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CHIKUNGUNYA

Find most of the information you need in these resources

Always refer to your local signed PGD's in practice, and remember the Green Book takes priority over the SPmC - and sometimes WHO takes priority over the Green Book! They don't always say the same!

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Keeping up to date: Things to know in practice currently:
Help with risk assessing
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Vimkunya (Bavarian Nordic) – MHRA approved May 1, 2025 for individuals aged 12+

  • Recombinant virus-like particle (VLP) vaccine—single 0.8 mL dose, IM injection

  • Seroresponse rates up to 98 % in 12–64 yrs; ~87 % in ≥ 65 yrs at 3 weeks, ~76–86 % at 6 months

  • Common reactions: injection site pain, fatigue, headache, myalgia

  • Not recommended for use in severe immunosuppression or pregnancy without specialist advice

Ixchiq (Valneva)

  • Live-attenuated vaccine, approved in Feb 2025 for individuals 18+

  • Single dose IM; initial seroresponse ~99%, remains high at 3 years in younger adults

  • Caution: temporarily restricted in people ≥ 60/65 yrs due to serious adverse events reported globally

Info arrow signage
Info arrow signage

JCVI Advice:

  • Vimkunya may be offered for those aged ≥ 12 traveling to outbreak areas or lab workers

  • Ixchiq may be offered to healthy individuals aged 18–59 if live vaccine is appropriate—avoided in ≥ 65 yrs pending

  • Storage: 2–8 °C; IM injection

  • Scheduling: Give ≥ 2 weeks before travel when possible

Want to geek out? Go deeper here:

  • Valneva have created a fabulous training resource for travel healthers "Neva". Lots of useful modules on there including a lovely NEW one all about Chikungunya. Free to register - and well worth it!

white mesh net on brown wooden floor
white mesh net on brown wooden floor
What is chikungunya anyway?

Chikungunya is a viral infection caused by Chikungunya virus, transmitted via Aedes mosquitoes. It causes sudden high fever and severe joint pain—symptoms that can linger for weeks or even months. The word “chikungunya” comes from a term meaning “that which bends up,” referring to the posture forced by joint pain. Chikungunya is an alphavirus with three genetically distinct lineages which was first identified as a result of a significant outbreak in southern Tanzania in 1952.

What happens If you catch it?

Symptoms typically appear 4–8 days after a bite and include high fever, debilitating polyarthralgia (usually in hands and feet), headache, rash, and fatigue. Though mortality is rare, persistent joint pain and fatigue can significantly impact quality of life—especially in older adults.

How does It Spread?

Via bites from Aedes aegypti or Aedes albopictus, daytime mosquitoes found in many tropical, subtropical, and increasingly, Mediterranean regions. Mosquitoes become infected when they feed on viremic nonhuman or human primates, both of which are likely the main amplifying reservoirs of the virus. Humans are typically viremic shortly before and in the first 2–6 days of illness. Bloodborne transmission is possible; 1 case has been documented in a health care worker who sustained a needle stick after drawing blood from an infected patient. Furthermore, chikungunya virus has been identified in donated blood products undergoing screening, although no transfusion-associated cases have been identified to date. Maternal–fetal transmission has been documented during pregnancy; the greatest risk occurs in the perinatal period when the pregnant woman is viremic at the time of delivery. Although chikungunya viral RNA was identified in the breast milk of 1 infected person, the breastfed infant had no symptoms or evidence of infection based on laboratory testing. Additionally, chikungunya viral RNA has been identified in semen, but no evidence of sexual transmission has been noted to date.

Does getting chikungunya make you Immune?

Yes—natural infection usually confers lifelong immunity. Vaccination induces protective immunity safely, without disease.

Can it be treated?

No specific antiviral. Treatment is supportive: fluids, rest, and non-steroidal anti‑inflammatory drugs. Severe or prolonged symptoms may warrant rheumatology referral or physical therapy.

Who’s most at risk?

  • Travellers to regions experiencing chikungunya outbreaks

  • Longer-stay visitors to Asia, Africa, the Americas, or Southern Europe (by the way, England may become a suitable habitat for the Aedes mosquitoes by the 2040s/2050s.)

  • Older adults (more likely to have chronic arthritis post-infection)

  • People with pre-existing joint conditions

  • Laboratory staff working with chikungunya virus

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Top reasons to encourage vaccination (when indicated):

  • In the first quarter of 2025, ~80,000 cases and 46 chikungunya related deaths in 14 countries/territories were reported. The highest burden of disease has been seen in Brazil, with high levels also seen in La Réunion and Mayotte.

  • Vaccines are now licensed in the UK

  • It’s very common in travellers. In one study, chikungunya was the second most common cause of fever in returned travellers from the Indian Ocean and Caribbean regions, just behind dengue (GeoSentinel data, 2016).

  • Prevents a painful, disabling illness: Severe joint pain affects up to 90% of symptomatic cases—and it can last for months or years. It’s not just “a bit of a virus.”

  • No treatment exists. The only protection is prevention.

  • Older adults are more likely to have long-term symptoms. Around 30–40% of those aged over 45 report pain 3–12 months after infection.

  • Outbreaks can occur in popular holiday hotspots like Mauritius, Thailand, Brazil, and southern Europe (Italy, France). Travellers may be unaware they’re heading into an active zone.

  • A single bite can infect! Aedes mosquitoes bite during the day and often indoors—repellent is helpful but not foolproof.

  • Hospitalisation may be needed in 5–8% of cases, even in healthy people. In high-risk groups (older adults, those with chronic disease), severe illness is more likely.

  • Mortality is low but real—up to 1 in 1,000 symptomatic cases die during outbreaks in older or immunocompromised populations.

  • Both Vimkunya and Ixchiq show strong antibody responses within 2–3 weeks of a single dose.

  • Better safe than sore. Yes, the vaccine can lead to a bit of an achy arm BUT travellers with prior joint issues, autoimmune disease, or fibromyalgia may experience months of flare-ups after infection with the disease. Vaccination is a much less achy option.

  • It ticks a gap in standard travel vaccines. Unlike shistosomiasis, Zika, or West Nile—which we are not fortunate enough to have vaccines for (yet...).