let's look at chikungunya with scott weaver, david haimer, and amish adalga. david haimer. let me start with you. how do we figure out in this time of jet travel, big ocean liners pleasure cruisers coming and going, how many people have gotten it, where they've gotten it and how sick they got? >> that's a challenging question. we have some reporting mechanisms that are useed to report current cases in local areas, transmission into the united states or into europe. there are also some surveillance networks including one that i'm part of called geosentinel that looks at migrants a by way as sentinels reporting infection. getting an accurate number is challenging. >> is it in part because so few physicians in the united states have even seen the disease? >> that's definitely part of it, however, familiarity with with it as more and more cases are imported over the last few months and so. >> if someone presents in the hospital with a set of symptoms that resemble this would you at least put chikungunya on the list of possibilities? >> it a variable. in florida the awareness is