“…In addition to a potent type I IFN response, the acute stage of chikungunya virus infection (<21 days after the onset of infection) is associated with elevated patient plasma levels of multiple soluble factors, including proinflammatory cytokines and chemokines (CCL2, macrophage migration inhibitory factor, CCL4, CXCL10, IL‐6, IL‐8, and IL‐16), antiinflammatory cytokines (IL‐1 receptor A, IL‐10, and IL‐13), growth factors (granulocyte colony‐stimulating factor [G‐CSF], granulocyte–macrophage colony‐stimulating factor [GM‐CSF], vascular endothelial growth factor, and stem cell growth factor β) and other mediators (IFNγ, IL‐4, IL‐7, and CXCL9) . This results in intense monocyte trafficking to the infected tissues , along with strong activation of both CD8+ T and natural killer (NK) cells to assist in clearing the virus . The post‐acute stage of chikungunya virus (from the fourth week to the third month after the onset of infection) is characterized by very polymorphous manifestations prolonging the initial inflammatory symptoms (acute arthritis) by diverse rheumatic disorders, including periarticular involvement, slowly regressive enthesitis, tenosynovitis, and bursitis, together with nonrheumatic and systemic symptoms .…”