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Viruses May 2022Chikungunya virus (CHIKV) is a mosquito-borne alphavirus that recently re-emerged in many parts of the world causing large-scale outbreaks. CHIKV infection presents as a... (Review)
Review
Chikungunya virus (CHIKV) is a mosquito-borne alphavirus that recently re-emerged in many parts of the world causing large-scale outbreaks. CHIKV infection presents as a febrile illness known as chikungunya fever (CHIKF). Infection is self-limited and characterized mainly by severe joint pain and myalgia that can last for weeks or months; however, severe disease presentation can also occur in a minor proportion of infections. Among the atypical CHIKV manifestations that have been described, severe arthralgia and neurological complications, such as encephalitis, meningitis, and Guillain-Barré Syndrome, are now reported in many outbreaks. Moreover, death cases were also reported, placing CHIKV as a relevant public health disease. Virus evolution, globalization, and climate change may have contributed to CHIKV spread. In addition to this, the lack of preventive vaccines and approved antiviral treatments is turning CHIKV into a major global health threat. In this review, we discuss the current knowledge about CHIKV pathogenesis, with a focus on atypical disease manifestations, such as persistent arthralgia and neurologic disease presentation. We also bring an up-to-date review of the current CHIKV vaccine development. Altogether, these topics highlight some of the most recent advances in our understanding of CHIKV pathogenesis and also provide important insights into the current development and clinical trials of CHIKV potential vaccine candidates.
Topics: Arthralgia; Chikungunya Fever; Chikungunya virus; Humans; Vaccine Development; Viral Vaccines
PubMed: 35632709
DOI: 10.3390/v14050969 -
Clinics in Laboratory Medicine Jun 2017For chikungunya virus (CHIKV), the long-term sequelae from infection are yet ill-defined. The prolonged debilitating arthralgia associated with CHIKV infection has... (Review)
Review
For chikungunya virus (CHIKV), the long-term sequelae from infection are yet ill-defined. The prolonged debilitating arthralgia associated with CHIKV infection has tremendous potential for impacting the global economy and should be considered when evaluating the human burden of disease and the allocation of resources. There is much still unknown about CHIKV and the illnesses that it causes. Developing a better understanding of the pathogenesis of CHIKV infection is a priority and forms the basis for developing effective strategies at infection prevention and disease control.
Topics: Arthralgia; Chikungunya Fever; Chikungunya virus; Humans; Resource Allocation
PubMed: 28457355
DOI: 10.1016/j.cll.2017.01.008 -
The Lancet. Infectious Diseases Apr 2017Re-emergence of chikungunya virus, a mosquito-transmitted pathogen, is of serious public health concern. In the past 15 years, after decades of infrequent, sporadic... (Review)
Review
Re-emergence of chikungunya virus, a mosquito-transmitted pathogen, is of serious public health concern. In the past 15 years, after decades of infrequent, sporadic outbreaks, the virus has caused major epidemic outbreaks in Africa, Asia, the Indian Ocean, and more recently the Caribbean and the Americas. Chikungunya virus is mainly transmitted by Aedes aegypti mosquitoes in tropical and subtropical regions, but the potential exists for further spread because of genetic adaptation of the virus to Aedes albopictus, a species that thrives in temperate regions. Chikungunya virus represents a substantial health burden to affected populations, with symptoms that include severe joint and muscle pain, rashes, and fever, as well as prolonged periods of disability in some patients. The inflammatory response coincides with raised levels of immune mediators and infiltration of immune cells into infected joints and surrounding tissues. Animal models have provided insights into disease pathology and immune responses. Although host innate and adaptive responses have a role in viral clearance and protection, they can also contribute to virus-induced immune pathology. Understanding the mechanisms of host immune responses is essential for the development of treatments and vaccines. Inhibitory compounds targeting key inflammatory pathways, as well as attenuated virus vaccines, have shown some success in animal models, including an attenuated vaccine strain based on an isolate from La Reunion incorporating an internal ribosome entry sequence that prevents the virus from infecting mosquitoes and a vaccine based on virus-like particles expressing envelope proteins. However, immune correlates of protection, as well as the safety of prophylactic and therapeutic candidates, are important to consider for their application in chikungunya infections. In this Review, we provide an update on chikungunya virus with regard to its epidemiology, molecular virology, virus-host interactions, immunological responses, animal models, and potential antiviral therapies and vaccines.
Topics: Aedes; Animals; Chikungunya Fever; Chikungunya virus; Communicable Diseases, Emerging; Disease Outbreaks; Global Health; Humans; Insect Vectors; Models, Animal
PubMed: 28159534
DOI: 10.1016/S1473-3099(16)30385-1 -
Current Opinion in Pediatrics Apr 2023Dengue, chikungunya and zika have caused significant epidemics in the Caribbean in recent years. This review highlights their impact in Caribbean children. (Review)
Review
PURPOSE OF REVIEW
Dengue, chikungunya and zika have caused significant epidemics in the Caribbean in recent years. This review highlights their impact in Caribbean children.
