The travel health consultation

Key information

Key information to consider for chikungunya risk includes travel to high-risk areas and previous travel. Current outbreaks can be checked on resources like NaTHNaC’s outbreak page and the UKHSA travel-associated infections page.

Awareness of chikungunya risk and severity is generally low among UK public travellers. The focus should be on more experienced travellers aware of mosquito-borne diseases, high-risk long-term travellers, and those visiting friends and relatives (VFRs) in high-risk areas.

During risk assessment, it is vital to discuss mosquito-borne infections, explain chikungunya's aetiology, the potential duration of symptoms, and prevention methods (including insect repellents and vaccination). Travellers need information to make informed decisions, considering factors like previous infections, destination infection levels, length of time at risk, affordability, and compliance with insect repellents.

Bite avoidance measures and products

Bite avoidance measures and products

Aedes aegypti and Aedes albopictus primarily bite during daytime hours, both indoors and outdoors, and lay eggs in containers with standing water.¹ To avoid bites, travellers should:¹

• Wear clothing that minimises skin exposure
• Use an insecticide-treated mosquito net if sleeping during the day

Recommended bite avoidance products include:²

• DEET: 50% concentration is a first choice, can be used on children from two months.
• Icaridin (picaridin): 20% concentration, comparable to DEET in repellent properties, well-tolerated.
• IR3535: Shorter protection duration, requires more frequent application
• Eucalyptus citriodora oil, hydrated, cyclised: slightly outperformed by DEET and more frequent applications than DEET required.
• Permethrin: insecticidal spray for clothing or pre-treated clothing.

Insect repellents exert their effects through interactions with olfactory receptors and gustatory receptors in mosquitoes.

DEET alters the response of olfactory receptor neurons to their ligands, which might mean that it is harder for the mosquito to locate and land on humans.

DEET, IR3535, Picaridin and citronellal also stimulate a specific gustatory neuron that is sensitive to feeding deterrents in Aedes aegypti, meaning that mosquitoes are deterred from landing.³

It’s important to remember the 98% of travellers do not apply the recommended protective dose of repellent.⁴ Repellent also needs to be applied on top of sunscreen.²

Discussing IXCHIQ® in a travel health consultation

Official recommendations

When discussing IXCHIQ^®, it is important to state its indication for active immunisation for the prevention of disease caused by CHIKV in individuals aged 18 and older, and that its use should align with official recommendations.⁵

As mentioned before, in June 2025, due to serious adverse events in older people, the Commission on Human Medicines (CHM) has temporarily restricted use of a chikungunya vaccine called IXCHIQ^® in people aged 65 and over until a further safety review has concluded.⁶