Although the Americas had been free of chikungunya until November 2013, the risk of an outbreak of this arbovirus was considered to be increasing in the French departments and communities of the Americas (DFA), due to the presence of a competent vector and growing international travel to endemic areas. In mid-November 2013, clusters of cases of febrile syndromes with arthralgia were reported in Saint Martin. Investigations confirmed the local circulation of chikungunya, leading to the activation, in the DFA, of the Chikungunya Surveillance, Alert, and Outbreak Management Program (Psage). This program incorporates surveillance and management actions, scaled according to the level of epidemic risk. Epidemiological surveillance is based on primary data sources, including outpatient care, clinical laboratories, and hospitals. Data are also collected during entomo-epidemiological surveys. Depending on the level, various spatio-temporal indicators related to laboratory-confirmed cases, outpatient medical visits, emergency room visits, hospitalized cases, and their severity are monitored. As of late April 2014, Saint Martin, Saint Barthélemy, Martinique, and Guadeloupe were or had been in the epidemic phase, while French Guiana remained in the moderate viral circulation phase, limited to the successive emergence of outbreaks. Due to the decline in the number of observed cases, Saint Martin was reclassified as being in the moderate viral circulation phase at the end of April 2014. The number of clinically suggestive cases seen in private practice and their incidence in Saint Martin, Saint Barthélemy, Martinique, and Guadeloupe were estimated at 3,160 (85 per thousand), 470 (52 per thousand), 19,650 (49 per thousand), and 7,820 (19 per thousand) inhabitants, respectively. A total of 418 cases were hospitalized; the characteristics of 229 of these were studied, and 13% were found to be severe. Six deaths, including 4 classified as indirectly linked to chikungunya and 2 pending classification, were reported. Drawing on experience gained in Réunion and during dengue epidemics in the Antilles and French Guiana, the DFA are currently implementing an integrated approach that brings together surveillance and response stakeholders to address this sudden emergence of chikungunya. (R.A.)