Surveillance and outbreak report Open Access
Like 0


Since the first documented autochthonous transmission of chikungunya virus in the Caribbean island of Saint Martin in 2013, the infection has been reported within the Caribbean region as well as North, Central and South America. The risk of autochthonous transmission of chikungunya virus becoming established in Spain may be elevated due to the large numbers of travellers returning to Spain from countries affected by the 2013 epidemic in the Caribbean and South America, as well as the existence of the vector in certain parts of Spain. We retrospectively analysed the laboratory diagnostic database of the National Centre for Microbiology, Institute of Health Carlos III (CNM-ISCIII) from 2008 to 2014. During the study period, 264 confirmed cases, of 1,371 suspected cases, were diagnosed at the CNM-ISCIII. In 2014 alone, there were 234 confirmed cases. The highest number of confirmed cases were reported from the Dominican Republic (n = 136), Venezuela (n = 30) and Haiti (n = 11). Six cases were viraemic in areas of Spain where the vector is present. This report highlights the need for integrated active case and vector surveillance in Spain and other parts of Europe where chikungunya virus may be introduced by returning travellers.


Article metrics loading...

Loading full text...

Full text loading...



  1. Weaver SC, Forrester NL. Chikungunya: Evolutionary history and recent epidemic spread. Antiviral Res. 2015;120:32-9.  https://doi.org/10.1016/j.antiviral.2015.04.016  PMID: 25979669 
  2. Van Bortel W, Dorleans F, Rosine J, Blateau A, Rousset D, Matheus S, et al. Chikungunya outbreak in the Caribbean region, December 2013 to March 2014, and the significance for Europe. Euro Surveill. 2014;19(13):20759.  https://doi.org/10.2807/1560-7917.ES2014.19.13.20759  PMID: 24721539 
  3. Pan American Health Organization (PAHO). Cummulative Number of Reported Cases of Chikungunya Fever in the Americas, by Country or Territory 2014. Epidemiological week 52 (updated 29 December 2014). Washington DC: PAHO; 2014. Available from: http://www.paho.org/hq/index.php?option=com_topics&view=readall&cid=5932&Itemid=40931&lang=es
  4. Ledrans M, Quatresous I, Renault P, Pierre V. Outbreak of chikungunya in the French Territories, 2006: lessons learned. Euro Surveill. 2007;12(36):pii=3262.
  5. Schuffenecker I, Iteman I, Michault A, Murri S, Frangeul L, Vaney MC, et al. Genome microevolution of chikungunya viruses causing the Indian Ocean outbreak. PLoS Med. 2006;3(7):e263.  https://doi.org/10.1371/journal.pmed.0030263  PMID: 16700631 
  6. Gasperi G, Bellini R, Malacrida AR, Crisanti A, Dottori M, Aksoy S. A new threat looming over the Mediterranean basin: emergence of viral diseases transmitted by Aedes albopictus mosquitoes. PLoS Negl Trop Dis. 2012;6(9):e1836. doi: 10.1371/journal.pntd.0001836.
  7. Enserink M. Entomology. A mosquito goes global. Science. 2008;320(5878):864-6.  https://doi.org/10.1126/science.320.5878.864  PMID: 18487167 
  8. Vega-Rua A, Zouache K, Caro V, Diancourt L, Delaunay P, Grandadam M, et al. High efficiency of temperate Aedes albopictus to transmit chikungunya and dengue viruses in the Southeast of France. PLoS One. 2013;8(3):e59716.  https://doi.org/10.1371/journal.pone.0059716  PMID: 23527259 
  9. Angelini P, Macini P, Finarelli AC, Pol C, Venturelli C, Bellini R, et al. Chikungunya epidemic outbreak in Emilia-Romagna (Italy) during summer 2007. Parassitologia. 2008;50(1-2):97-8. PMID: 18693568 
