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While the United States only reported 199 Chikungunya fever cases last year, recent research indicates this low number may be related to under-testing.
The U.S. Centers for Disease Control and Prevention (CDC) says that among the cases reported in 2024, a higher-than-expected number of Chikungunya cases occurred among returning travelers from India, where the National Center for Vector-Borne Diseases Control in India reported 192,343 CHIKV cases in 2024.
Although not listed as a hemorrhagic fever virus, the Chikungunya virus (CHIKV) can be easily confused with more well-known diseases, such as dengue or yellow fever.
According to the CDC, a Chikungunya diagnosis should be made by nucleic acid testing during the acute phase of infection or by serologic testing after the first week of illness.
Additionally, a positive CHIKV-specific IgM antibody test result should be confirmed by neutralizing antibody testing at a state public health laboratory or
Therefore, the CDC says healthcare providers should consider CHIKV infection in patients with acute onset of fever and polyarthralgia for appropriate clinical management. Providers are also encouraged to report suspected Chikungunya cases to health departments to facilitate diagnosis and mitigate the risk of local transmission.
These CDC recommendations are challenging as most CHIKV infections are related to international travelers visiting over 100 countries in Africa, Asia, and the Americas.
Furthermore, Pune's National Institute of Virology has indicated that CHIKV variants are causing more cases and lingering symptoms in 2024. A study published on October 19, 2024, identified Chikungunya's "Indian Ocean lineage" as the primary cause of the recent surge in cases and lingering symptoms.
This novel CHIKV lineage, first identified in 2006, has also spread globally.
These experts have determined that the incidence of post-chikungunya chronic rheumatism and fatigue and the impact on quality of life and chronic fatigue in adults seven years after infections were significant.
To alert travelers of this health risk, the CDC updated its Level 2 Travel Health Advisory regarding outbreaks in various Indian states, such as Maharashtra and Telangana. These areas are very popular destinations for international travelers.
In 2025, the CDC recommends travelers to Chikungunya outbreak areas speak with a travel vaccine expert about immunization options since the U.S. FDA has approved one effective vaccine commercially offered at clinics and pharmacies.
A more straightforward and less expensive CDC recommendation to reduce Chikungunya disease cases this year is to avoid mosquito bites when traveling abroad.
Health agencies continue to report a spike in measles cases during the initial two months of 2025.
Today, the Texas Department of State Health Services (DSHS) issued an updated report on an outbreak of measles in the South Plains region of western Texas. As of February 28, 2025, 146 cases have been identified since late January.
In eastern Texas, Harris County reported two measles patients related to international travel in 2025.
About 50% of these cases have an unknown vaccination status, as the investigation is ongoing. DSHS is investigating whether these cases received a measles vaccination after exposure.
As of March 1, 2025, DSHS has not reported any measles cases at Texas universities in Austin, San Antonio, or San Marcos.
DSHS wrote that due to the highly contagious nature of this disease, additional cases are likely to occur in the outbreak area and the surrounding communities.
In total, 164 measles cases were reported by nine U.S. jurisdictions this year.
The best way to prevent getting sick is to be immunized with two doses of a vaccine against measles, which is primarily administered as the combination measles-mumps-rubella vaccine. Measles vaccines are offered at public health facilities, pharmacies, and travel clinics in the United States.
Measles is a highly contagious virus that spreads to others through coughing and sneezing.
"Another option for healthcare professionals, as well as students and others at high risk for measles infection, is to have a tighter draw. This is a blood test for measles and costs less than $50 to know your status," V. Yvette Cheeks MSN, RN, NPE-C informed Vax-Before-Travel News.
"It is a quantitative test and tells you how immune you are," added Cheeks, the owner of The Immunization Clinic based in Missouri City, TX.
Over the last five years, measles outbreaks have been reported in 103 countries.
As of February 21, 2025, the U.S. Centers for Disease Control and Prevention (CDC) republished a global Watch-Level 1 Travel Health Notice, identifying measles outbreaks in 57 countries.
However, the CDC did not include Texas in this notice.
Both the Texas DSHS and CDC recommend that anyone concerned about measles exposure speak with a healthcare professional as soon as possible!
The World Health Organization (WHO) today announced the recommendations for the viral composition of the trivalent influenza vaccines for the 2025-2026 influenza season in the northern hemisphere.
Announced on February 28, 2025, the WHO recommendations are used by the national vaccine regulatory agencies and pharmaceutical companies to develop, produce, and license influenza vaccines for the following influenza season.
The twice-yearly update of viruses in influenza vaccines is necessary for the vaccines to be effective due to the constantly evolving nature of influenza viruses, including those circulating and infecting humans.
Additionally, the WHO's recommendation for the B/Yamagata lineage component of quadrivalent influenza vaccines remains unchanged from previous recommendations.
