Chikungunya: An Emerging Public Health Concern

Abstract

Purpose of review: The worldwide spread of chikungunya over the past two decades calls for greater knowledge and awareness of the virus, its route of transmission, methods of diagnosis, and the use of available treatment and prevention measures.

Recent findings: Chikungunya virus infection, an Aedes mosquito-borne febrile disease, has spread from Africa and Asia to Europe and the Americas and from the tropics and subtropics to temperate regions. International travel is a pivotal influence in the emergence of chikungunya as a global public health threat, as evidenced by a growing number of published reports on travel-related chikungunya infections. The striking features of chikungunya are arthralgia and arthritis, and the disease is often mistaken for dengue. Although mortality is low, morbidity can be profound and persistent. Current treatment for chikungunya is supportive; chikungunya vaccines and therapeutics are in development. Travelers planning to visit areas where the mosquito vectors are present should be advised on preventive measures.

Summary: Chikungunya is an emerging disease in the Americas. Frequent travel, the presence of at least two competent mosquito species, and a largely naïve human population in the Western Hemisphere create a setting conducive to future outbreaks. Awareness of the disease and its manifestations is critical to effectively and safely manage and limit its impact. Vaccines in late-stage clinical trials offer a new pathway to prevention.

Keywords: Alphavirus; Arbovirus; Arthritis; Importation; Infectious diseases; Travel; Vector-borne disease.

Fig. 1

Countries and territories where local transmission of chikungunya in humans has occurred. a Dark green areas indicate reported local transmission as of 2004, when an outbreak in Lamu Island, Kenya subsequently spread to different regions (sources: data from Bettis et al. [••], Weaver and Lecuit [••], and Weaver [20]). b Dark green areas show ongoing or previous local transmission of chikungunya as of March 2022, demonstrating spread to the Americas over the past decade (source: CDC [21])