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Chikungunya is a mosquito-borne viral infection causing acute fever and joint pains that may lead to chronic joint symptoms. It is transmitted to humans via the bite of infected Aedes mosquitoes, predominately Aedes aegypti and Aedes albopictus. Aedes mosquitoes are particularly persistent and aggressive and bite mainly during daylight hours.
Chikungunya is an unpleasant disease but is rarely fatal. The incubation period is usually 4 to 8 days (range 1 to 12 days). Symptoms include fever, joint pains (arthralgia) and muscle pains (myalgia), headaches, rash, nausea, fatigue and conjunctivitis. Joint symptoms may persist for weeks to months or years after acute infection has resolved.
Strict mosquito bite avoidance is the most effective way to reduce the risk of infection.
Two new vaccines have recently been approved for use in the UK, the European Union and the USA. IXCHIQ is a live-attenuated vaccine approved in the UK for individuals 18 years and older, and Vimkunya is a virus-like particle vaccine (not a live/replicating vaccine) for individuals 12 years and older. These vaccines will be reviewed by the Joint Committee on Vaccination and Immunisation (JCVI) and guidance drafted for the UK Health Security Agency 'Green Book' in due course.
Health professionals offering these vaccines must ensure they are adequately informed on their use. As the guidance for pre-travel risk assessment for chikungunya vaccine has yet to be established and may be complex, health professionals may wish to wait for the 'Green Book' guidance before providing this vaccine to travellers.
The U.S. Centres for Disease Control and Prevention (CDC) and the French National Authority for Health (HAS) have recently been investigating potential serious vaccine-associated adverse events in individuals over 60 years old vaccinated with IXCHIQ, many of whom had significant pre-existing comorbidities. Two individuals experienced symptoms similar to those of a severe form of chikungunya a few days after vaccination.
As of 7 May 2025, the U.S. CDC and Food and Drug Administration (FDA) reported 17 serious adverse events, including two deaths, in individuals 62 to 89 years of age. The exact cause of these adverse events and their relationship with the vaccine have not yet been determined. In light of these events, the U.S. CDC and FDA have recommended a pause in the use of IXCHIQ in individuals 60 years of age and older while post-licensing safety reports are investigated.
The JCVI will consider these reports as part of their review.
Travellers to affected areas are potentially at risk of chikungunya and should be aware of this infection. Aedes mosquitoes are particularly persistent and aggressive. They bite between dawn and dusk.
Travellers developing a fever during or on return from travel should be advised to seek medical attention as soon as possible. Travellers should always phone their GP first before visiting to reduce the risk of spreading infections to others.
Health professionals who suspect a mosquito or insect spread infection such as chikungunya in a recently returned traveller, should discuss this urgently with their local microbiology, virology or infectious diseases consultant. A full travel and clinical history will need to be provided. They may advise that appropriate samples are sent for testing to specialist laboratory facilities at the Rare and imported pathogens laboratory (RIPL) in the UK.
All suspected adverse reactions to IXCHIQ and Vimkunya® should be reported on the yellow card scheme and to the manufacturers Valneva for IXCHIQ (email medinfo@valneva.com) and Bavarian Nordic for Vimkunya (email drug.safety@bavarian-nordic.com).
For further information, see TRAVAX Chikungunya page.
