Measuring the global burden of chikungunya and Zika viruses: A systematic review

Abstract

Throughout the last decade, chikungunya virus (CHIKV) and Zika virus (ZIKV) infections have spread globally, causing a spectrum of disease that ranges from self-limited febrile illness to permanent severe disability, congenital anomalies, and early death. Nevertheless, estimates of their aggregate health impact are absent from the literature and are currently omitted from the Global Burden of Disease (GBD) reports. We systematically reviewed published literature and surveillance records to evaluate the global burden caused by CHIKV and ZIKV between 2010 and 2019, to calculate estimates of their disability-adjusted life year (DALY) impact. Extracted data on acute, chronic, and perinatal outcomes were used to create annualized DALY estimates, following techniques outlined in the GBD framework. This study is registered with PROSPERO (CRD42020192502). Of 7,877 studies identified, 916 were screened in detail, and 21 were selected for inclusion. Available data indicate that CHIKV and ZIKV caused the average yearly loss of over 106,000 and 44,000 DALYs, respectively, between 2010 and 2019. Both viruses caused substantially more burden in the Americas than in any other World Health Organization (WHO) region. This unequal distribution is likely due to a combination of limited active surveillance reporting in other regions and the lack of immunity that left the previously unexposed populations of the Americas susceptible to severe outbreaks during the last decade. Long-term rheumatic sequelae provided the largest DALY component for CHIKV, whereas congenital Zika syndrome (CZS) contributed most significantly for ZIKV. Acute symptoms and early mortality accounted for relatively less of the overall burden. Suboptimal reporting and inconsistent diagnostics limit precision when determining arbovirus incidence and frequency of complications. Despite these limitations, it is clear from our assessment that CHIKV and ZIKV represent a significant cause of morbidity that is not included in current disease burden reports. These results suggest that transmission-blocking strategies, including vector control and vaccine development, remain crucial priorities in reducing global disease burden through prevention of potentially devastating arboviral outbreaks.

Current Status of Chikungunya in India

“…Chikungunya fever (CHIKF) is an arthropod-borne viral (arbovirus) disease ( Mohan, 2006 ; Mohan and Sharma, 2007 ) that has become a global health concern following its resurgence since 2006 ( Pialoux et al, 2007 ; Simon et al, 2008 ). Historically, there have been reports of epidemics of fever along with arthralgia as far back as 1824, similar to present day CHIKF ( WHO, 2012 ; Puntasecca et al, 2021 ). However, the CHIKF was first officially described in 1952 after an outbreak on the Makonde Plateau, south-eastern Tanzania ( Lumsden, 1955 ; Robinson, 1955 ).…”

Mode-Dependent Antiviral Activity of Medicinal Plant Extracts against the Mosquito-Borne Chikungunya Virus

“…The virus has been documented in 114 countries and territories [ 5 ]. Recent analysis indicates that this virus caused an average yearly loss of over 106,000 disability-adjusted life years for the period 2010–2019 [ 6 ]. According to the surveillance done by the European Centre for Disease Prevention and Control, at least 170,000 cases of chikungunya fever occurred globally in the year 2020 [ 7 ].…”

“…Upon an acute infection, 80–97% of patients are symptomatic [ 10 ] and their clinical manifestations include arthralgia or polyarthralgia, high fever, headache, myalgia, skin rashes, joint swelling, and nausea [ 11 ]. Although the mortality rate is relatively low (0.07%), polyarthralgia can persist in the patients for several months or even years after resolution of the acute phase of infection, this being the most common long-term sequel of chikungunya virus infection [ 6 , 12 ]. Presently, patients with chikungunya fever are treated with antipyretic, analgesic, or anti-inflammatory drugs for symptomatic relief [ 5 ].…”

WolbachiastrainwAu differs in cellular perturbation and virus inhibition profiles from previously characterisedWolbachiastrains

“…The maternally inherited intracellular symbiotic bacteria Wolbachia are common in insects and can spread through insect populations by inducing cytoplasmic incompatibility (CI), a sperm modification that results in a pattern of crossing sterility that gives Wolbachia-carrying females a relative fitness advantage (1)(2)(3). They are not naturally carried by the mosquito Aedes aegypti, the primary vector of the flaviruses dengue (DENV), Zika (ZIKV), chikungunya (CHIKV) and yellow fever (YFV), and the alphavirus chikungunya (CHIKV), which together impose a huge public health burden across the tropics (4,5). However, following lab transfers of various Wolbachia strains into this mosquito, some strains can block the transmission of DENV, ZIKV, YFV and CHIKV; Wolbachia can also inhibit insect-specific flaviruses, West Nile Virus and experimental model arboviruses such as Semliki Forest Virus (SFV) (6)(7)(8)(9)(10)(11).…”