The total number of confirmed chikungunya cases reached 20 this week (6 October 2014). The distribution of confirmed cases (20) has been: George Town -seven; Cayman Brac three; West Bay five; and Bodden Town -five. Sixteen reported travel history to countries experiencing outbreaks, (two to the Dominican Republic, three to Guyana, ten to Jamaica and one to St Lucia).  The number of locally transmitted cases remains at four. Of the eight results awaited from the Caribbean Public Health Agency (CARPHA) since last week, six were received. Four of these tested negative for chikungunya. Both positive cases had a travel history to Jamaica, and were residents of Bodden Town. The onset of symptoms took place 25 and 27 September, 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 30 September to 6 October 2014. Eight had travelled to Jamaica, four to other countries where chikungunya is endemic, and eight reported no travel history. Total number of cases investigated for chikungunya since 25 June 2014 is 76. The total number of results received thus far is 54. Twenty have come back positive, 32 negative and two inconclusive. Results from 20 blood samples sent on 1-6 October and two previous samples are still awaited. Noting that some patients among the 20 potential new cases, and others still unknown, may have been infected with the virus, Dr. Kiran Kumar, Medical Officer of Health, pleads with the public to practice protective measures against mosquito bites.These include  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.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.As at 6 October 2014, 13, 006 confirmed/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 719,203.