For the 2024-2025 flu season, about 100 million influenza vaccines were distributed in the United States.
As of February 28, 2025, about 45.8% of children and 45.2% of adults, including 70% of adults 65+, reported receipt of an influenza vaccine this season. The CDC reported on May 25, 2024, that about 48% of U.S. adults received a flu shot during 2023-2024.
Dengue Fever is a year-round risk in many parts of the world, including the Republic of the Philippines.
According to the Department of Health (DOH), the Dengue outbreak 2025 has significantly increased in CALABARZON, the National Capital Region, and Central Luzon, which are active Dengue hot spots.
Seventeen local government units within these regions report increased Dengue cases in 2025.
This area of the Philippines includes the capital city of Manila, which has about 1.8 million residents.
The DOH has prepositioned thousands of Dengue IgG/IgM and RDT test kits to augment local testing efforts.
As of February 15, 2025, the DOH had reported 43,732 cases this year, 56% more than the 27,995 cases recorded in the same period last year.
Furthermore, this year's case fatality ratio, at 0.38%, is lower than the 0.42% observed in 2024.
Health Secretary Teodoro J. Herbosa commented in a press release on February 21, 2025, "Keep the inside and outside of the house dry—do not allow (Dengue-infected) mosquitoes to breed."
"Wear long sleeves and pants, and use anti-mosquito lotion or spray."
"Consult early if you have symptoms. Don't worry about the cost; PhilHealth will cover it."
The U.S. CDC recently updated its Travel Health Advisory to alert the millions of international travelers who visit the Philippines annually. While Dengue vaccines are no longer available in the U.S., the CDC recommends discussing immunization options with a travel vaccine expert.
When selecting an island destination for vacation in 2025, an archipelago of volcanic islands in the Pacific Ocean off the west coast of the Republic of Ecuador may be a great destination.
Named for their giant tortoises, 18 main Galápagos islands are centered on Baltra, the home to the primary commercial and private airport that welcomes about 265,000 visitors yearly.
According to the U.S. Centers for Disease Control and Prevention (CDC) and other health agencies, the Galapagos Islands do not have any targeted health advisories in effect as of late February 2025.
Furthermore, the CDC says there are no vaccination requirements for visiting the Galapagos, as the disease risk is very low across the archipelago.
However, the CDC does recommend that all travelers be up-to-date on routine vaccines like tetanus and measles. Other vaccine options include hepatitis A, hepatitis B, and typhoid fever, especially if you plan to visit areas of Ecuador besides the Galápagos.
However, if you spend time in Ecuador, the CDC warns travelers about two viruses that spread primarily through infected midges and mosquitoes.
In 2025, both Oropouche and Dengue travel advisories include Ecuador, which extends to Galápagos.
"The Galápagos Islands are a popular choice for travelers to view wildlife up close in stunning landscapes and varied island ecologies," Jeri Beales, MSN, RN, informed Vax-Before-Tarvel News.
"From a health perspective, there is no concern for malaria or yellow fever on any of the islands, but mosquitos are known to carry dengue fever, so visitors need to prevent bites while visiting."
"And you should have a health professional look over your vaccine records before leaving to ensure you're up-to-date on CDC recommended immunizations. If you plan to combine a trip to the Galápagos with areas of mainland Ecuador, be sure to mention this to your doctor or travel clinic because there are other health risks to consider," added Beales, who leads Destination Health Clinic, a Boston-area travel health provider specializing in health education and vaccination for international travelers.
Additionally, there has been evidence of transmission of Chikungunya, Malaria, Yellow Fever, and the Zika virus in Ecuador within the last five years.
Proof of Yellow Fever vaccination is required for most travelers arriving in Ecuador from Brazil.
From a safety perspective, the U.S. Department of State ranks Ecuador and the Galapagos Islands as Level 2 destinations. While several areas in Equador are at risk, and visitors should exercise increased caution, the islands 500 miles to the west are not mentioned by the State Department.
If you travel to Ecuador, enroll in the Smart Traveler Enrollment Program to receive digital alerts, making locating you in an emergency easier. Or visit the U.S. Embassy in Quito, Ecuador.
As the Galápagos Islands are a year-round travel destination, the local government strives to ensure everyone has a healthy and safe visit in 2025.
The previously scheduled U.S. Food and Drug Administration (FDA) Vaccines and Related Biological Products Advisory Committee (VRBPAC) meeting to determine which strains of influenza should be used in the 2025-2026 seasonal influenza vaccines is no longer listed on the FDA website.
As of February 27, 2025, Inside Medicine reported that a current VRBPAC member confirmed the schedule change.
The VRBPAC meets twice yearly to evaluate the effectiveness of approved flu shots and determine if the influenza strains have changed between the Southern and Northern hemispheres. Once a determination is rendered, the FDA coordinates with vaccine manufacturers and the World Health Organization.
