Mosquitoes should be feared. Health officials declared chikungunya an epidemic in Puerto Rico on Thursday and warn the majority of these mosquito-borne virus cases have been reported in the capital of San Juan and its surrounding areas.

There have been more than 200 reported cases of the virus on the island as of June 25, according to Health Secretary Ana Rius. While Puerto Rico declared an official epidemic, health officials in Jamaica reported their island has just confirmed its first case. Chief Medical Officer Dr. Kevin Harvey said the infected person had recently traveled to a country where the disease has been transmitted locally.

Chikungunya is fairly young as far as diseases are concerned. It was first identified in Africa in 1953 after doctors were receiving patients with high fevers and complaining of severe pain in their joints. Currently there is no vaccine cure for the disease, and it is mainly treated with pain medication. The feverish joint pain causes patients to hobble around, and the unmistakable rash that spreads across sufferers’ faces is one of the most notable characteristics of chikungunya.

In the past, the disease stayed within other parts of the world, specifically Asia and Africa; however, when it arrived in the Caribbean in December, it infected as many as 250,000 people in the area and created looming threats to surrounding countries. Public officials in the Caribbean announced they were struggling to contain the outbreak, according to the National Geographic.

The first case of chikungunya reported in the United States was reported Thursday in Florida as well, and although the virus is not a death sentence and can’t be passed from person to person, it brings crippling pains and agony for months and even years. Health officials in the U.S. have been tracking cases carefully and encouraging people who currently reside or travel to infected areas to avoid infections and clean up areas of still water, as mosquitoes will readily breed there.

The Dominican Republic has been hit the hardest, currently with 135,000 suspected cases. Guadeloupe comes in second place with 40,000, followed closely behind by Haiti’s 39,000 cases. The Pan American Health Organization has recorded more than 354,000 cases across the Caribbean since July 11.

"The whole Caribbean is just full of it," Paola Lichtenberger, the director of the Tropical Medicine Program at the University of Miami, told National Geographic. "I'm pretty sure we're going to have cases here, if we already haven't had them.”

Doctors are having difficulty diagnosing the disease because, for many, it’s the first time they’ve seen the symptoms, and without proper diagnosis it could be mistaken for influenza. Even though it’s not a public health threat just yet, sick people need to take precautions to protect themselves from further mosquito bites.