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Chikungunya virus disease cases in the United States (as of Aug. 5, 2014)

Gert van der Hoek

Gert van der Hoek

In Memoriam - Editor, Senior Moderator
Chikungunya cases in the United States now total 30

Charles Simmins

June 5, 2014

Imported cases of the mosquito borne illness chikungunya continue to arrive in the United States. Using public health data, media reports and personal contacts, the compiled number of chikungunya cases discovered as of June 5 is 30. There have been no locally acquired chikungunya illnesses in the continental United States.

The Centers for Disease Control have begun listing a count for the number of chikungunya cases reported to them. As of June 2, their count showed 26 imported cases in the continental U.S. One imported case has been found in the U.S. Virgin Islands and one locally acquired chikungunya case in Puerto Rico.

Florida is reporting any chikungunya cases in that state in its weekly Arbovirus Surveillance report. Their May 31 report shows 18 imported cases, two more than the CDC has. WLBT in Jackson MS, reports that an imported case has been diagnosed in nearby Flowood. A U.S. aid worker in Rhode Island has confirmed to me that she has been diagnosed with chikungunya. She returned from Haiti about May 23. Those four cases, added to the CDC count, provide the current national total of 30 chikungunya cases.

More: Examiner
 
Re: Chikungunya cases in the United States now total 30

Re: Chikungunya cases in the United States now total 30

Chikungunya in the Americas
...
Chikungunya virus in the United States

  • Chikungunya is not a nationally notifiable disease in the United States. However, chikungunya cases can be reported to ArboNET, the national surveillance system for arthropod-borne diseases.
  • From 2006‒2013, studies identified an average of 28 people per year in the United States with positive tests for recent chikungunya virus infection (Range 5‒65 per year). All were travelers visiting or returning to the United States from affected areas, mostly in Asia. Only a quarter of the cases were reported to ArboNET.
  • Beginning in 2014, cases have been identified in travelers returning from the Caribbean. As of June 10, a total of 39 chikungunya cases have been reported to ArboNET from U.S. states and territories (Table). One locally transmitted case has been reported from Puerto Rico. All other cases occurred in travelers returning from affected areas in the Caribbean (N=37) or Asia (N=1). To date, no local transmission has been identified in the continental United States.
  • With the recent outbreaks in the Caribbean and the Pacific, the number of chikungunya cases among travelers visiting or returning to the United States from affected areas will likely increase. These imported cases could result in local spread of the virus in the continental United States.
...
<TABLE id=arbonet-data summary="This table displays states reporting Chikungunya virus disease cases to ArboNET, classified as either travel-associated cases or locally-transmitted cases"><CAPTION>Table. Chikungunya virus disease cases reported to ArboNET ? United States, 2014 (as of June 10)*</CAPTION><THEAD><TR><TH class="col1 left" rowSpan=2 scope=col>State or territory</TH><TH class=cases colSpan=2 scope=col>Travel-associated cases??
(N=38)

</TH><TH class=cases colSpan=2 scope=col>Locally-transmitted cases
(N=1)

</TH></TR><TR><TH class="col2 arbono noper" scope=col>No.</TH><TH class="col2 arboper noper" scope=col>(%)</TH><TH class="col2 arbono noper" scope=col>No.</TH><TH class="col2 arboper noper" scope=col>(%)</TH></TR></THEAD><TBODY><TR><TH class="left state" scope=row>Arkansas</TH><TD class=arbono>1</TD><TD class=arboper>(3)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>California</TH><TD class=arbono>1</TD><TD class=arboper>(3)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Connecticut</TH><TD class=arbono>3</TD><TD class=arboper>(8)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Florida</TH><TD class=arbono>23</TD><TD class=arboper>(61)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Maryland</TH><TD class=arbono>1</TD><TD class=arboper>(3)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Minnesota



</TH><TD class=arbono>1</TD><TD class=arboper>(3)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Nebraska



</TH><TD class=arbono>1</TD><TD class=arboper>(3)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Nevada</TH><TD class=arbono>1</TD><TD class=arboper>(3)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>New York</TH><TD class=arbono>1</TD><TD class=arboper>(3)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Puerto Rico</TH><TD class=arbono>0</TD><TD class=arboper>(0)</TD><TD class=arbono>1</TD><TD class=arboper>(100)</TD></TR><TR><TH class="left state" scope=row>US Virgin Islands</TH><TD class=arbono>1</TD><TD class=arboper>(3)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Virginia</TH><TD class=arbono>4</TD><TD class=arboper>(11)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR></TBODY></TABLE>

http://www.cdc.gov/chikungunya/geo/americas.html
 
Re: Chikungunya cases in the United States now total 129as of July 1, 2014

Re: Chikungunya cases in the United States now total 129as of July 1, 2014

Chikungunya virus in the United States

Updates of chikungunya case counts are publically released every Tuesday evening (MT).