The FDA uses committees and panels to obtain independent expert advice on scientific, technical, and policy matters.
Over the initial weeks of 2025, the Texas Department of State Health Services (DSHS) has been reporting on an ongoing outbreak. Today, DSHS confirmed a school-aged child, an unvaccinated hospitalized patient in Lubbock, Texas, has died from measles.
As of February 26, 2025, DSHS stated eighteen additional measles patients were hospitalized throughout the outbreak.
Texas has reported 126 measles cases this year: two in Harris County, 80 in Gaines County, and 21 in Terry County, Dawson, Yokaum, Ecktor, Lynn, and San Marcus Counties.
The Dallam-Hartley Counties Hospital District in north Texas recently said several measles cases have been confirmed.
Additionally, measles exposures have been reported adjacent to Texas universities in 2025.
"As a healthcare professional, it is with a heavy heart that I address the recent measles outbreak in Texas, which has now claimed the life of a school-age child. This is the first measles-related death in the United States since 2015 and the first measles cases in Texas since 2023," V. Yvette Cheeks MSN, RN, NPE-C, informed Vax-Before-Travel News.
"We urge parents and guardians to vaccinate their children according to the recommended immunization schedule. If you or your child have not been vaccinated, be sure to get in touch with your healthcare provider immediately to discuss your options," added Cheeks, owner of the Immunization Clinic in
Missouri City, TX.
Although the data is delayed, the U.S. CDC has reported 93 measles cases in eight jurisdictions this year.
The CDC and DSHS strongly recommend most people speak with their healthcare provider about getting the MMR vaccine.
This CDC recommendation was recently highlighted in the Level 1 Global Measles Outbreak advisory that highlighted 57 counties reporting measles cases.
The mosquito-transmitted chikungunya disease virus has been reported in Brazil since 2014, with 2024 setting record increases in cases and associated fatalities.
According to Brazil's Ministry of Health Arboviruses report on February 25, 2025, 16 confirmed chikungunya deaths were confirmed this year, on pace with the 236 deaths in 2024.
Unlike last year, the case/death ratio currently exceeds the data reported in the previous year.
In Brazil's hot spot, Sao Paulo State's ratio (2,063/1) appears to be on pace with 2024.
When visiting Brazil, the U.S. CDC says vaccination is recommended for people aged 65 years or older, especially those with underlying medical conditions, who may spend at least 2 weeks (cumulative time) in indoor or outdoor areas where mosquitoes are present in Brazil, or those planning to stay in Brazil for a cumulative period of 6 months or more.
From a risk mitigation perspective, the U.S. FDA-approved chikungunya vaccine is more widely available in 2025, as most travel clinics and pharmacies will offer this innovative vaccine to international travelers visiting outbreak areas.
Over the past few years, the Republic of El Salvador has significantly rekindled its tourism industry. During 2024, market research data indicates about 17% more people, about 4 million, visited this Central American country's beaches and mountains.
One of the factors behind this tourism increase is safety.
In March 2022, the Government of El Salvador declared a "State of Exception", which remains effective in late February 2025.
The U.S. Department of State reissued its Level 2: Exercise Increased Caution, Travel Advisory, which stated that crime activity has dropped significantly over the last three years.
The State Department wrote on February 7, 2025, that hikers should engage local guides certified by the national or local tourist authority when in backcountry areas. They should also use caution and follow water condition warnings when swimming near El Salvador's beaches.
Additionally, the U.S. recommends enrolling in the Smart Traveler Enrollment Program to receive Alerts from the U.S. Embassy, which can help locate you in an emergency.
From a health perspective, El Salvador, like its neighboring countries, continues reporting mosquito-transmitted diseases such as chikungunya (2), dengue (411), and Zika (6) cases as of February 25, 2025.
Last year, the U.S. Embassy reported that a Red Alert warning had been issued for excessive dengue cases in 2024.
"Because of its natural beauty and improving public safety, more travelers are choosing a vacation getaway to El Salvador. While there is no risk of malaria and yellow fever, visitors do need to protect against other mosquito diseases like dengue fever, chikungunya, and Zika and use insect repellents for skin and clothing," Jeri Beales MSN, RN, BS informed Vax-Before-Travel News.
"Some travelers to El Salvador may benefit from the chikungunya vaccine, but there is no vaccine available yet in the US against dengue fever and zika."
"Other routine and travel vaccines like hepatitis A and typhoid fever are recommended by public health, but it's best to speak with your doctor or local travel clinic to review your vaccine records before leaving, added Beales, with Destination Health Travel Clinic in Massachusetts (Braintree, Natick, Longmeadow).
The U.S. CDC suggests speaking with a travel vaccine expert about vaccination options at least one month before visiting disease outbreak areas such as El Salvador.
Note: This news article was updated on Feb. 26, 2025, to include travel vaccine expert insight.