RECENT FINDINGS
Dengue has been increasingly intense and severe, seroprevalence is 80-100% in the Caribbean, children have increased attributable morbidity and mortality. Severe dengue, especially dengue with haemorrhage was significantly associated with haemoglobin SC disease and multiple organ-systems involved. These included the gastrointestinal and haematologic systems with extremely high lactate dehydrogenases and creatinine phosphokinases and severely abnormal bleeding indices. Despite appropriate interventions, mortality was highest within the first 48 h of admission. Chikungunya, a togavirus, affected 80% of some Caribbean populations. Paediatric presentations included high fever, skin, joint and neurological manifestations. Children less than 5 years of age had the highest morbidity and mortality. This maiden chikungunya epidemic was explosive and overwhelmed public health systems. Zika, another flavivirus, has a seroprevalence of 15% in pregnancy, so the Caribbean remains susceptible. Paediatric complications include pregnancy losses, stillbirths, Congenital Zika syndrome, Guillain-Barre syndrome, acute disseminated encephalomyelitis and transverse myelitis. Neurodevelopment stimulation programs for zika-exposed infants have been effective in improving language and positive behaviour scores.
SUMMARY
Caribbean children remain at risk for dengue, chikungunya and zika, with high attributable morbidity and mortality.
Topics: Child; Humans; Zika Virus Infection; Chikungunya Fever; Dengue; Seroepidemiologic Studies; Arbovirus Infections; Zika Virus; Caribbean Region
PubMed: 36801979
DOI: 10.1097/MOP.0000000000001229 -
The Journal of Clinical Investigation Mar 2017Chikungunya virus (CHIKV), a reemerging arbovirus, causes a crippling musculoskeletal inflammatory disease in humans characterized by fever, polyarthralgia, myalgia,... (Review)
Review
Chikungunya virus (CHIKV), a reemerging arbovirus, causes a crippling musculoskeletal inflammatory disease in humans characterized by fever, polyarthralgia, myalgia, rash, and headache. CHIKV is transmitted by Aedes species of mosquitoes and is capable of an epidemic, urban transmission cycle with high rates of infection. Since 2004, CHIKV has spread to new areas, causing disease on a global scale, and the potential for CHIKV epidemics remains high. Although CHIKV has caused millions of cases of disease and significant economic burden in affected areas, no licensed vaccines or antiviral therapies are available. In this Review, we describe CHIKV epidemiology, replication cycle, pathogenesis and host immune responses, and prospects for effective vaccines and highlight important questions for future research.
Topics: Aedes; Animals; Chikungunya Fever; Chikungunya virus; Humans; Virus Replication
PubMed: 28248203
DOI: 10.1172/JCI84417 -
Journal of Biomedical Science Dec 2021Chikungunya virus (CHIKV) is a re-emerging mosquito-borne human pathogen that causes chikungunya fever, which is typically accompanied by severe joint pain. In Asia,... (Review)
Review
Chikungunya virus (CHIKV) is a re-emerging mosquito-borne human pathogen that causes chikungunya fever, which is typically accompanied by severe joint pain. In Asia, serological evidence indicated that CHIKV first emerged in 1954. From the 1950's to 2005, sporadic CHIKV infections were attributed to the Asian genotype. However, the massive outbreak of CHIKV in India and the Southwest Indian Ocean Islands in 2005 has since raised chikungunya as a worldwide public health concern. The virus is spreading globally, but mostly in tropical and subtropical regions, particularly in South and Southeast Asia. The emergence of the CHIKV East/Central/South African genotype-Indian Ocean lineage (ECSA-IOL) has caused large outbreaks in South and Southeast Asia affected more than a million people over a decade. Notably, the massive CHIKV outbreaks before 2016 and the more recent outbreak in Asia were driven by distinct ECSA lineages. The first significant CHIKV ECSA strains harbored the Aedes albopictus-adaptive mutation E1: A226V. More recently, another mass CHIKV ECSA outbreak in Asia started in India and spread beyond South and Southeast Asia to Kenya and Italy. This virus lacked the E1: A226V mutation but instead harbored two novel mutations (E1: K211E and E2: V264A) in an E1: 226A background, which enhanced its fitness in Aedes aegypti. The emergence of a novel ECSA strain may lead to a more widespread geographical distribution of CHIKV in the future. This review summarizes the current CHIKV situation in Asian countries and provides a general overview of the molecular virology, disease manifestation, diagnosis, prevalence, genotype distribution, evolutionary relationships, and epidemiology of CHIKV infection in Asian countries over the past 65 years. This knowledge is essential in guiding the epidemiological study, control, prevention of future CHIKV outbreaks, and the development of new vaccines and antivirals targeting CHIKV.
