Co esponding au ho : Enoch Chi Ngai Lim
Copy igh © 2025 Au ho (s) e ain he copy igh o his a icle. This a icle is published unde he e ms o he C ea i e Commons A ibu ion Liscense 4.0.
Chikungunya i us: A global e-eme gence and e iew o he e idence
Enoch Chi Ngai Lim *
T ansla ional Resea ch Depa men , Specialis Medical Se ices G oup, Ea lwood, NSW 2206, Aus alia.
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 27(02), 1030-1034
Publica ion his o y: Recei ed on 07 July 2025; e ised on 12 Augus 2025; accep ed on 15 Augus 2025
A icle DOI: h ps://doi.o g/10.30574/wja .2025.27.2.2970
Abs ac
Chikungunya e e is a mosqui o-bo ne i al disease ha has e-eme ged globally in ecen decades, causing explosi e
ou b eaks wi h signi ican public heal h impac . In 2025, pa s o Sou heas Asia and he Indian Ocean islands
expe ienced majo chikungunya ou b eaks, unde lining he con inued h ea o his a bo i al in ec ion. This na a i e
e iew aims o p o ide a comp ehensi e and up- o-da e o e iew o chikungunya e e , co e ing epidemiology,
pa hogenesis, clinical mani es a ions, diagnosis, compa isons wi h simila condi ions, ea men , and p e en ion
s a egies. Rele an li e a u e was iden i ied h ough da abase sea ches and au ho i a i e heal h o ganiza ion epo s,
wi h emphasis on s udies om he las i e yea s. In summa y, chikungunya e e emains an impo an e-eme ging
disease wo ldwide. S eng hened su eillance, accu a e diagnosis (dis inguishing i om co-ci cula ing a bo i uses),
and in eg a ed mosqui o con ol a e i al o mi iga e i s impac , while new accines o e hope o u u e ou b eak
p e en ion.
Keywo ds: Chikungunya Fe e ; Re iew; Ou b eaks; Diagnosis; P e en ion
1. In oduc ion
Chikungunya e e is an acu e eb ile illness caused by he chikungunya i us (CHIKV), an RNA i us in he
genus Alpha i us ( amily Ga iidae) [1]. The disease is ansmi ed o humans by Aedes mosqui oes (p ima ily Aedes
Egyp ian Aedes albopic us), he same ec o s ha sp ead dengue and Zika i uses [2]. The name “chikungunya”
o igina es om he Kimonoed language o Tanzania, meaning “ o become con o ed,” desc ibing he s ooped pos u e o
su e e s wi h se e e join pain [3]. Fi s iden i ied in Tanzania in 1952, CHIKV caused spo adic ou b eaks in A ica and
Asia o se e al decades [4].
Since he mid-2000s, chikungunya has d ama ically e-eme ged on a global scale. No ably, a mu a ion in he i al
en elope (E1-A226V) enabled CHIKV o be ansmi ed mo e e icien ly by Ae. albopic us, acili a ing i s sp ead o new
egions [5]. Beginning a ound 2004–2005, la ge ou b eaks occu ed in Kenya and he Indian Ocean islands, including a
2005–2006 epidemic in La Réunion ha a ec ed an es ima ed 244,000–300,000 people [6]. The i us subsequen ly
caused epidemics in Sou h Asia in 2006–2008, and in la e 2013 CHIKV eached he Ame icas [7]. As o 2025, o e 110
coun ies ac oss Asia, A ica, he Ame icas, and Eu ope ha e epo ed cases [8,9].
In 2025, ou b eaks we e epo ed in La Réunion, Mayo e, Mau i ius, and sou he n China. Guangdong p o ince eco ded
o e 7,000 con i med cases in July o ea ly Augus 2025 [9]. These e en s highligh ha chikungunya emains a p essing
heal h issue in opical and sub opical egions. In ligh o ongoing ou b eaks and accine de elopmen , his a icle
se es as a e eshe and aims o consolida e ecen e idence o clinicians, esea che s, and public heal h p o essionals.
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2. Me hodology
We conduc ed a na a i e e iew using PubMed, Scopus, and Google Schola . Sea ch e ms included “chikungunya,”
“CHIKV,” “chikungunya e e ,” “ou b eak,” “clinical ea u es,” “ ea men ,” “diagnosis,” and “ accine.” Li e a u e in he
las i e yea s om Janua y 2020 o Augus 2025 was p io i ized. Repo s om WHO, CDC, ECDC, and na ional heal h
agencies we e also e iewed.
3. Epidemiology
Chikungunya was once con ined o pa s o A ica and Asia. Since 2004, i has expanded in o he Ame icas and Eu ope
[10,11]. O e 110 coun ies ha e epo ed local ansmission [8]. A majo ou b eak occu ed in La Réunion in 2005 [6],
and a widesp ead epidemic ollowed in he Ame icas in 2013–2014 [12,13]. In 2023, Pa aguay expe ienced a
esu gence [14]. In 2025, sou he n China epo ed i s la ges ou b eak [9]. Chikungunya ou b eaks a e explosi e, wi h
a ack a es exceeding 30% [15]. Immuni y a e in ec ion appea s long-las ing [16]. T ansmission peaks du ing ainy
seasons when mosqui o densi y ises [17]. T a ele s can in oduce he i us o new a eas.