  10. Grandadam M, Caro V, Plumet S, Thiberge JM, Souarès Y, Failloux AB, et al. Chikungunya virus, southeastern France. Emerg Infect Dis. 2011;17(5):910-3.  https://doi.org/10.3201/eid1705.101873  PMID: 21529410 
  11. Delisle E, Rousseau C, Broche B, Leparc-Goffart I, L’Ambert G, Cochet A, et al. Chikungunya outbreak in Montpellier, France, September to October 2014. Euro Surveill. 2015;20(17):21108.  https://doi.org/10.2807/1560-7917.ES2015.20.17.21108  PMID: 25955774 
  12. Alarcón-Elbal PM, Estrella SD, Arrondo IR, Collantes F, Iniesta JA, Morales-Bueno J, et al. Updated distribution of Aedes albopictus (Diptera: Culicidae) in Spain: new findings in the mainland Spanish Levante, 2013. Mem Inst Oswaldo Cruz. 2014;109(6):782-6.  https://doi.org/10.1590/0074-0276140214  PMID: 25317706 
  13. Delacour-Estrella SCF, Ruiz Arrondo I, Alarcón-Elbal PM, Delgado JA, Eritja R, Bartumeus F, et al. Primera cita de mosquito tigre, Aedes albopictus (Diptera, Culicidae), para Andalucía y primera corroboración de los datos de la aplicación Tigatrapp. [First Record of Asian Tiger Mosquito, Aedes Albopictus (Diptera, Culicidae), in Anadalusia and First Corroboration of the Data from Tigatrapp Application]. Anales De Biología 2014;36:93-6. Spanish.
  14. Delacour S, Barandika JF, García-Pérez AL, Collantes F, Ruiz-Arrondo I, Alarcón-Elbal PM, et al. Detección temprana de mosquito tigre, Aedes albopictus (Skuse, 1894), en el País Vasco (España). [Early detection of tiger mosquito, Aedes albopictus (Skuse, 1894), in the Basque Country (Spain)]. Anales de Biologia, 2015;37:25-30. Spanish.
  15. Spanish Ministry of Health, Social Services and Equality. Información para profesionales sanitarios: fiebre chickungunya. [Chikungunya fever: information for health professionals]. Spanish. Madrid: Spanish Ministry of Health, Social Services and Equality. [Accessed 15 Jun 2015]. Spanish. Available from: http://www.msssi.gob.es/profesionales/saludPublica/ccayes/alertasActual/docs/Informacion_Profesionales_Sanitarios_CHIKV.pdf
  16. European Centre for Disease Prevention and Control (EDCD). Information for Health Practitioners. Chikungunya Virus. Stockholm: ECDC. [Accessed 2 Feb 2015]. Available from: http://ecdc.europa.eu/en/healthtopics/Documents/Chikungunya_Fever_Factsheet_for_Health_Practitioners.pdf
  17. Domingo C, de Ory F, Sanz JC, Reyes N, Gascón J, Wichmann O, et al. Molecular and serologic markers of acute dengue infection in naive and flavivirus-vaccinated travelers. Diagn Microbiol Infect Dis. 2009;65(1):42-8.  https://doi.org/10.1016/j.diagmicrobio.2009.05.004  PMID: 19679234 
  18. Collao X, Negredo AI, Cano J, Tenorio A, Ory F, Benito A, et al. Different lineages of Chikungunya virus in Equatorial Guinea in 2002 and 2006. Am J Trop Med Hyg. 2010;82(3):505-7.  https://doi.org/10.4269/ajtmh.2010.09-0435  PMID: 20207882 
  19. Domingo C, Niedrig M, Gascón J, Palacios G, Reyes N, Malo MJ, et al. Molecular surveillance of circulating dengue genotypes through European travelers. J Travel Med. 2011;18(3):183-90.  https://doi.org/10.1111/j.1708-8305.2011.00501.x  PMID: 21539658 
  20. World Tourism Organization (UNWTO). UNWTO Tourism Highlights. 2014 Edition. Madrid: UNWTO; 2014. Available from: http://www.e-unwto.org/doi/book/10.18111/9789284416226
