{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T03:48:34Z","timestamp":1793936914173,"version":"4.8.0"},"reference-count":91,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2023,1,17]],"date-time":"2023-01-17T00:00:00Z","timestamp":1673913600000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,4,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Rationale for review<\/jats:title><jats:p>Chikungunya outbreaks continue to occur, with changing epidemiology. Awareness about chikungunya is low both among the at-risk travellers and healthcare professionals, which can result in underdiagnosis and underreporting. This review aims to improve awareness among healthcare professionals regarding the risks of chikungunya for travellers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key findings<\/jats:title><jats:p>Chikungunya virus transmission to humans occurs mainly via daytime-active mosquitoes, Aedes aegypti and Aedes albopictus. The areas where these mosquitoes live is continuously expanding, partly due to climate changes. Chikungunya is characterized by an acute onset of fever with joint pain. These symptoms generally resolve within 1\u20133\u00a0weeks, but at least one-third of the patients suffer from debilitating rheumatologic symptoms for months to years. Large outbreaks in changing regions of the world since the turn of the 21st century (e.g. Caribbean, La R\u00e9union; currently Brazil, India) have resulted in growing numbers of travellers importing chikungunya, mainly to Europe and North America. Viremic travellers with chikungunya infection have seeded chikungunya clusters (France, United States of America) and outbreaks (Italy in 2007 and 2017) in non-endemic countries where Ae. albopictus mosquitoes are present. Community preventive measures are important to prevent disease transmission by mosquitoes. Individual preventive options are limited to personal protection measures against mosquito bites, particularly the daytime-active mosquitos that transmit the chikungunya virus. Candidate vaccines are on the horizon and regulatory authorities will need to assess environmental and host risk factors for persistent sequelae, such as obesity, age (over 40\u00a0years) and history of arthritis or inflammatory rheumatologic disease to determine which populations should be targeted for these chikungunya vaccines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions\/recommendations<\/jats:title><jats:p>Travellers planning to visit destinations with active CHIKV circulation should be advised about the risk for chikungunya, prevention strategies, the disease manifestations, possible chronic rheumatologic sequelae and, if symptomatic, seek medical evaluation and report potential exposures.<\/jats:p><\/jats:sec>","DOI":"10.1093\/jtm\/taad008","type":"journal-article","created":{"date-parts":[[2023,1,17]],"date-time":"2023-01-17T22:47:22Z","timestamp":1673995642000},"source":"Crossref","is-referenced-by-count":65,"title":["Chikungunya: risks for travellers"],"prefix":"10.1093","volume":"30","author":[{"given":"Fabrice","family":"Simon","sequence":"first","affiliation":[{"name":"Service de Pathologie Infectieuse et Tropicale, H\u00f4pital d\u2019Instruction des Arm\u00e9es Laveran , Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Caumes","sequence":"additional","affiliation":[{"name":"Centre de Diagnostic, H\u00f4pital de l\u2019H\u00f4tel-Dieu , Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomas","family":"Jelinek","sequence":"additional","affiliation":[{"name":"Berlin Centre for Travel and Tropical Medicine , Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rogelio","family":"Lopez-Velez","sequence":"additional","affiliation":[{"name":"Ram\u00f3n y Cajal Institute for Health Research (IRyCIS), Ram\u00f3n y Cajal University Hospital , Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Steffen","sequence":"additional","affiliation":[{"name":"Epidemiology , Biostatistics and Prevention Institute, WHO Collaborating Center on Travelers\u2019 Health, , Zurich, Switzerland"},{"name":"University of Zurich , Biostatistics and Prevention Institute, WHO Collaborating Center on Travelers\u2019 Health, , Zurich, Switzerland"},{"name":"Department of Epidemiology , Human Genetics and Environmental Sciences, , Houston, TX, USA"},{"name":"University of Texas School of Public Health , Human Genetics and Environmental Sciences, , Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin H","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Travel Medicine , Mount Auburn Hospital, Cambridge, MA, USA"},{"name":"Faculty of Medicine , Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,1,16]]},"reference":[{"key":"2023040512344482900_","volume-title":"UNWTO tourism data dashboard"},{"key":"2023040512344482900_","doi-asserted-by":"crossref","first-page":"2363","DOI":"10.1099\/vir.0.82858-0","article-title":"Changing patterns of chikungunya virus: re-emergence of a zoonotic arbovirus","volume":"88","author":"Powers","year":"2007","journal-title":"J Gen Virol"},{"key":"2023040512344482900_","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1038\/nrmicro2368","article-title":"Biology and pathogenesis of chikungunya virus","volume":"8","author":"Schwartz","year":"2010","journal-title":"Nat Rev Microbiol"},{"key":"2023040512344482900_","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1001\/jamadermatol.2014.2034","article-title":"Chikungunya: emerging threat to the United States","volume":"151","author":"Stamm","year":"2015","journal-title":"JAMA Dermatol"},{"key":"2023040512344482900_","first-page":"94","article-title":"Chikungunya virus infections","volume":"373","author":"Weaver","year":"2015","journal-title":"N Engl J Med"},{"key":"2023040512344482900_","first-page":"500","article-title":"Notes from the field: chikungunya virus spreads in the Americas - 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