Chikungunya at the Door — Déjà Vu All Over Again?

A chikungunya fever outbreak that appeared in the Caribbean in December has spread to the Americas, where populations were not previously exposed to alphaviruses. The potential for chikungunya to become established in the Western Hemisphere must be considered. In 2008, we noted that the global reemergence of dengue fever threatened U.S. residents. 1 An outbreak of locally acquired dengue subsequently occurred in Florida, and the risk of U.S. dengue outbreaks will probably continue indefinitely. We now face a new threat posed by the unrelated chikungunya virus, which causes a disease clinically similar to dengue in a similar epidemiologic pattern, which is transmitted by the same mosquito vectors, and for which we also lack vaccines and specific treatments. In December 2013, an outbreak of chikungunya fever appeared in the French sector of Saint-Martin/Sint Maarten and spread epidemically throughout the French . . .