauler cases. And for the record—yes, chronic arthritis after chikungunya is real, and rheumatologists are increasingly seeing it in their clinics.
Of course, medicine can only do so much once someone is infected — which is why governments throw enormous resources at stopping the virus before it spreads. As they should. But in some places, those efforts have sparked controversy.
From Public Health To Government Overreach
When chikungunya hits, the response has to be fast and broad. CHIK is a notifiable disease — when a case is confirmed, it’s reported to public health authorities immediately, buying communities precious time to respond.
In a typical outbreak, clinicians recognize symptoms and order tests, epidemiologists trace clusters, entomologists hunt down mosquito breeding sites, and community health workers distribute repellents, nets, and public education. Local governments coordinate large-scale mosquito control and track mosquito populations in real time.
But in Guangdong province, the government has gone far beyond these standard measures. Soldiers are fogging streets and parks with insecticide. Drones buzz overhead, spraying chemicals over neighborhoods. Community workers go door-to-door, checking every balcony and alley for stagnant water.
Some tactics are eerily reminiscent of China’s zero-COVID era. In Zhanjiang, more than 260 kilometers from the outbreak’s epicenter, a single mother posted a video showing police and health workers entering her children’s bedroom in the middle of the night — without her present — to take blood samples. A pharmacy had apparently reported her son to authorities after he came in with a fever. The incident went viral on Weibo, China’s biggest social media platform, and sparked fierce debate about government overreach.
Health authorities are also ordering pharmacies to report sales of certain fever medications — a move that helped identify the Zhanjiang children but drew public outrage — and, according to health policy experts, forcing some people who test positive into hospital isolation even though chikungunya is only mosquito-borne.
Officials argue the stakes are high. With no population immunity, dense urban conditions, and a climate perfect for mosquitoes, they say speed is essential. And to their credit, case numbers in Foshan do seem to be plateauing.
Still, the aggressive response — from drones in the skies to surveillance on the ground — is raising questions about where to draw the line between effective vector control and heavy-handed intrusion into daily life.
Prevention
There’s some good news on the prevention front. We now have two FDA-approved vaccines for chikungunya virus.
The first, Ixchiq — also known by its development name VLA1553 — is a live-attenuated vaccine originally developed by Valneva. The FDA first approved it in late 2023 for adults 18 years and older at increased risk of exposure, like travelers headed to outbreak zones or certain lab workers. Factors to consider include level of disease activity at your destination, duration of travel or residence, and likelihood of exposure to mosquitoes. For a while, there was caution about using it in people over 60, but as of August 2025, that restriction has been lifted. Now, it’s authorized for all adults 18+, though for those 65 and older, it’s still worth having a conversation with your healthcare provider about risks and benefits before rolling up your sleeve.
The second, VIMKUNYA, is a virus-like particle (VLP) vaccine — meaning it’s not live — approved by the FDA in February 2025 for anyone 12 years and older. This makes it an option for younger travelers and a good alternative for people who shouldn’t get live vaccines.
And both vaccines aren’t just U.S.-only — they’ve also been licensed in the European Union, the U.K., and other countries, with Ixchiq even approved in Brazil, the first endemic nation to authorize it. Global supply agreements aim to expand access further, especially in regions where chikungunya is already entrenched. This is really great progress on protecting people from this debilitating disease.
The CDC notes that certain groups are at higher risk of severe disease — including adults over 65, people with chronic conditions like diabetes or heart disease, and newborns or very young children. But their advice isn’t to cancel travel; it’s to travel prepared. Whether you’re headed somewhere with an ongoing outbreak or you discover local transmission near you at home, one of these vaccines can help protect you if you’re eligible. Talk to your doctor about your personal risk and the right prevention steps for you.
And because mosquitoes carry more than just CHIK and can carry more than one disease at a time, mosquito control is still critical, even if you get the CHIK vaccine: repellents, nets, screens, and eliminating standing water. And that’s a lot harder than it sounds—because Aedes mosquitoes don’t just live in swamps or ponds; they can breed in a puddle you could miss with a single glance.
Aedes eggs can survive for months under dry conditions, but once they’re submerged by rain, they hatch in just 2 to 4 days. Living on the Gulf Coast, I’ve seen this firsthand. If it rains, clean up those puddles within a couple of days and you’ll prevent a lot of mosquitoes. One tip I learned from arbovirus expert Scott Weaver back in grad school: around here, skip the bird feeders and let the birds eat the skeeters instead.
Here’s a little tip from my own front lines. When my son was born, I wanted a mosquito solution that didn’t involve spraying chemicals — especially for those rare perfect days when it’s cool enough to be outside here without sweltering or freezing. I tried a "natural" mosquito repellent made with lemon eucalyptus oil, on myself first thank God, and it felt like I lit my skin on fire. Not allergic to anything I know of but this was a nightmare. So, I ended up getting an electric bug zapper that also used a mosquito attractant. And for us, it worked surprisingly well. The proof was in the cleanup — far more mosquito carcasses under it than anything else. Yes, it did catch a few moths too — and that’s not ideal — but in that moment, the priority was being able to step outside without turning into a mosquito buffet. Sometimes, you just have to balance the realities of prevention with actually living your life.
Eco tip: If you use a bug zapper with a mosquito lure, you can limit collateral damage by running it smart, not nonstop. Turn it on about one to two hours before you plan to be outside, during peak mosquito times—early morning or late afternoon for day-biting species like Aedes aegypti and Aedes albopictus. That way, you’re thinning out the local mosquito population right where you’ll be, but you’re not running it all day and zapping every night-flying moth in the neighborhood. And once you’re outside, consider switching it off if it’s close to where you’re sitting, so you’re not luring mosquitoes toward you. Pair that with repellent, a good outdoor fan, or even citronella candles and tiki torches if you’d rather not put repellent on your skin. None of these work perfectly on their own, but together, they make a noticeable difference.
Chikungunya isn’t the loudest outbreak in the world right now. But it’s here—and in some places, it’s surging.
It’s a virus that can spread silently from one bite to the next, turning healthy people into patients, and lingering in their bodies long after the fever fades. And it’s carried by mosquitoes that are moving into new places every year. The lesson is simple: don’t underestimate mosquito-borne diseases. They don’t need to kill to cause massive disruption and lifelong health problems.
So, if you’re traveling—or even if you’re at home in a place where Aedes mosquitoes are present—protect yourself. Use mosquito control measures. Wear long sleeves. Keep your living space screened and free of standing water. And if you're at increased risk, get the vaccine. Also, if you develop a sudden high fever with joint pain and rash, see a healthcare provider immediately.
Because the mosquitoes needed to transmit this bugger are here. And there will be other cases of local transmission, of CHIK, yes but also of other arboviruses like West Nile, Zika, Dengue and Yellow Fever.
If you learned something today, share this episode—or leave a review. And follow me on social media...I'm on Bluesky and Twitter if you can stomach it. Bring me your questions and ideas! I'd love to see you there.
Stay healthy, stay informed, and spread knowledge, not diseases.
Comments