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The Centers for Disease Control and Prevention (CDC) in the United States have issued a Level 2 travel alert warning American citizens planning to visit Cuba, Bangladesh, Sri Lanka, and Guangdong province in China about the active chikungunya outbreak, a viral disease transmitted by mosquitoes that has no cure or specific treatment.
“American travelers should take enhanced precautions”, health authorities stated in a statement on December 5.
Chikungunya, found in more than 100 countries, primarily circulates in tropical and subtropical regions. However, the availability and quality of epidemiological surveillance varies between countries, so complete information is not always available.
Key Recommendations from the CDC
The CDC prioritizes alerts that directly affect American travelers and considers factors such as:
Laboratory case confirmation.
-Comparison with historical levels.
-Mosquito season.
-Increase in cases among American travelers.
-Size and extent of the outbreak.
- Appearance in areas previously free of the virus.
-Volume of American travelers to the destination.
The goal is to empower travelers to make informed decisions about their risk of exposure to the chikungunya virus.
This warning is particularly significant in a context where multiple vector-borne infectious diseases are spreading across the Caribbean and Southeast Asia, causing alarm among international epidemiologists and migration authorities.
What is chikungunya and why is it a concern?
The chikungunya virus, whose name comes from a word in the Makonde language meaning "to bend from pain", primarily causes sudden fever and severe joint pain, although it can also lead to headaches, rashes, extreme fatigue, and, in some cases, more serious complications.
Symptoms typically appear 3 to 7 days after being bitten by an infected mosquito, usually of the genus Aedes aegypti or Aedes albopictus. Most people recover within a week, but in more severe cases, joint pain can persist for months or even years.
The World Health Organization has warned that "some patients may require hospitalization due to the risk of organ damage and death."
Between January and September 2025, the WHO reported 445,000 suspected and confirmed cases of chikungunya and 155 deaths worldwide.
Cuba: The Focus of Concern for the United States
The current outbreak in Cuba has raised particular concern due to its rapid spread and the conditions that favor it.
Dr. María Eugenia Toledo Romaní, a researcher at the Pedro Kourí Institute of Tropical Medicine (IPK), recently acknowledged that Cuba is experiencing its first major epidemic of chikungunya, something unprecedented in the country.
"It cannot be determined when the epidemic wave will end," he stated on national television, also warning that the population is highly susceptible to the virus due to having had no previous contact with it.
A multidimensional health crisis
Cuba is not only facing an outbreak of chikungunya.
The country is experiencing a health crisis with the simultaneous presence of dengue and Oropouche fever, the latter being an emerging disease also transmitted by mosquitoes and other blood-feeding insects.
According to official data, 33 people have died in 2025 from mosquito-borne diseases, 21 of them from chikungunya.
Independent organizations, such as the Cuban Observatory of Conflicts (OCC), raise that number to 87 fatalities, with reported impacts in several provinces.
The deterioration of the public health system, the shortage of insecticides, the interrupted fumigation campaigns, and the lack of basic medications further worsen the situation.
"The simultaneous presence of several mosquito-borne illnesses has raised alarm bells," warned Cuban doctor Luis Felipe Felipe, residing in Florida, who has even suggested considering a temporary suspension of flights to Cuba as a preventive measure.
International Reaction: from Havana to Washington
The United States Embassy in Cuba already issued a health advisory to its citizens in September, urging extreme caution when traveling to the island.
The CDC reinforced that position with their recent advisory, additionally recommending vaccination against chikungunya for those planning to visit the affected areas.
Other countries have also responded. Russia urged its citizens to cover their skin, avoid humid areas, and use repellent.
Canada issued a similar alert, and Mexico advised obtaining medical insurance before traveling to the island.
These warnings reflect a common fear: the exportation of the virus to countries where the vector mosquito is already present and where climatic conditions favor its reproduction.
What do the CDC recommend?
In their statement from December 5, the CDC emphasizes that travelers should be informed about active outbreaks in order to make appropriate decisions, especially if they belong to vulnerable groups such as pregnant women.
Among the key recommendations are:
Get vaccinated before traveling if visiting an area with an active outbreak.
-Wear clothing that covers arms and legs.
-Apply insect repellent several times a day.
-Avoid areas with stagnant water or dense vegetation.
-Consult official sources before, during, and after the trip.
-Seek immediate medical attention if symptoms occur after returning.
The goal, according to the CDC, is to “protect American travelers and minimize the risk of transmission.”
The threat at home: Can it reach the United States?
Although no cases of locally acquired chikungunya have been reported in the U.S. since 2019, the high volume of traveler traffic between Cuba and Florida, combined with the effects of climate change on the proliferation of Aedes aegypti, keeps epidemiologists on edge.
"We are facing a scenario where a single imported case could reactivate local transmission," explain experts in tropical diseases. Hence, the importance of surveillance, vaccination, and prevention campaigns.
Conclusion: travel informed, act with caution
Traveling to Cuba right now is not impossible, but it does require thorough health preparations.
The spread of chikungunya, combined with the structural crisis of the healthcare system on the island, creates a high-risk environment, particularly for individuals with preexisting medical conditions or those without access to immediate medical care.
As Dr. Luis Felipe Felipe recalled:
"Visitors are at a high risk of infection, especially those who are unaware of the magnitude of the outbreak and do not take appropriate precautions."
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