Twenty-one children are among 33 people who have died in Cuba of the mosquito-borne chikungunya and dengue viruses since July, authorities said Monday.

Most of the deaths were attributed to chikungunya — characterized by fever and joint pain that can be debilitating but rarely fatal — while the flu-like dengue claimed 12 lives, the country's deputy health minister Carilda Pena said on state TV.

The chikungunya virus emerged in Cuba's western Matanzas province in July, but soon spread to all 15 provinces of the country of 9.7 million people.

The chikungunya virus was first identified in Africa in the early 1950s. Chikungunya's symptoms include severe joint aches, fever, and fatigue, according to the Centers for Disease Control and Prevention. Symptoms usually start within three to seven days after a bite from an infected mosquito, the CDC says.

Most people recover within a week, according to the agency, though some experience severe joint pain for months or even years after their illness. Deaths are rare, the CDC says. Newborns infected around the time of birth, people over 65, and people with preexisting medical conditions are most likely to experience severe illness, the CDC says.

Simultaneously, the communist island has been afflicted by an outbreak of dengue that hit as Cuba battles shortages of clean water, food, fuel and medicine during its worst economic crisis in decades.

Cuba, long known for its medical and pharmaceutical expertise, was able to deal a swift blow to a previous chikungunya outbreak in 2014. There is no specific treatment for the disease, but vaccines are available and recommended for people visiting an area experiencing an outbreak, the CDC says. The disease can't be spread from person to person.

This time, the one-party state reports, the outbreak spiraled out of control due to "lack of hygiene, accumulated garbage" and people storing water in tanks to mitigate the intermittent availability of clean tap water.

With the country under U.S. sanctions and its critical tourism sector left in ruins by Covid, a dearth of foreign currency has seen a steep decline in Cuba's medical services and prevention programs such as mosquito fumigation.

The CDC has issued travel notices for Americans traveling to countries with chikungunya outbreaks, including Cuba, advising them to practice increased precautions, including getting vaccinated for chikungunya and taking steps to stave off mosquitoes. China and countries near the Indian Ocean, including Madagascar and Kenya, have also been named in travel notices.

New York saw its first-ever locally acquired case of chikungunya in October 2025. It was the first such case reported in the U.S. since 2019. Multiple other chikungunya cases have been reported in the U.S., but they were linked to international travel.

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