A Review on Chikungunya Virus Epidemiology, Pathogenesis and Current Vaccine Development

Abstract

Chikungunya virus (CHIKV) is a mosquito-borne alphavirus that recently re-emerged in many parts of the world causing large-scale outbreaks. CHIKV infection presents as a febrile illness known as chikungunya fever (CHIKF). Infection is self-limited and characterized mainly by severe joint pain and myalgia that can last for weeks or months; however, severe disease presentation can also occur in a minor proportion of infections. Among the atypical CHIKV manifestations that have been described, severe arthralgia and neurological complications, such as encephalitis, meningitis, and Guillain-Barré Syndrome, are now reported in many outbreaks. Moreover, death cases were also reported, placing CHIKV as a relevant public health disease. Virus evolution, globalization, and climate change may have contributed to CHIKV spread. In addition to this, the lack of preventive vaccines and approved antiviral treatments is turning CHIKV into a major global health threat. In this review, we discuss the current knowledge about CHIKV pathogenesis, with a focus on atypical disease manifestations, such as persistent arthralgia and neurologic disease presentation. We also bring an up-to-date review of the current CHIKV vaccine development. Altogether, these topics highlight some of the most recent advances in our understanding of CHIKV pathogenesis and also provide important insights into the current development and clinical trials of CHIKV potential vaccine candidates.

Keywords: chikungunya; epidemiology; immunopathogenesis; pathogenesis; vaccine; virus receptor.

Figure 1

Countries with previous or current chikungunya transmission are blue-colored, according to the Centers for Disease Control and Prevention (CDC) (available at https://www.cdc.gov/chikungunya/geo/index.html, accessed on 28 April 2022), as reported by February 2022. La Réunion Island is red-colored, given its historical importance. Does not include imported cases. Although the United States territory of Alaska is blue-colored, no CHIKV transmission was documented in this area.