In the last two decades, the illness has become a threat to US travelers

Chikungunya is a mosquito-transmitted virus that causes fever and severe joint pain—and while it’s rare in the United States, it’s become more prevalent in recent years. The virus is more common in other countries, however, so travelers are often warned to watch out for its symptoms.

No matter where you are, protecting yourself from insect bites can reduce the risk of chikungunya (pronounced: chik-en-gun-ye) and other mosquito-borne illnesses. Here’s what else you should know about this painful and sometimes debilitating condition.

Chikungunya in the United States

Before 2006, chikungunya was rarely diagnosed in American travelers, according to the CDC. Then, between 2006 and 2013, about 30 people a year in the United States tested positive for the virus—all of whom had spent time in Asia or Africa, or on islands in the Indian Ocean.

In 2013, an outbreak in the Caribbean marked the first time that mosquitoes in the Americas were found to be infected with the chikungunya virus and had transmitted it to humans. Since then, cases of local transmission have surged in the Americas—particularly in Florida, Puerto Rico, and the U.S. Virgin Islands.

In 2014, a total of 2,811 cases of chikungunya virus disease were reported from U.S. states, while 4,710 cases were reported from U.S. territories. Since that year, annual cases have numbered in the hundreds.

Chikungunya symptoms

Chikungunya made headlines back in 2015 when the actress Lindsay Lohan contracted the virus in Bora Bora. Her mother Dina told Newsday that Lindsay had been suffering from a high fever and joint pain before checking into the hospital—all standard chikungunya symptoms, according Aileen Marty, MD, professor of infectious diseases at Florida International University. Other signs of chikungunya include headaches, muscle pain, and joint swelling.

“It’ll take a little less than a week to notice the symptoms, and then you’ll get a fever and pain in your joints," Dr. Marty tells Health. "The best thing to do is to take an aspirin or other anti-inflammatories to calm that down.”

Some people with chikungunya can also face more severe symptoms, such as chronic arthritis. People over age 65—and those with high blood pressure, diabetes, or heart disease—face a higher risk of complications, according to the CDC, but chikungunya isn't usually life-threatening, Dr. Marty says.

How is chikungunya transmitted?

Most cases of chikungunya occur in places like the Caribbean, Central and South America, and the French Polynesian Islands. But if American travelers head to those areas and contract the disease, it's possible that they could infect mosquitoes who bite them once they return home, while they still have high levels of the virus in their blood.

That means, in theory, people can unwittingly start the infection cycle in their own backyard. And in places like Florida, the bugs never really die off. “Over the winter, the mosquitoes are like a bear hibernating until it’s warm enough,” Dr. Marty says.

How to protect yourself

At this point, there’s no vaccine or cure for Chikungunya other than treating the individual symptoms, so if you’re heading to a warm locale, the only way to really protect yourself from the virus is to avoid getting bitten.

Wear clothes that cover your arms and legs, and use an EPA-registered mosquito repellent. The bugs carrying chikungunya are mostly active during the day, the CDC says, and in general mosquitoes tend to be more attracted to pregnant women or beer drinkers since both groups tend to exhale more CO2 than other people.

“If you’re not traveling outside the US, you’re not going to have very many problems,” Dr. Marty says. “But if you’re headed overseas, stop at a travel medical clinic before you go. Do all the mosquito prevention that you can. Awareness is the most important thing.”

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This post was originally published on January 22, 2015 and has been updated for accuracy.