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Distribution of Chikungunya as of J une 2014.

Does not include


countries where only imported cases have been documented.
Map adapted from CDC.





What is Chikungunya, and where is it found?

Chikungunya (CHIK) [chick-en-GUN-yah], also known as
chikungunya virus disease or chikungunya fever, is a debilitating
viral illness spread by the bite of infected mosquitoes. It
resembles other arboviral infections (like dengue fever) in that a
high fever and severe joint pain are the primary symptoms, and
symptoms can last from a few days to a few weeks.
Chikungunya occurs mainly in Africa, India, and Southeast Asia.
There have been a number of outbreaks (epidemics) in the
Philippines and on islands throughout the Indian Ocean.
Additionally, a localized outbreak on the European continent
was reported in 2007. The first locally acquired cases of
Chikungunya in the Americas were reported in the Caribbean
(St. Martin) in late 2013. The mosquito species that transmit
Chikungunya are well established throughout the Americas and
place the region at risk for further introduction and spread of the
virus.

How do people become i nfected with Chikungunya virus?

The virus is spread by bites from infected Aedes mosquitoes.
If an infected person is bitten by a mosquito, that mosquito may
later spread the virus by biting another person. An infectious
person cannot spread the infection directly to another person.
Aedes mosquitoes are aggressive daytime biters with peak
activity at dawn and dusk.

What are the symptoms of Chikungunya infection?

The symptoms of Chikungunya include sudden onset of high
fever, severe joint pain, muscle pain and headaches. The symptoms appear on average 3 to 7 days (but can range from
2 to 12 days) after being bitten by an infected mosquito. In the Kimakonde language of Mozambique, chikungunya
means that which contorts or bends up. This is in reference to the contorted (or stooped) posture of patients who are
afflicted with the severe joint pain, which is the most common symptom of the disease. While most patients recover after
a few days or weeks, a small number of patients may develop chronic joint pain. Some patients have reported temporary
disabling joint pain or arthritis which may last for weeks or months. Other possible, but rare, complications include gastro-
intestinal or cardiovascular disease. Hospitalizations and fatalities are rare.

Is there a treatment for Chikungunya infection?

No specific vaccine or medication is currently available; treatment is mainly supportive (such as rest, fluids and non-
steroidal anti-inflammatory medications).

What should I do if I think I have Chikungunya?

If you experience the symptoms described above and have traveled to an area where Chikungunya is known to occur,
seek medical attention immediately. Chikungunya resembles dengue fever, and laboratory confirmation is required to
differentiate between the two. Be sure to tell your health care provider your recent travel history. Limit the risk of further
mosquito bites as much as possible, as this will help prevent the virus from spreading to others in case you do have
Chikungunya.

FACT SHEET 18-029-0714
CHIKUNGUNYA
Aedes albopictus (left) and Ae. aegypti (right) mosquitoes are the
primary vectors of CHIK. Both species feed readily on humans.
Ae. aegypti is the most important vector in tropical climates, and
Ae. albopictus plays a more significant role in temperate areas.
Both species are well established throughout the Americas.
Courtesy Graham Snodgrass USAPHC
U.S. Army Public Health Command
Entomological Sciences
5158 Blackhawk Road, APG, MD 21010-5403
COM 410-436-3613 / DSN 312-584-3613 / Website: http://phc.amedd.army.mil
Approved for Public Release, Distribution Unlimited

Combined use of all elements of the DOD Insect Repellent
System provides maximum and safe protection from
mosquitoes that carry CHIK virus. It is DOD policy that
Soldiers use the DOD Insect Repellent System when the
threat of vector-borne disease transmission is likely.
How can chikungunya be prevented?

AVOID MOSQUITO BITES! The best method of protection from mosquitoes is the use of the DOD Insect Repellent
System. It incorporates permethrin repellent on the uniform, DEET or picaridin repellent on exposed skin, a properly worn
uniform and sleeping under a permethrin-treated bed net. Uniforms factory-treated with permethrin will have a garment
label similar to the one shown below. Another important preventive measure is to eliminate mosquito breeding sites.
Empty water from birdbaths, old tires, and other outdoor containers that collect water. When indoors, stay in air-
conditioned areas. Make sure door and window screens are in place and do not have holes. Minimize time outdoors after
dawn and before dusk, which are the peak biting times for the Aedes mosquitoes that transmit Chikungunya.

What can I use to treat my clothing with permethri n?

Army Combat Uniforms (ACUs) that are factory-treated with
permethrin (ACU Permethrin) are now available to all Soldiers. The
ACU Permethrin will have a sewn-in label on both the trouser and
the blouse indicating the uniform has been factory-treated with
permethrin. If not factory-treated, apply permethrin to uniforms in the
field before wearing using either the IDA Kit (NSN 6840-01-345-
0237), which can last up to 50 washings, or aerosol can (NSN 6840-
01-278-1336), which lasts 5-6 washings. Other aerosol products
containing 0.05% permethrin, and permethrin-impregnated garments
are also commercially available for civilian use.

What are the standard mil itary insect repel lent products
available for use on exposed skin?

Ultrathon (NSN 6840-01-284-3982) 33% controlled-release
DEET lotion; one application protects for 12 hours.
Ultra 30 Insect Repellent Lotion (NSN 6840-01-584-8393) contains 30% Lipo DEET; the formulation is not as greasy
and one application protects for up to 12 hours.
Cutter

pump spray (NSN 6840-01-584-8598) contains 23% DEET; one application protects for up to 8 hours.
Sunsect combination sunscreen & repellent (6840-01-288-2188) contains 20% DEET and SPF 15 sun protection.
Natrapel

pump spray (NSN 6840-01-619-4795) contains 20% picaridin; provides improved protection against
Anopheles mosquitoes (carriers of malaria).
Camouflage Face Paint (CFP) with 30% DEET (NSN 6840-01-493-7334).
NOTE: Do not apply repellent to the eyes or lips, or to sensitive or damaged skin.









What is considered a properl y worn uniform ?

Worn properly, your uniform acts as a physical barrier against insects. Wear the sleeves rolled down. Close all openings
in your clothing that might provide access to insects: tuck your pants into your boots and your undershirt into your pants.
Wear your uniform loosely since mosquitoes can bite through fabric that is pulled tight against the skin.

What are the standard bed nets availabl e to help protect Soldiers from mosquito bites while sleeping?

Lightweight, Self-Supporting, Pop-Up Bed Nets factory-treated with permethrin are available in Coyote Brown (NSN 3740-
01-518-7310) or OD Green (NSN 8415-01-516-4415). Untreated Mosquito Bed Nets (NSN 7210-00-266-9736) should be
treated with permethrin aerosol before setting up to prevent mosquitoes from biting through the net.

Where can I get more information on chikungunya?

The Armed Forces Pest Management Boards Dengue and Chikungunya Vector Control Pocket Guide (Tech Guide 47)
can be found at: http://afpmb.org/content/technical-guides
Centers for Disease Control and Prevention (CDC): http://www.cdc.gov/chikungunya/index.html
Standard military insect repellents for
use on exposed skin come in a variety of
formulations (left). All standard skin
repellents contain the active ingredient
DEET or picaridin and are registered by
the USEPA. These products are safe to
use and effective at repelling
mosquitoes that carry the CHIK virus.
Use of trademarked name does not imply endorsement by the U.S. Army but is intended only to assist in identification of a specific product.
For more information please consult the USAPHC website - http://phc.amedd.army.mil

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