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      A scoping review of Chikungunya virus infection: epidemiology, clinical characteristics, viral co-circulation complications, and control

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          Graphical abstract

          Highlights

          • Chikungunya disease has been reported in all continents, except Antarctica.

          • The co-circulation of CHIKV with other arboviruses requires a robust differential diagnosis, ideally combining epidemiological, clinical and laboratory findings.

          • In addition to severe arthralgia, CHIKV infections can lead to atypical manifestations, such as Guillain-Barré syndrome, alopecia and bullous lesions in babies.

          • There are no vaccines or specific drugs licensed for CHIKV.

          • The ideal control strategy for CHIKV transmission should combine an integrated vector management with mass immunization.

          Abstract

          Chikungunya fever is a mosquito-borne viral illness characterized by a sudden onset of fever associated with joint pains. It was first described in the 1950s during a Chikungunya virus (CHIKV) outbreak in southern Tanzania and has since (re-) emerged and spread to several other geographical areas, reaching large populations and causing massive epidemics. In recent years, CHIKV has gained considerable attention due to its quick spread to the Caribbean and then in the Americas, with many cases reported between 2014 and 2017. CHIKV has further garnered attention due to the clinical diagnostic difficulties when Zika (ZIKV) and dengue (DENV) viruses are simultaneously present. In this review, topical CHIKV-related issues, such as epidemiology and transmission, are examined. The different manifestations of infection (acute, chronic and atypical) are described and a particular focus is placed upon the diagnostic handling in the case of ZIKV and DENV co-circulating. Natural and synthetic compounds under evaluation for treatment of chikungunya disease, including drugs already licensed for other purposes, are also discussed. Finally, previous and current vaccine strategies, as well as the control of the CHIKV transmission through an integrated vector management, are reviewed in some detail.

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          Most cited references162

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          Emergence and potential for spread of Chikungunya virus in Brazil

          Background In December 2013, an outbreak of Chikungunya virus (CHIKV) caused by the Asian genotype was notified in the Caribbean. The outbreak has since spread to 38 regions in the Americas. By September 2014, the first autochthonous CHIKV infections were confirmed in Oiapoque, North Brazil, and in Feira de Santana, Northeast Brazil. Methods We compiled epidemiological and clinical data on suspected CHIKV cases in Brazil and polymerase-chain-reaction-based diagnostic was conducted on 68 serum samples from patients with symptom onset between April and September 2014. Two imported and four autochthonous cases were selected for virus propagation, RNA isolation, full-length genome sequencing, and phylogenetic analysis. We then followed CDC/PAHO guidelines to estimate the risk of establishment of CHIKV in Brazilian municipalities. Results We detected 41 CHIKV importations and 27 autochthonous cases in Brazil. Epidemiological and phylogenetic analyses indicated local transmission of the Asian CHIKV genotype in Oiapoque. Unexpectedly, we also discovered that the ECSA genotype is circulating in Feira de Santana. The presumed index case of the ECSA genotype was an individual who had recently returned from Angola and developed symptoms in Feira de Santana. We estimate that, if CHIKV becomes established in Brazil, transmission could occur in 94% of municipalities in the country and provide maps of the risk of importation of each strain of CHIKV in Brazil. Conclusions The etiological strains associated with the early-phase CHIKV outbreaks in Brazil belong to the Asian and ECSA genotypes. Continued surveillance and vector mitigation strategies are needed to reduce the future public health impact of CHIKV in the Americas. Electronic supplementary material The online version of this article (doi:10.1186/s12916-015-0348-x) contains supplementary material, which is available to authorized users.
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            The Newala epidemic. III. The virus: isolation, pathogenic properties and relationship to the epidemic.

            R. W. Ross (1956)
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              High level of vector competence of Aedes aegypti and Aedes albopictus from ten American countries as a crucial factor in the spread of Chikungunya virus.

