**9.2 Preparation phase**

Strengthen the fever syndromic surveillance sentinel site, so that officers can detect cases of chikungunya (CHIKV). The percentage of patients presenting with fever and arthralgia or fever and arthritis with no known etiology (eg, testing negative for malaria or dengue), should be tested for CHIK in an adequate national referral laboratory [141].

### **9.3 Response phase**

Once a case of chikungunya (CHIKV) is detected, an in-depth epidemiological investigation will be carried out to (1). Track the spread of viruses; (2). Monitor the possibility that cases have entered the surrounding area; (3). Describe the epidemiological features and main clinical features; (4). Assess the severity and impact on society; (5). Identify risk factors or factors that cause disease severity; (6) identify the circulating CHIKV lineage. These efforts will form the basis to develop effective control measures [136, 141].

### **9.4 Continuous transmission**

Continuous surveillance to monitor changes in the epidemiology and ecology of CHIKV transmission. Any changes in surveillance at the national level should be communicated immediately to surveillance partners and other prevention units to ensure quality and uniformity of data collected [136, 141].