  21. Sánchez-Seco MP, Negredo AI, Puente S, Pinazo MA, Shuffenecker I, Tenorio A, et al. [Microbiological diagnosis of chikungunya virus in Spain (2006-2007): case detection in travelers]. Enferm Infecc Microbiol Clin. 2009;27(8):457-61. Spanish.  https://doi.org/10.1016/j.eimc.2008.07.011  PMID: 19524328 
  22. Pan American Health Organization (PAHO). Cummulative Number of Reported Cases of Chikungunya Fever in the Americas, by Country or Territory 2014. Epidemiological week 44 (updated 31 October 2014). Washington DC: PAHO; 2014. Available from: http://www.paho.org/hq/index.php?option=com_topics&view=readall&cid=5932&Itemid=40931&lang=es
  23. Requena-Méndez A, Garcia C, Aldasoro E, Vicente JA, Martínez MJ, Pérez-Molina JA, et al. Cases of chikungunya virus infection in travellers returning to Spain from Haiti or Dominican Republic, April-June 2014. Euro Surveill. 2014;19(28):20853.  https://doi.org/10.2807/1560-7917.ES2014.19.28.20853  PMID: 25060571 
  24. Instituto Nacional de Estadistica (INE). Avance del Padrón municipal a 1 de enero de 2010. Datos provisionales. [The progress of Municipal Register at 1 January 2010. Provisional data]. Madrid: INE. Press release. Available from: http://ine.es/prensa/np595.pdf
  25. Warne B, Weld LH, Cramer JP, Field VK, Grobusch MP, Caumes E, et al. EuroTravNet Network. Travel-related infection in European travelers, EuroTravNet 2011. J Travel Med. 2014;21(4):248-54.  https://doi.org/10.1111/jtm.12120  PMID: 24750378 
  26. Ministerio da Saude Brasil. Monitoramento dos casos de dengue, febre de chikungunya e febre pelo vírus Zika até a Semana Epidemiológica 52, 2015. [Data monitoring for dengue, chikungunya and zika cases, epidemiological week 52, 2015]. Boletim Epidemiológico. 2016;47(3):1-10. Portuguese. Available from: http://portalsaude.saude.gov.br/images/pdf/2016/janeiro/15/svs2016-be003-dengue-se52.pdf
  27. Burki T. Re-emergence of neglected tropical diseases in Venezuela. Lancet Infect Dis. 2015;15(6):641-2.  https://doi.org/10.1016/S1473-3099(15)00011-0  PMID: 26008842 
  28. Gudo ES, Vene S, Manhica I, Deus ND, Mandlaze A, Muianga A, et al. First evidence of circulation of chikungunya virus in Mozambique. 16th International Congress on Infectious Diseases. 16th International Congress on Infectious Diseases. Pre-Congress Symposium: Emerging African Investigators Symposium. Cape Town, South Africa. 2 Apr 2014.
  29. Alfaro-Toloza P, Clouet-Huerta DE, Rodríguez-Morales AJ. Chikungunya, the emerging migratory rheumatism. Lancet Infect Dis. 2015;15(5):510-2.  https://doi.org/10.1016/S1473-3099(15)70160-X  PMID: 25932584 
  30. Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Red Nacional de Vigilancia Epidemiológica. Protocolos de enfermedades de declaración obligatoria. [Protocols for notifiable diseases]. Madrid: Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Red Nacional de Vigilancia Epidemiológica; 2013. Spanish. Available from: http://www.isciii.es/ISCIII/es/contenidos/fd-servicios-cientifico-tecnicos/fd-vigilancias-alertas/PROTOCOLOS_RENAVE.pdf
  31. I. Disposiciones generals. Ministerio de Sanidad, Servicios Sociales e Igualdad. [I. General Provisions. Ministry of Health, Social Services and Equality]. Boletin Oficial del Estado. 2015;65:24012-5. 17 Mar 2015. BOE-A-2015-2837. Spanish. Available from: http://www.boe.es/boe/dias/2015/03/17/pdfs/BOE-A-2015-2837.pdf
  32. Giménez N, Barahona M, Casasa A, Domingo A, Gavagnach M, Martí C. [Introduction of Aedes albopictus in Spain: a new challenge for public health]. Gac Sanit. 2007;21(1):25-8. Spanish. PMID: 17306183 
