Chikungunya: risks for travellers

Abstract

Rationale for review: Chikungunya outbreaks continue to occur, with changing epidemiology. Awareness about chikungunya is low both among the at-risk travellers and healthcare professionals, which can result in underdiagnosis and underreporting. This review aims to improve awareness among healthcare professionals regarding the risks of chikungunya for travellers. Key findings: Chikungunya virus transmission to humans occurs mainly via daytime-active mosquitoes, Aedes aegypti and Aedes albopictus. The areas where these mosquitoes live is continuously expanding, partly due to climate changes. Chikungunya is characterized by an acute onset of fever with joint pain. These symptoms generally resolve within 1–3 weeks but at least one-third of the patients suffer from debilitating rheumatologic symptoms for months to years. Large outbreaks in changing regions of the world since the turn of the 21st century (e.g. Caribbean, La Réunion; currently Brazil, India) have resulted in growing numbers of travellers importing chikungunya, mainly to Europe and North America. Viremic travellers with chikungunya infection have seeded chikungunya clusters (France, United States of America) and outbreaks (Italy in 2007 and 2017) in non-endemic countries where Ae. albopictus mosquitoes are present. Community preventive measures are important to prevent disease transmission by mosquitoes. Individual preventive options are limited to personal protection measures against mosquito bites, particularly the daytime-active mosquitos that transmit the chikungunya virus. Candidate vaccines are on the horizon and regulatory authorities will need to assess environmental and host risk factors for persistent sequelae, such as obesity, age (over 40 years), and history of arthritis or inflammatory rheumatologic disease to determine which populations should be targeted for these chikungunya vaccines. Conclusions/recommendations: Travellers planning to visit destinations with active CHIKV circulation should be advised about the risk for chikungunya, prevention strategies, the disease manifestations, possible chronic rheumatologic sequelae, and if symptomatic, seek medical evaluation and report potential exposures.

The Chikungunya virus: A reemerging cause of acute febrile illness in the high jungle of northern Peru

“…In addition to this, epidemiological evidence indicates that there is also an increased risk of serious complications of viral infection [ 33 ]. This is partly because adipose-derived cytokines and chemokines altered in obesity by chronic low-grade inflammation affect the immune response and make obese patients prone to severe disease or death [ 32 , 34 ].…”

Mucocutaneous manifestations of chikungunya fever: an update

“…One‐third of the population was projected to be infected by chikungunya virus during epidemics in Indian Ocean Islands in 2005–2006 8 . In Europe, the cases were imported by travelers followed by local transmission in 2007 9 . Chikungunya fever outbreak was first reported in USA in December 2013 and became a major health problem by December 2015.…”

“…8 In Europe, the cases were imported by travelers followed by local transmission in 2007. 9 Chikungunya fever outbreak was first reported in USA in December 2013 and became a major health problem by ª 2023 the International Society of Dermatology.…”

Optimization of a ternary photonic crystal biosensor for enhanced chikungunya virus detection

“…1,2 It originates from chikungunya fever, a febrile illness marked by joint pain and other symptoms such as muscular pain, headache, joint swelling, fatigue, and so on. 3 Chikungunya is a Makonde (Bantu language) word that means "the one who bends up," referring to the affected patient's posture due to excruciating joint pain. 4 CHIKV is a spherical, contained, positive-strand RNA virus (60 to 70 nm in diameter).…”

“…Chikungunya virus (CHIKV) is an alphavirus disseminated through the bites from the Togaviridae family of female mosquitoes that have become infected 1 , 2 . It originates from chikungunya fever, a febrile illness marked by joint pain and other symptoms such as muscular pain, headache, joint swelling, fatigue, and so on 3 . Chikungunya is a Makonde (Bantu language) word that means “the one who bends up,” referring to the affected patient’s posture due to excruciating joint pain 4 .…”