...
Beginning in 2014, cases have been identified in travelers returning from the Caribbean. As of July 1, a total of 129 chikungunya cases have been reported to ArboNET from U.S. states and territories (Table). Fifteen locally-transmitted cases have been reported from Puerto Rico and the US Virgin Islands. All other cases occurred in travelers returning from affected areas in the Caribbean (N=110), the Pacific Islands (N=3), or Asia (N=1). To date, no local transmission has been identified in the continental United States.

With the recent outbreaks in the Caribbean and the Pacific, the number of chikungunya cases among travelers visiting or returning to the United States from affected areas will likely increase. These imported cases could result in local spread of the virus in the continental United States.

Table. Chikungunya virus disease cases reported to ArboNET ? United States, 2014 (as of July 1)*

<TABLE id=arbonet-data summary="This table displays states reporting Chikungunya virus disease cases to ArboNET, classified as either travel-associated cases or locally-transmitted cases"><THEAD><TR><TH class="col1 left" rowSpan=2 scope=col>State or territory</TH><TH class=cases colSpan=2 scope=col>Travel-associated cases??
(N=114)
</TH><TH class=cases colSpan=2 scope=col>Locally-transmitted cases
(N=15)
</TH></TR><TR><TH class="col2 arbono noper" scope=col>No.</TH><TH class="col2 arboper noper" scope=col>(%)</TH><TH class="col2 arbono noper" scope=col>No.</TH><TH class="col2 arboper noper" scope=col>(%)</TH></TR></THEAD><TBODY><TR><TH class="left state" scope=row>Arizona</TH><TD class=arbono>1</TD><TD class=arboper>(1)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Arkansas</TH><TD class=arbono>1</TD><TD class=arboper>(1)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>California</TH><TD class=arbono>7</TD><TD class=arboper>(6)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Connecticut</TH><TD class=arbono>6</TD><TD class=arboper>(5)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Florida</TH><TD class=arbono>34</TD><TD class=arboper>(30)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Georgia</TH><TD class=arbono>3</TD><TD class=arboper>(3)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Indiana</TH><TD class=arbono>1</TD><TD class=arboper>(1)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Kansas</TH><TD class=arbono>1</TD><TD class=arboper>(1)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Kentucky</TH><TD class=arbono>1</TD><TD class=arboper>(1)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Louisiana</TH><TD class=arbono>1</TD><TD class=arboper>(1)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Maryland</TH><TD class=arbono>2</TD><TD class=arboper>(2)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Massachusetts</TH><TD class=arbono>2</TD><TD class=arboper>(2)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Michigan</TH><TD class=arbono>3</TD><TD class=arboper>(3)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Minnesota


</TH><TD class=arbono>4</TD><TD class=arboper>(4)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Mississippi</TH><TD class=arbono>2</TD><TD class=arboper>(2)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Nebraska


</TH><TD class=arbono>1</TD><TD class=arboper>(1)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Nevada</TH><TD class=arbono>1</TD><TD class=arboper>(1)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>New Jersey</TH><TD class=arbono>4</TD><TD class=arboper>(4)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>New York</TH><TD class=arbono>8</TD><TD class=arboper>(7)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>North Carolina</TH><TD class=arbono>4</TD><TD class=arboper>(4)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Ohio</TH><TD class=arbono>2</TD><TD class=arboper>(2)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Oklahoma</TH><TD class=arbono>2</TD><TD class=arboper>(2)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Oregon</TH><TD class=arbono>1</TD><TD class=arboper>(1)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Pennsylvania</TH><TD class=arbono>3</TD><TD class=arboper>(3)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Puerto Rico</TH><TD class=arbono>0</TD><TD class=arboper>(0)</TD><TD class=arbono>14</TD><TD class=arboper>(93)</TD></TR><TR><TH class="left state" scope=row>Rhode Island</TH><TD class=arbono>3</TD><TD class=arboper>(3)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Tennessee</TH><TD class=arbono>8</TD><TD class=arboper>(7)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>US Virgin Islands</TH><TD class=arbono>2</TD><TD class=arboper>(2)</TD><TD class=arbono>1</TD><TD class=arboper>(7)</TD></TR><TR><TH class="left state" scope=row>Virginia</TH><TD class=arbono>6</TD><TD class=arboper>(5)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR></TBODY></TABLE>