  33. European Centre for Disease Prevention and Control (ECDC). Rapid Risk assessment. Chikungunya outbreak in Caribbean region. 25 june 2014. Stockholm: ECDC; 2014. Available from: http://www.ecdc.europa.eu/en/publications/Publications/chikungunya-caribbean-june-2014-risk-assessment.pdf
  34. Romi R, Severini F, Toma L. Cold acclimation and overwintering of female Aedes albopictus in Roma. J Am Mosq Control Assoc. 2006;22(1):149-51.  https://doi.org/10.2987/8756-971X(2006)22[149:CAAOOF]2.0.CO;2  PMID: 16646341 
  35. La Ruche G, Souarès Y, Armengaud A, Peloux-Petiot F, Delaunay P, Desprès P, et al. First two autochthonous dengue virus infections in metropolitan France, September 2010. Euro Surveill. 2010;15(39):19676. PMID: 20929659 
  36. Borgherini G, Poubeau P, Jossaume A, Gouix A, Cotte L, Michault A, et al. Persistent arthralgia associated with chikungunya virus: a study of 88 adult patients on reunion island. Clin Infect Dis. 2008;47(4):469-75.  https://doi.org/10.1086/590003  PMID: 18611153 
  37. Litzba N, Schuffenecker I, Zeller H, Drosten C, Emmerich P, Charrel R, et al. Evaluation of the first commercial chikungunya virus indirect immunofluorescence test. J Virol Methods. 2008;149(1):175-9.  https://doi.org/10.1016/j.jviromet.2008.01.004  PMID: 18294706 
  38. Omarjee R, Prat C, Flusin O, Boucau S, Tenebray B, Merle O, et al. Importance of case definition to monitor ongoing outbreak of chikungunya virus on a background of actively circulating dengue virus, St Martin, December 2013 to January 2014. Euro Surveill. 2014;19(13):20753.  https://doi.org/10.2807/1560-7917.ES2014.19.13.20753  PMID: 24721537 
  39. Panning M, Grywna K, van Esbroeck M, Emmerich P, Drosten C. Chikungunya fever in travelers returning to Europe from the Indian Ocean region, 2006. Emerg Infect Dis. 2008;14(3):416-22.  https://doi.org/10.3201/eid1403.070906  PMID: 18325256 
  40. Friedrich-Jänicke B, Emmerich P, Tappe D, Günther S, Cadar D, Schmidt-Chanasit J. Genome analysis of Mayaro virus imported to Germany from French Guiana. Emerg Infect Dis. 2014;20(7):1255-7.  https://doi.org/10.3201/eid2007.140043  PMID: 24960052 
  41. Receveur MC, Grandadam M, Pistone T, Malvy D. Infection with Mayaro virus in a French traveller returning from the Amazon region, Brazil, January, 2010. Euro Surveill. 2010;15(18):19563. PMID: 20460093 
  42. Hassing RJ, Leparc-Goffart I, Blank SN, Thevarayan S, Tolou H, van Doornum G, et al. Imported Mayaro virus infection in the Netherlands. J Infect. 2010;61(4):343-5.  https://doi.org/10.1016/j.jinf.2010.06.009  PMID: 20600300 
  43. Tappe D, Kapaun A, Emmerich P, Campos RM, Cadar D, Günther S, et al. O’nyong-nyong virus infection imported to Europe from Kenya by a traveler. Emerg Infect Dis. 2014;20(10):1766-7.  https://doi.org/10.3201/eid2010.140823  PMID: 25271361 
  44. Gould EA, Gallian P, De Lamballerie X, Charrel RN. First cases of autochthonous dengue fever and chikungunya fever in France: from bad dream to reality! Clin Microbiol Infect. 2010;16(12):1702-4.  https://doi.org/10.1111/j.1469-0691.2010.03386.x  PMID: 21040155 
  45. World Tourism Organization (UNWTO). Compendium of Tourism Statistics, 2015 Edition. Madrid: UNWTO; 2015. Available from: http://statistics.unwto.org/news/2015-02-11/compendium-tourism-statistics-2015-edition

Data & Media loading...

Submit comment
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error