              Chikungunya virus (CHIKV) causes a major public health problem. In 2004, CHIKV began an unprecedented global expansion and has been responsible for epidemics in Africa, Asia, islands in the Indian Ocean region, and surprisingly, in temperate regions, such as Europe. Intriguingly, no local transmission of chikungunya virus (CHIKV) had been reported in the Americas until recently, despite the presence of vectors and annually reported imported cases. Here, we assessed the vector competence of 35 American Aedes aegypti and Aedes albopictus mosquito populations for three CHIKV genotypes. We also compared the number of viral particles of different CHIKV strains in mosquito saliva at two different times postinfection. Primarily, viral dissemination rates were high for all mosquito populations irrespective of the tested CHIKV isolate. In contrast, differences in transmission efficiency (TE) were underlined in populations of both species through the Americas, suggesting the role of salivary glands in selecting CHIKV for highly efficient transmission. Nonetheless, both mosquito species were capable of transmitting all three CHIKV genotypes, and TE reached alarming rates as high as 83.3% and 96.7% in A. aegypti and A. albopictus populations, respectively. A. albopictus better transmitted the epidemic mutant strain CHIKV_0621 of the East-Central-South African (ECSA) genotype than did A. aegypti, whereas the latter species was more capable of transmitting the original ECSA CHIKV_115 strain and also the Asian genotype CHIKV_NC. Therefore, a high risk of establishment and spread of CHIKV throughout the tropical, subtropical, and even temperate regions of the Americas is more real than ever. Until recently, the Americas had never reported chikungunya (CHIK) autochthonous transmission despite its global expansion beginning in 2004. Large regions of the continent are highly infested with Aedes aegypti and Aedes albopictus mosquitoes, and millions of dengue (DEN) cases are annually recorded. Indeed, DEN virus and CHIK virus (CHIKV) share the same vectors. Due to a recent CHIK outbreak affecting Caribbean islands, the need for a Pan-American evaluation of vector competence was compelling as a key parameter in assessing the epidemic risk. We demonstrated for the first time that A. aegypti and A. albopictus populations throughout the continent are highly competent to transmit CHIK irrespective of the viral genotypes tested. The risk of CHIK spreading throughout the tropical, subtropical, and even temperate regions of the Americas is more than ever a reality. In light of our results, local authorities should immediately pursue and reinforce epidemiological and entomological surveillance to avoid a severe epidemic.
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                Author and article information

                Contributors
                Journal
                Acta Trop
                Acta Trop
                Acta Tropica
                Elsevier
                0001-706X
                1873-6254
                6 September 2018
                December 2018
                6 September 2018
                : 188
                : 213-224
                Affiliations
                [a ]Oswaldo Cruz Foundation, Aggeu Magalhães Institute, Department of Virology, Recife, PE, Brazil
                [b ]Federal University of Santa Maria, Department of Preventive Veterinary Medicine, Virology Section, Santa Maria, RS, Brazil
                [c ]Liège University, Faculty of Veterinary Medicine, Department of Infectious and Parasitic Diseases, Belgium
                [d ]Federal University of Paraíba, Department of Fisiology and Pathology, João Pessoa, PB, Brazil
                [e ]Federal University of Pernambuco, Laboratory of Immunopathology Keizo Asami, Virology Section, Recife, PE, Brazil
                Author notes
                [* ]Corresponding author at: Department of Preventive Veterinary Medicine, Virology Section, Federal University of Santa Maria (UFSM), 97105-900, Santa Maria, RS, Brazil. josevalterjsilvajr@ 123456gmail.com
                [** ]Corresponding author at: Department of Virology, Aggeu Magalhães Institute (IAM), Oswaldo Cruz Foundation (FIOCRUZ), 50670-420, Recife, PE, Brazil. laura@ 123456cpqam.fiocruz.br
                Article
                S0001-706X(18)30937-9
                10.1016/j.actatropica.2018.09.003
                7092809
                30195666
                0835fdb0-ecd4-4790-958b-d7b56f34d121
                © 2018 Elsevier B.V. All rights reserved.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 28 July 2018
                : 2 September 2018
                : 3 September 2018
                Categories
                Article

                Ecology
                chikungunya fever,arboviruses,dengue,zika
                Ecology
                chikungunya fever, arboviruses, dengue, zika

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