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. 2016 May 19;21(20):10.2807/1560-7917.ES.2016.21.20.30234.
doi: 10.2807/1560-7917.ES.2016.21.20.30234.

Global distribution and environmental suitability for chikungunya virus, 1952 to 2015

E O Nsoesie #  1   2   3 , M U Kraemer #  4 , N Golding  5   6 , D M Pigott  3   5 , O J Brady  5 , C L Moyes  5 , M A Johansson  7   8 , P W Gething  9 , R Velayudhan  10 , K Khan  11 , S I Hay #  3   5 , J S Brownstein #  1   2   12
Affiliations

Global distribution and environmental suitability for chikungunya virus, 1952 to 2015

E O Nsoesie et al. Euro Surveill. .

Abstract

Chikungunya fever is an acute febrile illness caused by the chikungunya virus (CHIKV), which is transmitted to humans by Aedes mosquitoes. Although chikungunya fever is rarely fatal, patients can experience debilitating symptoms that last from months to years. Here we comprehensively assess the global distribution of chikungunya and produce high-resolution maps, using an established modelling framework that combines a comprehensive occurrence database with bespoke environmental correlates, including up-to-date Aedes distribution maps. This enables estimation of the current total population-at-risk of CHIKV transmission and identification of areas where the virus may spread to in the future. We identified 94 countries with good evidence for current CHIKV presence and a set of countries in the New and Old World with potential for future CHIKV establishment, demonstrated by high environmental suitability for transmission and in some cases previous sporadic reports. Aedes aegypti presence was identified as one of the major contributing factors to CHIKV transmission but significant geographical heterogeneity exists. We estimated 1.3 billion people are living in areas at-risk of CHIKV transmission. These maps provide a baseline for identifying areas where prevention and control efforts should be prioritised and can be used to guide estimation of the global burden of CHIKV.

Keywords: arboviral diseases; chikungunya virus; emerging or re-emerging diseases; spatial modelling; surveillance.

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Conflict of interest statement

Conflict of interest

None declared.

Figures

Figure 1
Figure 1. Environmental covariates used in this study to predict the global environmental suitability of chikungunya virus transmission
EVI: enhanced vegetation index; LST: land surface temperature. A. Urban accessibility, with brown representing high relative accessibility to urban areas and yellow representing rural isolated areas; B. Urban, peri-urban and rural areas; C. Aedes aegypti suitability,with red representing high environmental suitability for the vector and blue representing low suitability; D. Ae. albopictus suitability, with red representing high environmental suitability for the vector and blue representing low suitability; E. EVI mean values, whereby dark green represents areas with year round vegetation growth and light green represents areas with low moisture levels; F. EVI range; G. LST mean values, whereby orange represents high temperatures and yellow lower relative temperatures; H. LST range, with orange representing high variation throughout an average year and yellow representing little annual variation.
Figure 2
Figure 2. Distribution per continent of chikungunya virus transmission occurrence points from peer-reviewed evidence and health organisations, 1952–May 2015
Figure 3
Figure 3. Evidence consensus (a) and predicted environmental suitability (b) for chikungunya virus in Africa and Europe, as of May 2015
The colour legend for the evidence consensus ranges from red to blue, representing complete consensus on presence to complete consensus on absence. Indeterminate consensus is in yellow. Evidence consensus is presented at Admim1 level for Italy and France, and Admino level for all other countries. The predicted environmental suitability map is presented in similar colours with 1 and 0 representing most and least suitability for chikungunya virus, respectively.
Figure 4
Figure 4. Evidence consensus (a) and predicted environmental suitability (b) for chikungunya virus in the Americas, as of May 2015
The colour legend for the evidence consensus ranges from red to blue representing complete consensus on presence to complete consensus on absence. Indeterminate consensus is in yellow. Evidence consensus is presented at Admin1 level for United States, Mexico, Argentina and Brazil, and Admin0 level for all other countries. The predicted environmental suitability map is presented in similar colours with 1 and 0 representing most and least suitability for chikungunya virus, respectively.
Figure 5
Figure 5. Evidence consensus (a) and predicted environmental suitability (b) for chikungunya virus in Asia and Oceania, as of May 2015
The colour legend for the evidence consensus ranges from red to blue representing complete consensus on presence to complete consensus on absence. Indeterminate consensus is in yellow. Evidence consensus is presented at Admin1 level for India and China, and country level for all other countries. The predicted environmental suitability map is presented in similar colours with 1 and 0 representing most and least suitability for chikungunya virus, respectively.
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