...
http://www.cdc.gov/chikungunya/geo/united-states.html
 
Chikungunya virus disease cases in the United States (as of July 29, 2014)

Chikungunya virus disease cases in the United States (as of July 29, 2014)

Chikungunya virus in the United States

Updates of chikungunya case counts are publically released every Tuesday evening (MT).

  • Chikungunya is not a nationally notifiable disease in the United States. However, chikungunya cases can be reported to ArboNET, the national surveillance system for arthropod-borne diseases.
  • From 2006‒2013, studies identified an average of 28 people per year in the United States with positive tests for recent chikungunya virus infection (Range 5‒65 per year). All were travelers visiting or returning to the United States from affected areas, mostly in Asia. Only a quarter of the cases were reported to ArboNET.
  • Beginning in 2014, cases have been identified in travelers returning from the Caribbean. As of July 29, a total of 601 chikungunya cases have been reported to ArboNET from U.S. states and territories (Table). Two hundred and three locally-transmitted cases have been reported from Florida, Puerto Rico, and the US Virgin Islands. All other cases occurred in travelers returning from affected areas in the Caribbean and South America (N=391), the Pacific Islands (N=5), or Asia (N=2).
  • With the recent outbreaks in the Caribbean and the Pacific, the number of chikungunya cases among travelers visiting or returning to the United States from affected areas will continue to increase. These imported cases could result in local spread of the virus in the continental United States.
Chikungunya virus disease cases reported by state or territory ? United States, 2014 (as of July 29, 2014)

CHIK_State_Report-072914.jpg




<TABLE id=arbonet-data summary="This table displays states reporting Chikungunya virus disease cases to ArboNET, classified as either travel-associated cases or locally-transmitted cases"><CAPTION>Table. Chikungunya virus disease cases reported to ArboNET ? United States, 2014 (as of July 29)*</CAPTION><THEAD><TR><TH class="col1 left" rowSpan=2 scope=col>State or territory</TH><TH class=cases colSpan=2 scope=col>Travel-associated cases??
(N=398)

</TH><TH class=cases colSpan=2 scope=col>Locally-transmitted cases
(N=203)

</TH></TR><TR><TH class="col2 arbono noper" scope=col>No.</TH><TH class="col2 arboper noper" scope=col>(%)</TH><TH class="col2 arbono noper" scope=col>No.</TH><TH class="col2 arboper noper" scope=col>(%)</TH></TR></THEAD><TBODY><TR><TH class="left state" scope=row>Arizona</TH><TD class=arbono>1</TD><TD class=arboper>(<1)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Arkansas</TH><TD class=arbono>3</TD><TD class=arboper>(1)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>California</TH><TD class=arbono>19</TD><TD class=arboper>(5)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Connecticut</TH><TD class=arbono>11</TD><TD class=arboper>(3)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Delaware</TH><TD class=arbono>1</TD><TD class=arboper>(<1)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Florida</TH><TD class=arbono>105</TD><TD class=arboper>(26)</TD><TD class=arbono>2</TD><TD class=arboper>(1)</TD></TR><TR><TH class="left state" scope=row>Georgia</TH><TD class=arbono>8</TD><TD class=arboper>(2)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Hawaii</TH><TD class=arbono>1</TD><TD class=arboper>(<1)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Idaho</TH><TD class=arbono>1</TD><TD class=arboper>(<1)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Illinois</TH><TD class=arbono>1</TD><TD class=arboper>(<1)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Indiana</TH><TD class=arbono>7</TD><TD class=arboper>(2)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Kansas</TH><TD class=arbono>2</TD><TD class=arboper>(1)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Kentucky</TH><TD class=arbono>7</TD><TD class=arboper>(2)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Louisiana</TH><TD class=arbono>6</TD><TD class=arboper>(2)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Maine</TH><TD class=arbono>1</TD><TD class=arboper>(<1)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Maryland</TH><TD class=arbono>8</TD><TD class=arboper>(2)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Massachusetts</TH><TD class=arbono>2</TD><TD class=arboper>(1)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Michigan</TH><TD class=arbono>8</TD><TD class=arboper>(2)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Minnesota



