In recent years, countries in South-East Asia have been severely affected by outbreaks of Chikungunya fever. India was hit in 2006 after a quiescence of 32 years, following the re-emergence in Kenya in 2004 and the spread in the Indian Ocean islands in 2005. Indonesia, Maldives, and Sri Lanka have also been affected by Chikungunya. In 2008, India, Sri Lanka, Malaysia and Indonesia reported outbreaks.
Below we present an update of the Chikungunya situation in Thailand, Malaysia and Singapore the 3 countries for which information is publicly available. Some popular touristic areas currently report Chikungunya transmission. Therefore it is recommended that persons who develop symptoms after coming back from such areas consult their general practitioner, mentioning their travels. Persons travelling to areas reporting Chikungunya transmission are recommended to foresee personal protective measures to avoid mosquito bites. These include mainly the use of mosquito repellent, and the wearing of long sleeves and trousers.
In Thailand, in 2009, a large outbreak has affected mainly the southern region, some of the areas being touristic destinations. A total of 32,960 cases have been notified from 1st January to 10th July in 50 provinces (no deaths are currently reported). The most affected areas are the southern provinces: Songula (reporting 29% of the cases), Narathiwat (24%), Pattani (13%) and Yala (8%) .
Chikungunya infection seems to quickly be spreading from the southern provinces to the upper parts of the country. The touristic area of Phuket and the regions of Phatihalung and Trang reported the largest increase in number of cases in the last months. These three provinces reported a total of 2,931 cases in June which represents 50% of the total number of cases reported that month in the entire country. From 1st May to 10th July, a total of 2,257 cases were notified in Phuket while only 6 cases were notified from 1st January to 30th April . Several cases among foreigners have been reported.
Additionally, some confirmed cases are now reported in provinces in Middle, North and North-East of Thailand.
A total of 2,873 cases have been reported in Malaysia from the beginning of the year 2009 to 4th July. Kedah is the most affected province (reporting 27% of the cases), then Perak, Selangor, Kelantan, and Sarawak. In week 26 (28th June - 4th July), 37 cases have been reported, almost half of them (49%) from the Northern provinces of Penang.
It seems that the number of cases is decreasing in the last weeks particularly in the northwestern province of Kedah .
In Singapore, since the beginning of the year up to week 26 (4th July), 294 cases have been notified including 31 imported cases and 263 cases following autochthonous transmission (one case occurred in week 26) .
More information on Chikungunya fever is also available from the ECDC fact sheet
 Ministry of Health, Thailand. Chikungunya Epidemiological status July 10 2009.
Available from: http://www.thaivbd.org/cms/index.php?option=com_content&task=view&id=142&Itemid=0
 Director General of Health, Malaysia. Epidemiological week 26, 28th June-4th July 2009.
Available from: http://moh.gov.my/MohPortal/newsFull.jsp?action=load&id=432
 Ministry of Health Singapore. Weekly infectious disease bulletin. Epidemiological week 26, 28 June-4 July 2009. Available from: http://www.moh.gov.sg/mohcorp/uploadedFiles/Statistics/