The total number of confirmed chikungunya cases reached 25 this week (13 October 2014). The distribution of confirmed cases (25) has been: George Town -nine; Cayman Brac three; West Bay six; Bodden Town five and Little Cayman two. Twenty one reported travel history to countries experiencing outbreaks, (two to the Dominican Republic, three to Guyana, fifteen to Jamaica and one to St Lucia).  The number of locally transmitted cases remains at four. Of the twenty- two results awaited from the Caribbean Public Health Agency (CARPHA) since last week, eighteen were received. Twelve of these tested negative for chikungunya and one inconclusive. The five who tested positive had a travel history to Jamaica, and are residents of George Town (two), Little Cayman (two) and West Bay (one). The onset of symptoms took place between 25 September 2014 and 3 October 2014, therefore the patients are no longer considered infectious. (The chikungunya virus is transmitted by Aedes aegypti mosquitoes biting infected persons during the first week of illness.) Twenty new cases were placed under investigation during the week 7-13 October 2014. Nine had travelled to Jamaica, where a chikungunya outbreak is reportedly occurring and eleven reported no travel history. Total number of cases investigated for chikungunya since 25 June 2014 is 96. The total number of results received thus far is 72. Twenty- five have come back positive, 44 negative and three inconclusive. Results from 20 blood samples during 7-13 October and four previous samples are still awaited.Chikungunya causes fever, severe joint pain, muscle pain, headache, nausea, fatigue and rash. Officials urge anyone who may be experiencing these symptoms to immediately see a healthcare provider. Using mosquito repellent with DEET on the skin, and wearing long sleeve pants and shirts when outside during times that mosquitoes bite, whether in the Cayman Islands or on travels.As at 13 October 2014, 14,121/probable cases of chikungunya have been reported from 22 of the 24 CARPHA Member States and 11 other Caribbean countries/territories. The total number of suspected cases is 728,09