Chikungunya Virus Infection

Abstract

Chikungunya virus (CHIKV) is an alphavirus transmitted by mosquitoes, mostly Aedes aegypti and Aedes albopictus. After half a century of focal outbreaks of acute febrile polyarthralgia in Africa and Asia, the disease unexpectedly spread in the past decade with large outbreaks in Africa and around the Indian Ocean and rare autochthonous transmission in temperate areas. This emergence brought new insights on its pathogenesis, notably the role of the A226V mutation that improved CHIKV fitness in Ae. albopictus and the possible CHIKV persistence in deep tissue sanctuaries for months after infection. Massive outbreaks also revealed new aspects of the acute stage: the high number of symptomatic cases, unexpected complications, mother-to-child transmission, and low lethality in debilitated patients. The follow-up of patients in epidemic areas has identified frequent, long-lasting, rheumatic disorders, including rare inflammatory joint destruction, and common chronic mood changes associated with quality-of-life impairment. Thus, the globalization of CHIKV exposes countries with Aedes mosquitoes both to brutal outbreaks of acute incapacitating episodes and endemic long-lasting disorders.

Cardiovascular involvement and manifestations of systemic Chikungunya virus infection: A systematic review

“…albopictus is more common in Asia, and has become worthy of mentioning in the Southeast of the United States and the Caribbean region 6 . CHIKV currently circulating in America seems to no longer be related to the African lineage, but to strains documented in Asia and the Phillipines 2, 4 .…”

“…The word “Chikungunya” means “which contorts or bends up” in Makonde language from Tanzania and Mozambique, referring accurately to the difficulty in deambulation or walking of those affected 1, 2 . Despite CHIKV first being documented in 1954 in Tanzania, Africa and subsequently Asia 1, 3, 4 , it was not until 2006 that CHIKV first alarmed the world for being a major public health concern. After an explosive epidemic outbreak in French island La Réunion, where 35% of the total population was infected over six months, CHIKV arrived to central France and extended to Germany, Italy, Norway, and Switzerland 1 .…”

Emergence and Surveillance of Chikungunya

“…Genetic analysis of the envelope glycoprotein sequences showed three different strains: the West African cluster, the East-Central and South African cluster (ECSA) and the Asian cluster [1]; to date, no differences in virulence between the three different lineages has been reported in humans [7]. CHIKV epidemics are characterised by sudden outbreaks alternating with periods of quiescence that can last for years or decades.…”

“…The detection of CHIKV-RNA, based on detection of viral nucleic acid in serum samples by reverse-transcriptase PCR, results positive during the first week after symptom onset (viremic phase) and has an excellent sensitivity and specificity [22]. The indirect methods are based on antibody detection: Anti-CHIKV antibodies can be usually detected 5 days after symptom onset for IgM and a few days later for IgG [7,23]. False positive and false negative results are possible, due to cross-reactivity with other viruses of the same family and to mixed cryoglobulinemia induced by CHIKV, respectively [7,24].…”

“…The indirect methods are based on antibody detection: Anti-CHIKV antibodies can be usually detected 5 days after symptom onset for IgM and a few days later for IgG [7,23]. False positive and false negative results are possible, due to cross-reactivity with other viruses of the same family and to mixed cryoglobulinemia induced by CHIKV, respectively [7,24].…”