</TH><TD class=arbono>10</TD><TD class=arboper>(3)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Mississippi</TH><TD class=arbono>5</TD><TD class=arboper>(1)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Missouri</TH><TD class=arbono>1</TD><TD class=arboper>(<1)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Nebraska



</TH><TD class=arbono>4</TD><TD class=arboper>(1)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Nevada</TH><TD class=arbono>1</TD><TD class=arboper>(<1)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>New Hampshire</TH><TD class=arbono>3</TD><TD class=arboper>(1)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>New Jersey</TH><TD class=arbono>25</TD><TD class=arboper>(6)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>New York</TH><TD class=arbono>44</TD><TD class=arboper>(11)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>North Carolina</TH><TD class=arbono>12</TD><TD class=arboper>(3)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Ohio</TH><TD class=arbono>12</TD><TD class=arboper>(3)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Oklahoma</TH><TD class=arbono>7</TD><TD class=arboper>(2)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Oregon</TH><TD class=arbono>3</TD><TD class=arboper>(1)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Pennsylvania</TH><TD class=arbono>11</TD><TD class=arboper>(3)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Puerto Rico</TH><TD class=arbono>16</TD><TD class=arboper>(4)</TD><TD class=arbono>199</TD><TD class=arboper>(98)</TD></TR><TR><TH class="left state" scope=row>Rhode Island</TH><TD class=arbono>14</TD><TD class=arboper>(4)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Tennessee</TH><TD class=arbono>18</TD><TD class=arboper>(5)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Texas</TH><TD class=arbono>4</TD><TD class=arboper>(1)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>US Virgin Islands</TH><TD class=arbono>2</TD><TD class=arboper>(1)</TD><TD class=arbono>2</TD><TD class=arboper>(1)</TD></TR><TR><TH class="left state" scope=row>Virginia</TH><TD class=arbono>11</TD><TD class=arboper>(3)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>West Virginia</TH><TD class=arbono>1</TD><TD class=arboper>(<1)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR><TR><TH class="left state" scope=row>Wisconsin</TH><TD class=arbono>2</TD><TD class=arboper>(1)</TD><TD class=arbono>0</TD><TD class=arboper>(0)</TD></TR></TBODY></TABLE>


http://www.cdc.gov/chikungunya/geo/united-states.html
 
Re: Chikungunya virus disease cases in the United States (as of July 29, 2014)

Re: Chikungunya virus disease cases in the United States (as of July 29, 2014)

Source: http://www.cdc.gov/chikungunya/geo/united-states.html

Chikungunya virus in the United States
Updates of chikungunya case counts are publically released every Wednesday afternoon.

Chikungunya is not a nationally notifiable disease in the United States. However, chikungunya cases can be reported to ArboNET, the national surveillance system for arthropod-borne diseases.
From 2006‒2013, studies identified an average of 28 people per year in the United States with positive tests for recent chikungunya virus infection (Range 5‒65 per year). All were travelers visiting or returning to the United States from affected areas, mostly in Asia. Only a quarter of the cases were reported to ArboNET.
Beginning in 2014, cases have been identified in travelers returning from the Caribbean. As of August 5, a total of 484 chikungunya virus disease cases have been reported to ArboNET from U.S. states (Table 1). Four locally-transmitted cases have been reported from Florida (Figure 1). All other cases occurred in travelers returning from affected areas in the Caribbean or South America (N=472), the Pacific Islands (N=5), or Asia (N=3).
A total of 221 chikungunya virus disease cases have been reported to ArboNET from U.S. territories (Table 2). Two hundred and three locally-transmitted cases have been reported from Puerto Rico and the US Virgin Islands. The remaining 18 cases occurred in travelers returning from other affected areas in the Caribbean.
With the recent outbreaks in the Caribbean and the Pacific, the number of chikungunya cases among travelers visiting or returning to the United States from affected areas will continue to increase. These imported cases could result in local spread of the virus in the continental United States...
 
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