The chikungunya virus, transmitted through infected mosquito bites, has spread to 25 Caribbean nations
Holidaymakers are being told to cover their skin while visiting sun-drenched Caribbean nations that are struggling with an outbreak of a potentially fatal mosquito-borne disease.
The chikungunya virus, transmitted through infected mosquito bites, has spread to 25 Caribbean nations since it was first reported by the World Health Organisation in December 2013.
With over 700,000 suspected cases and 118 deaths reported, experts are telling tourists to protect themselves if they are heading to the region for winter sun.
The United States Centers for Disease Control and Prevention (CDC) reported more than 1,600 travellers returning to the US with chikungunya as of November 4.
Canadian authorities have reported more than 200 returning with symptoms, while 37 British travellers have been affected by the agonising virus - 33 of them after visiting the Caribbean.
The majority of those affected were returning from the Dominican Republic and Antigua and Barbuda, according to the National Travel Health Network and Centre (NaTHNaC).
More cases are being reported every day on the island as victims arrive at hospitals or surgeries with chikungunya symptoms, including fever, headaches, rashes and muscle and joint pain.
The worst of the outbreak in the Caribbean is occurring in the Dominican Republic, Guadeloupe, Haiti and Martinique, where over 600,000 suspected cases have been reported.
Cover up: Exerts say visitors to the affected countries increase their risk with ample bare skin
Dr Laith Yakob, an infectious disease ecologist with the London School of Hygiene and Tropical Medicine, said people should speak to their GP or a travel doctor before their trip.
Once they arrive, they should keep their skin covered during the day, as mosquitoes are 'day biters', and regularly apply insect repellent containing DEET, he said.
And they should seek immediate medical attention at the onset of symptoms.
He told MailOnline Travel: 'For most people within three to seven days they'll have fever, then joint pain in the hands and wrists can persist for weeks or even months.
'The joint pain can spread and can be quite debilitating.'
Popular tourist destinations such as the Dominican Republic are among the worst-hit nations
Dr Yakob said the elderly are at particular risk of developing severe symptoms that can result in death.
There is no vaccine or cure, but patients can recover within three to five days with proper treatment.
A small number of cases result in death and up to 10 per cent of patients suffer from arthritis, chronic joint pain and fatigue.
Complications can include hepatitis, myocarditis (inflammation of the heart muscle), and neurological and ocular disorders.
A tourist makes a purchase at a fruit and vegetable market in Grenada, where some Brits have fallen ill
The majority of UK cases are associated with travel to South and South East Asia, say experts
Chikungunya is a viral disease transmitted by infected female mosquitoes with symptoms including high fever, headaches, rashes and severe joint pain.
After being bitten the onset of illness occurs usually between four and eight days but can range from two to 12.
There is no vaccine or cure and treatment is focused on relieving the symptoms.
Most patients recover fully but in some cases joint pain may persist for several months or even years.
Occasional cases of eye, neurological and heart complications have been reported, in addition to gastrointestinal complaints.
Serious complications are not common, but in older people, the disease can contribute to the cause of death.
The disease was first described during an outbreak in Tanzania in 1952 and has spread to nearly 40 countries in Asia, Africa, the Americas and Europe.
Europe's first transmission was reported during a localised outbreak that affected nearly 200 people in north-eastern Italy in 2007.
Last month, France confirmed four cases of 'locally-acquired' infection in Montpellier. Since 2005, India, Indonesia, Thailand, Maldives and Myanmar have reported over 1.9 million cases.
Experts say chikungunya shares some clinical signs with dengue and can be misdiagnosed in areas where dengue is common.
The name 'chikungunya' derives from a word in the Kimakonde language, meaning 'to become contorted' and describes the stooped appearance of sufferers with joint pain.
Source: World Health Organisation
Dr Yakob said the symptoms of chikungunya and dengue fever, also spread by infected mosquitoes, are similar, so people who believe they are infected should seek a proper lab diagnosis.
The virus does not occur in the UK but Public Health England has been monitoring for signs of infected blood-suckers.
The majority of UK cases are associated with travel to South and South East Asia, NaTHNaC says.
Dr Jane Jones, a travel and migrant health expert at Public Health England, said in a statement: 'Chikungunya is an unpleasant viral illness that is transmitted by day-biting mosquitoes.
As there is no specific preventive medicine or vaccination against chikungunya, prevention relies on travellers avoiding mosquito bites - particularly around dusk and dawn when the day biting mosquitoes are most active.'