Chikungunya Outbreaks from 2000 to 2015: A Review

Abstract

Chikungunya is a mosquito-borne disease caused by an alphavirus from the Togaviridae family. The Chikungunya virus (CHIKV) is transmitted by the Aedesmosquitoes. The usual clinical signs of chikungunya are non-specific flu-like symptoms, a distinctive rash and severe joint pains. The disease shares some clinical signs with dengue and can be misdiagnosed in areas where dengue is endemic. There is neither vaccine nor a specific antiviral treatment for CHIKV. CHIKV was initially seen in the early 1950s at the boundary of Tanzania and Mozambique. For the past 5 decades, CHIKV was limited to sub-Saharan Africa in addition to Southeast Asia. The situation worsened when CHIKV re-emerged in Kenya in 2004 and reached several other countries in and around the Indian Ocean. The epidemic swiftly reached regions like India and Southeast Asia and transmission of CHIKV was reported for the first time in Europe in 2007 in Italy. The purpose of this review is to summarize CHIKV outbreaks that have been reported in the 15-year period from 2000 to 2015 to show that periodic outbreaks have occurred not only in Asia and Africa, but in Europe and the Americas. It is evident that CHIKV is not restricted to a single region but has become a global public health challenge. As many citizens from non-endemic countries visit areas endemic for CHIKV fever, medical professionals must learn to recognize such cases among travelers returning from such areas with non-specific symptoms such as fever, arthralgia and skin eruptions. In endemic areas for mosquito-borne diseases, clinicians must be educated about the recognition, diagnosis and timely reporting of chikungunya virus disease cases.

Evidence for chikungunya and dengue transmission in Quelimane, Mozambique: Results from an investigation of a potential outbreak of chikungunya virus

“…However, the test-to-test comparison between the results of the IgG-ELISA and the neutralization assay showed 100% agreement, supporting CHIKV as the cause of the detected infections. The presence of CHIKV in Quelimane was not surprising, because chikungunya has been reported in neighboring countries [ 26 , 27 ] and the prevalence of previous CHIKV infections in East Africa has been estimated as 72% in Kenya in 2004 [ 28 ] and 45% in Madagascar in 2009 [ 29 ]. In Mozambique, serological surveys first detected evidence of CHIKV infections in 1957 [ 16 ].…”

SeverePlasmodium knowlesiwith dengue coinfection

“…Possible explanations for the least likelihood of coinfection include difference in habitats of the vectors, immunity from infection in endemic areas and very low chance of concurrent infection given the prevalence of dengue and malaria in certain areas 10. It is undeniable that both Chikungunya11 and Zika virus12 infections has been reported in Malaysia. The last outbreak of Chikungunya in Kelantan was in 2009.…”

Global epidemiology of Zika and Chikungunya virus human infections

“…The situation worsened when the CHIKV re-emerged in It was the first time, during an outbreak, neurological manifestations, foetal infections, and mortality (237 deaths) were associated with CHIKV (23). During this outbreak, was observed an elevate death-rate and a case-fatality ratio of about 1 in 1000.…”

“…There were cases in 15 atolls of the Caribbean in April 2014 and the total number of cases reached 35,000 (23). Puerto Rico and Samoa have also reported locally acquired cases.…”