Expert Recommendations to Strengthen Chikungunya Outbreak Surveillance and Reporting for Traveler Health Protection

Chikungunya, a debilitating mosquito-borne disease caused by chikungunya virus, has surged dramatically in the past two decades. Chikungunya outbreaks can intensify rapidly, with infections posing a significant endemic health burden in tropical/subtropical areas and for travelers. Health professionals require timely and accurate outbreak information to adequately protect travelers and assess chikungunya risk. However, detection is often insufficient in the areas most susceptible to outbreaks, leading to diagnostic and reporting delays. Consequently, travelers are often unaware of increased chikungunya infection risk at their destination. We assessed chikungunya surveillance and reporting resources, and we developed expert recommendations for traveler health protection. Because data-reporting cadences, reliability, and availability vary, we organized structured activities and convened an expert panel to compare these resources and evaluate their strengths and weaknesses. We provide a synthesis of the expert panel discussion and provide recommendations on how to improve chikungunya surveillance and risk communication to travelers. Assessing outbreak risk requires using multiple local and international reporting resources because no single resource contains all of the necessary information. The panelists identified several challenges regarding chikungunya surveillance and outbreak reporting: inadequate chikungunya surveillance infrastructure and diagnostic capacity; varying case definitions; limited understanding of the local health care context; inadequate awareness of chikungunya in health care settings; and restricted or delayed access to real-time surveillance data. As chikungunya risk increases worldwide, greater attention and resources are needed to improve timely, sensitive, and specific diagnostic testing and rapid communication to health care workers and travelers, particularly in resource-poor regions where outbreaks occur.