Molecular Epidemiology, Evolution and Reemergence of Chikungunya Virus in South Asia

Abstract

Chikungunya virus (CHIKV) is a vector (mosquito)-transmitted alphavirus (family Togaviridae). CHIKV can cause fever and febrile illness associated with severe arthralgia and rash. Genotypic and phylogenetic analysis are important to understand the spread of CHIKV during epidemics and the diversity of circulating strains for the prediction of effective control measures. Molecular epidemiologic analysis of CHIKV is necessary to understand the complex interaction of vectors, hosts and environment that influences the genotypic evolution of epidemic strains. In this study, different works published during 1950s to 2020 concerning CHIKV evolution, epidemiology, vectors, phylogeny, and clinical outcomes were analyzed. Outbreaks of CHIKV have been reported from Bangladesh, Bhutan, India, Pakistan, Sri Lanka, Nepal, and Maldives in South Asia during 2007–2020. Three lineages- Asian, East/Central/South African (ECSA), and Indian Ocean Lineage (IOL) are circulating in South Asia. Lineage, ECSA and IOL became predominant over Asian lineage in South Asian countries during 2011–2020 epidemics. Further, the mutant E1-A226V is circulating in abundance with Aedes albopictus in India, Bangladesh, Nepal, and Bhutan. CHIKV is underestimated as clinical symptoms of CHIKV infection merges with the symptoms of dengue fever in South Asia. Failure to inhibit vector mediated transmission and predict epidemics of CHIKV increase the risk of larger global epidemics in future. To understand geographical spread of CHIKV, most of the studies focused on CHIKV outbreak, biology, pathogenesis, infection, transmission, and treatment. This updated study will reveal the collective epidemiology, evolution and phylogenies of CHIKV, supporting the necessity to investigate the circulating strains and vectors in South Asia.

Seroepidemiology of Chikungunya Fever in Dhaka, Bangladesh: A Crosssectional Study

“…CHIKV infection can be diagnosed based on clinical, epidemiological and laboratory findings 3 . The sudden appearance of high-grade fever and debilitating pain in the joint are the major criteria for clinical diagnosis.…”

Effectiveness of CHIKV vaccine VLA1553 demonstrated by passive transfer of human sera

“…After 2005, multiple outbreaks and large epidemics of chikungunya (CHIK) emerged across different continents including Asia, Europe, and North America (3)(4)(5). Specifically, South America and Southeast Asia were affected by outbreaks in recent years (6,7). CHIKV infections are characterized by acute febrile disease accompanied by headache, muscle pain, and skin rash, which results in chronic and incapacitating arthralgia in up to 60% of patients (8)(9)(10).…”

Multiple chikungunya virus introductions in Lao PDR from 2014 to 2020

“…During the acute phase of human infection, CHIKV infection is clinically characterized by sudden onset of high fever often accompanied by severe joint pain and other symptoms such as headache, maculopapular rash evolving to chronic poly arthralgia in up to one third of the patients [2]. Since 1952, CHIKV was recorded in more than 60 countries in Africa, Asia, Europe, the Southern Pacific region and the Americas [3][4][5][6]. The genetic polymorphism of the CHIKV genome allows to discriminate four lineages: the West African (WA), East/Central/South African (ECSA), ECSA-derived Indian Ocean (ECSA-IOL) and Asian [7].…”

“…The genetic polymorphism of the CHIKV genome allows to discriminate four lineages: the West African (WA), East/Central/South African (ECSA), ECSA-derived Indian Ocean (ECSA-IOL) and Asian [7]. In Southeast Asia, the circulation of the Asian lineage was described since the 1950s and an active co-circulation of the Asian, ECSA and ECSA-IOL lineages was highlighted since the beginning of the 2000's [3,5,6].…”