Topics: Asia; Chikungunya Fever; Chikungunya virus; Evolution, Molecular; Genotype; Humans
PubMed: 34857000
DOI: 10.1186/s12929-021-00778-8 -
Viruses Aug 2019Alphaviruses belong to a family of positive sense, single-stranded RNA viruses that are transmitted mainly by mosquitoes through a blood meal and cause arthritis and/or...
Alphaviruses belong to a family of positive sense, single-stranded RNA viruses that are transmitted mainly by mosquitoes through a blood meal and cause arthritis and/or encephalitis in humans and animals [...].
Topics: Animals; Arthritis; Chikungunya Fever; Chikungunya virus; Communicable Diseases, Emerging; Disease Outbreaks; Encephalitis; Humans; Mosquito Vectors
PubMed: 31450552
DOI: 10.3390/v11090779 -
The Lancet. Microbe May 2023
Topics: Humans; Chikungunya Fever; Brazil; Chikungunya virus; Dengue
PubMed: 37148895
DOI: 10.1016/S2666-5247(23)00120-9 -
Revue Scientifique Et Technique... Aug 2015Chikungunya is an acute viral disease characterised by fever and painful arthralgia. The arthritic symptoms associated with chikungunya can be debilitating and may... (Review)
Review
Chikungunya is an acute viral disease characterised by fever and painful arthralgia. The arthritic symptoms associated with chikungunya can be debilitating and may persist for months or even years in some patients. Severe neurological complications such as encephalitis have also been reported during recent large outbreaks. The disease is caused by chikungunya virus (CHIKV), a mosquito-borne alphavirus from the Togaviridae family, which has recently emerged to become one of the most important exotic viral threats worldwide. Chikungunya is endemic throughout Africa, and over the past decade, it has also spread throughout the Indian Ocean, Asia, the South Pacific, southern Europe, the Caribbean and Central America. The rapid emergence of CHIKV has been linked to expansion of the mosquito vector species, Aedes aegypti and Ae. albopictus, throughout most tropical and subtropical regions of the world. Furthermore, mutations in some strains of CHIKV have been associated with increased transmissibility of the virus. The lack of a commercial vaccine and the failure of vector control strategies to limit the expansion of chikungunya have prompted the need for further options to prevent the spread of this disease.
Topics: Chikungunya Fever; Chikungunya virus; Communicable Diseases, Emerging; Disease Outbreaks; Global Health; Humans
PubMed: 26601450
DOI: 10.20506/rst.34.2.2373 -
Cardiology 2021Neglected tropical diseases are a group of communicable diseases that occur in tropical and subtropical conditions and are closely related to poverty and inadequate...
INTRODUCTION
Neglected tropical diseases are a group of communicable diseases that occur in tropical and subtropical conditions and are closely related to poverty and inadequate sanitation conditions. Among these entities, chikungunya remains one of the most widely spread diseases. Although the main symptoms are related to a febrile syndrome, cardiovascular (CV) involvement has been reported, with short- and long-term implications. As part of the "Neglected Tropical Diseases and other Infectious Diseases involving the Heart" (NET-Heart) Project, the aim of this review is to compile all the information available regarding CV involvement of this disease, to help healthcare providers gain knowledge in this field, and contribute to improving early diagnosis, treatment, and prevention strategies.
METHODS
We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement in conducting and reporting this systematic review. The search was conducted using MEDLINE/PubMed, SciELO, and LILACS databases to identify any relevant studies or reviews detailing an association between chikungunya and cardiac involvement published from January 1972 to May 31, 2020.
RESULTS
Despite its mechanism not being fully understood, CV involvement has been described as the most frequent atypical presentation of chikungunya (54.2%). Myocarditis is the most prevalent CV complication. Different rhythm disturbances have been reported in 52% of cases, whereas heart failure was reported in 15% of cases, pericarditis in 5%, and acute myocardial infarction in 2%. Overall estimated CV mortality is 10%, although in patients with other comorbidities, it may increase up to 20%. In the proper clinical setting, the presence of fever, polyarthralgia, and new-onset arrhythmia suggests chikungunya virus-related myocarditis.
CONCLUSION
Although most cases are rarely fatal, CV involvement in chikungunya infection remains the most frequent atypical presentation of this disease and may have severe manifestations. Timely diagnosis and appropriate management are necessary to improve patient outcomes.
Topics: Chikungunya Fever; Comorbidity; Fever; Humans; Myocarditis; Pericarditis
PubMed: 33789296
DOI: 10.1159/000514206