Chikungunya (or chikungunya fever) is a Category III notifiable medical condition in South Africa. The disease is caused by the mosquito-borne chikungunya virus that is transmitted mainly by Aedes aegypti and Aedes albopictus mosquitos, and which is endemic to a number of countries in Africa, Asia, the Americas and Oceania and the Pacific Islands. Sporadic and typically transient outbreaks have been reported from elsewhere. In South Africa, chikungunya is reported in travellers returning to South Africa from destinations where chikungunya outbreaks are being reported.
From December 2024 to 28 July 2025, a total of 10 laboratory confirmed (PCR and/or IgM serology) have been reported in South Africa involving returning travellers. These cases had travel histories to Mauritius (n=4), Kenya (n=1), India and the Himalayas (n=1), La Réunion (n=1), Seychelles (n=1), and Madagascar (n=2).
Ongoing outbreaks
Chikungunya fever outbreaks have occurred across Africa, the Americas, the Caribbean, Asia, and the Indian and Pacific Oceans. Autochthonous (locally transmitted) outbreaks are reported occasionally in areas not considered to be endemic for the diseases.
As of 4 May 2025, the Americas reported the highest number of chikungunya cases globally: 135,654 cases, including 54,377 confirmed infections. There are current outbreaks in Africa, in La Réunion, Mayotte, Mauritius, Madagascar, Kenya, Somalia, and Sri Lanka. As of 4 May 2025, over 47,500 cases and 12 deaths had been reported in La Réunion. The virus was first introduced to Mauritius on 15 March 2025, and by the end of April, 26 cases had been confirmed. Mayotte reported 116 cases by 4 May 2025. The initial imported case of this outbreak was identified on 5 March 2025. Madagascar has been reporting cases as of June 2025. This resurgence comes nearly 20 years after the significant 2005–2006 outbreak that began in Comoros and spread to La Réunion, Mayotte, Mauritius, the Seychelles, and Madagascar. La Réunion experienced an explosive outbreak, with 264,000 infections out of a population of 770,000 and 237 associated deaths. Mayotte reported approximately 7,300 cases during that period.
Disease symptoms
Symptoms include fever, muscle aches, rash, arthralgia, and arthritis. Although the illness is typically self-limiting, symptoms can be severe and debilitating, with arthritis occasionally becoming chronic. A clinical diagnosis of chikungunya is suspected in a patient with a relevant travel or exposure history and the clinical signs described above. Confirmation may be obtained through specialised laboratory testing such as RT-PCR and/or serology testing. Testing is available at the NICD/NHLS and private pathology laboratories.
The chikungunya virus is not spread from person-to-person. An autochthonous outbreak of chikungunya begins when a viremic traveller (a person ill with chikungunya and with virus present in the blood) from an endemic area is bitten by a local Aedes mosquito in a non-endemic region. The mosquito becomes infected, and after an incubation period, transmits the virus to local residents. If conditions favor mosquito breeding and human–mosquito contact, the virus spreads among the local population, creating sustained local transmission.
The risk for South Africa
Chikungunya is occasionally reported in travellers returning to South Africa from various destinations where the disease is present. During 2025, outbreaks have been reported from popular travel locations, such as the Indian Ocean Islands, which are common holiday destinations, thereby increasing the likelihood of cases being diagnosed and reported in South Africa. Although there have been no autochthonous cases of chikungunya reported in South Africa that have been linked to the current outbreaks occurring outside of the country, the presence of Aedes aegypti in urban areas means that the risk of potential autochthonous outbreaks should be considered. These mosquitoes are especially common along the east coast, particularly in KwaZulu-Natal and the Eastern Cape, as well as in the high-altitude Gauteng province.
Recommendations for travellers:
- Seek medical attention during or after travel if you experience fever, joint pain, headache, muscle aches, joint swelling, or rash. Symptoms usually appear shortly after returning from affected regions due to incubation periods (time between mosquito bite exposure and clinical illness) of up to 14 days.
- Pregnant individuals are advised to reconsider travel to affected areas due to potential health risks in consultation with their health care providers.
- Prevent mosquito bites, especially during the day and late afternoon. Use effective insect repellents on exposed skin, wear long-sleeved clothing and trousers, and stay in air- conditioned or well-screened environments.
- Chikungunya vaccine is not readily available worldwide, and not yet available in South Africa.