4. Pa hogenesis
CHIKV en e s h ough a mosqui o bi e, eplica es in ib oblas s, and sp eads sys emically [18]. I a ge s muscle and
join issues, leading o in lamma ion and pain [19]. Mos pa ien s eco e wi hin wo weeks, bu 30–50% de elop
pe sis en a h algia due o immune dys egula ion o an igen pe sis ence [20,21]. Ch onic a h i is esembles
heuma oid a h i is bu usually lacks au oan ibodies [22]. Se e e cases in ol ing he hea , b ain, o li e a e a e and
occu mos ly in in an s and elde ly adul s [23,24]. The case a ali y a e emains unde 0.3% [25].
5. Clinical Mani es a ions
Typical ea u es include ab up onse o high e e , se e e polya h i is o a h algia, ash, and a igue [26]. Join pain
a ec s small join s symme ically and may pe sis o weeks o longe [27]. Rash, headache, conjunc i i is, and mild
bleeding can also occu [28]. As indica ed in Table 1, he ini ial clinical p esen a ion o Chikungunya e e may esemble
ha o o he i al in ec ions, such as dengue o Zika i us. Labo a o y indings include leukopenia, mild
h ombocy openia, and ele a ed li e enzymes [29]. Ch onic join pain can pe sis beyond 3 mon hs, especially in olde
adul s [22]. Se e e complica ions include encephali is, seizu es, and myoca di is [24].
Table 1 Compa ison o Chikungunya, Dengue, and Zika In ec ions
Fea u e
Chikungunya
Dengue
Zika
Fe e
High, ab up
High, biphasic
Mild o absen
A h algia/A h i is
Se e e, pe sis en
Mild
Mild
Rash
Common
Common
Common
Hemo hagic endency
Ra e
Common in se e e cases
Ra e
Conjunc i i is
Uncommon
Uncommon
Common
Th ombocy openia
Mild
Ma ked
Mild
Ch onic sequelae
Common
Ra e
Ra e
6. Diagnosis
RT-PCR de ec s i al RNA in blood du ing he i s 7 days o illness [30]. A e wa ds, se ology is p e e ed; IgM
an ibodies appea by day 5 and pe sis o weeks. IgG indica es pas exposu e. In egions wi h dengue and Zika co-
ci cula ion, di e en ial diagnosis is essen ial. Dengue o en causes bleeding and low pla ele s, while Zika may p esen
wi h milde symp oms and conjunc i i is [28].
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7. T ea men
The e is no speci ic an i i al ea men o chikungunya. Managemen is p ima ily suppo i e. Pa ace amol is
ecommended o e e and pain elie . Aspi in and NSAIDs should be a oided ini ially o ule ou dengue, which may
co-ci cula e [3,8]. Once dengue is excluded, NSAIDs can be used o con ol in lamma ion. Ch onic a h algia may equi e
a longe cou se o NSAIDs o co icos e oids, especially in se e e o disabling cases [21,22]. Some pa ien s bene i om
physio he apy du ing he ch onic phase. Me ho exa e o o he DMARDs may be conside ed o pe sis en
in lamma o y a h i is esembling heuma oid a h i is, al hough e idence is limi ed [20,21].
8. P e en ion
Se e al p e en ion s a egies a e indica ed in Table 2. Vec o con ol emains he co ne s one o chikungunya
p e en ion. This includes elimina ing mosqui o b eeding si es, using insec epellen s (e.g., DEET, pica idin), wea ing
p o ec i e clo hing, and ins alling window sc eens [8,10]. Communi y engagemen in sani a ion e o s is essen ial o
educe Aedes popula ions. T a ele s o endemic a eas should ake s ic mosqui o bi e p ecau ions. Du ing ou b eaks,
in ec ed indi iduals should a oid mosqui o exposu e o p e en u he sp ead [8].
A single-dose, li e-a enua ed chikungunya accine (IXCHIQ/VLA1553) [31] o in amuscula injec ion was de eloped
by Valne a and ecei ed app o al in Eu ope, he Uni ed S a es, Canada, and he Uni ed Kingdom, o use in a elle s
aged 18 and olde [32,33,34,35]. In 2024, Valne a ecei ed $41.3 million g an o suppo b oade access o he accine,
and o e alua e i s e ec i eness in ulne able g oups, such as child en and p egnan women [36]. A sa e, e ec i e, and
widely a ailable accine could signi ican ly educe he global disease bu den.
Table 2 Key P e en ion S a egies o Chikungunya
S a egy
Desc ip ion
Vec o con ol
Remo e s anding wa e , la icides, ogging
Pe sonal p o ec ion
Repellen s, long clo hing, mosqui o ne s
Su eillance and ou b eak esponse
Ea ly case de ec ion and apid mosqui o con ol
Public educa ion
Communi y awa eness on p e en ion
Vaccina ion ( u u e)
VLA1553 accine app o ed; o he s in de elopmen
9. Conclusion
Chikungunya e e con inues o pose a signi ican public heal h challenge ac oss endemic and newly a ec ed egions.
I s expanding geog aphic ange, debili a ing ch onic symp oms, and absence o a ge ed an i i al he apy highligh he
need o con inued su eillance, p omp diagnosis, and e ec i e ec o con ol s a egies. Recen p og ess in accine
de elopmen o e s hope o long- e m p e en ion. G ea e public awa eness, heal h sys em eadiness, and in es men
in esea ch a e essen ial o mi iga e he impac o u u e ou b eaks and educe he disease bu den globally.
Compliance wi h e hical s anda ds
Disclosu e o con lic o in e es
The au ho decla es no con lic o in e es .
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