The Tennessee Department of Health is reminding vacation and business travelers about the importance of protecting themselves from mosquitoes that may transmit chikungunya virus and other mosquito-borne illnesses like dengue. The first confirmed case of chikungunya virus disease in Tennessee occurred in 2014; since then 42 additional cases have been documented, all involving travel outside the state.


“Travel plans to warmer destinations should include necessary precautions to avoid mosquito bites,” said TDH Commissioner John Dreyzehner, MD, MPH. “Because there is no vaccine to prevent chikungunya virus disease, the only way to prevent its spread is the effective use of repellants and personal protection strategies.”

Prior to 2013, chikungunya virus disease was found primarily in Africa, Asia, Europe and in the Indian and Pacific Ocean areas. The illness draws its name from an African word meaning “to become contorted” as most patients suffer from severe joint pain. Chikungunya is rarely fatal, but can cause fever, joint and muscle pain, headaches, fatigue and rash. It can also lead to chronic joint pain. In the past year, health organizations have reported the disease spreading in additional areas, including the Caribbean and the Americas.

“Since it first surfaced here chikungunya has sickened more than one million people in 44 countries and territories in the Western Hemisphere,” Dreyzehner said. “We take the growing threat of chikungunya seriously and we are worried we will see more of it.”

Reason for Concern:  The number of cases of chikungunya continues to rise in the Caribbean, South America and Mexico, increasing the chances for American travelers to become infected with chikungunya. Chikungunya and dengue are very similar mosquito-borne illnesses; both go from mosquito to human to mosquito directly. Dengue symptoms include high fever, severe headache and muscle/bone pain.

Tennessee Department of Health recommendations for preventing mosquito bites include:

  • Use insect repellants such as DEET, Picaridin, oil of lemon eucalyptus or IR3535 on your skin, following all label recommendations for usage. Pay particular attention to recommendations for use on children and never apply any of these products around the mouth or eyes at any age. Consult your health care provider if you have questions.
  • Certain products containing permethrin are recommended for use on clothing, shoes, bed nets and camping gear. Permethrin is highly effective as a repellent. Permethrin-treated clothing repels and kills mosquitoes and other pests and retains this effect after repeated washing. Some commercial products are available pretreated with permethrin. Permethrin is not to be used directly on skin.
  • Do not use perfumes, colognes or scented deodorants or soap if you’re going outside, as fragrances may attract insects.
  • Remember “long, loose and light” when selecting outdoor wear. Long-sleeved shirts and long pants are best, and for improved effectiveness, tuck your pants into your socks and your shirt into your pants to form bug barriers. Wear loose-fitting clothing to prevent bites through the fabric. Light-colored clothes are less attractive to many insects and may allow you to spot them more easily.

Related: Chikungunya cases increase in Colombia and Nicaragua

“People at risk for more serious effects from chikungunya virus disease include newborns, those over age 65 and those with health conditions such as heart disease, diabetes or high blood pressure,” said Abelardo Moncayo, PhD, director of the TDH Vector-Borne Diseases program. “While there is no medicine to treat or cure the infection, rest, fluids to prevent dehydration and medicines like acetaminophen to relieve fever and pain are helpful. Fortunately, once a person has been infected with chikungunya, he or she is likely to be protected from future infections, and the disease rarely results in death.”

Chikungunya is the latest mosquito bite-borne threat to travelers that threatens to become more common as ill travelers return home and mosquitoes that bite them can sicken other people. Other, longer-standing threats include dengue, malaria and West Nile virus. None of these illnesses are prevented by vaccine, so the Tennessee Department of Health urges you to use repellents to help prevent mosquito bites.