Chikungunya Virus: A Comprehensive Insight to Symptoms, Pathogenesis and Epidemiological Trends
Abstract
Chikungunya virus (CHIKV), an alphavirus transmitted by mosquitoes, has re-emerged recently, causing significant global outbreaks. Infection leads to chikungunya fever (CHIKF), an acute febrile illness primarily characterized by severe joint pain and myalgia, which can persist for weeks to months. The pain is much more pronounced and localized to the joints and tendons in chikungunya fever. Although CHIKF is usually self-limiting, severe cases with complications like persistent systematic clinical manifestations and fatalities have been documented. The virus’s resurgence is likely driven by factors such as viral evolution, globalization, and climate change, exacerbated by the absence of licensed vaccines or antiviral therapies. In light of its expanding range and unpredictable outbreaks, CHIKV has become a major global health threat. No specific and effective antiviral therapy is available, and vaccines are still in trial. The only effective preventive measures consist of individual protection against mosquito bites and vector control. The main objective of this study is to investigate the clinical manifestations, pathogenesis and epidemiology of CHIKV disease.
References
Abraham, R., Mudaliar, P., Padmanabhan, A., & Sreekumar, E. (2013). Induction of cytopathogenicity in human glioblastoma cells by chikungunya virus. PLoS One, 8(9), e75854. https://doi.org/10.1371/journal.pone.0075854.
Ali, I., & Dasti, J. I. (2018). Chikungunya virus; an emerging arbovirus in Pakistan. J Pak Med Assoc, 68(2), 252–257.
Badar, N., Ikram, A., Salman, M., Alam, M. M., Umair, M., Arshad, Y., Mushtaq, N., Mirza, H. A., Ahad, A., Farooq, U., Yasin, M. T., & Qazi, J. (2021). Chikungunya virus: Molecular epidemiology of nonstructural proteins in Pakistan. PLoS One, 16(12), e0260424. https://doi.org/10.1371/journal.pone.0260424.
Bartok, B., & Firestein, G. S. (2010). Fibroblast-like synoviocytes: key effector cells in rheumatoid arthritis. Immunol Rev, 233(1), 233–255. https://doi.org/10.1111/j.0105-2896.2009.00859.x.
Bettis, A. A., L Azou Jackson, M., Yoon, I. K., Breugelmans, J. G., Goios, A., Gubler, D. J., & Powers, A. M. (2022). The global epidemiology of chikungunya from 1999 to 2020: A systematic literature review to inform the development and introduction of vaccines. PLoS Negl Trop Dis, 16(1), e0010069. https://doi.org/10.1371/journal.pntd.0010069.
Bierbrier, R., Javelle, E., Norman, F. F., Chen, L. H., Bottieau, E., Schwartz, E., Leder, K., Angelo, K. M., Stoney, R. J., Libman, M., Hamer, D. H., Huits, R., Connor, B. A., Simon, F., Barkati, S., & Network, f. t. G. (2024). Chikungunya infection in returned travellers: results from the GeoSentinel network, 2005–2020. Journal of Travel Medicine, 31(2). https://doi.org/10.1093/jtm/taae005.
Bonifay, T., Vesin, G., Bidaud, B., Bonnefoy, C., Dueymes, M., Nacher, M., Djossou, F., & Epelboin, L. (2019). Clinical characteristics and predictive score of dengue vs. chikungunya virus infections. Medecine et maladies infectieuses, 49(4), 250–256. https://doi.org/https://doi.org/10.1016/j.medmal.2018.09.010.
Burt, F. J., Rolph, M. S., Rulli, N. E., Mahalingam, S., & Heise, M. T. (2012). Chikungunya: a re-emerging virus. Lancet, 379(9816), 662–671. https://doi.org/10.1016/s0140-6736(11)60281-x.
Calvez, E., Miot, E. F., Keosenhom, S., Vungkyly, V., Viengphouthong, S., Bounmany, P., Brey, P. T., Marcombe, S., & Grandadam, M. (2022). Low Transmission of Chikungunya Virus by Aedes aegypti from Vientiane Capital, Lao PDR. Pathogens, 12(1). https://doi.org/10.3390/pathogens12010031.
Chen, M.-Y., Huang, A. S.-E., Yang, C.-F., Hsu, T.-C., Wang, T.-C., Su, C.-L., Chang, M.-C., Peng, S.-H., & Shu, P.-Y. (2021). Chikungunya infection: First autochthonous cases in Taiwan. Journal of the Formosan Medical Association, 120(7), 1526–1530. https://doi.org/https://doi.org/10.1016/j.jfma.2020.10.032.
Chen, W., Foo, S. S., Rulli, N. E., Taylor, A., Sheng, K. C., Herrero, L. J., Herring, B. L., Lidbury, B. A., Li, R. W., Walsh, N. C., Sims, N. A., Smith, P. N., & Mahalingam, S. (2014). Arthritogenic alphaviral infection perturbs osteoblast function and triggers pathologic bone loss. Proc Natl Acad Sci U S A, 111(16), 6040–6045. https://doi.org/10.1073/pnas.1318859111.
Chen, W., Foo, S. S., Rulli, N. E., Taylor, A., Sheng, K. C., Herrero, L. J., Herring, B. L., Lidbury, B. A., Li, R. W., Walsh, N. C., Sims, N. A., Smith, P. N., & Mahalingam, S. (2014). Arthritogenic alphaviral infection perturbs osteoblast function and triggers pathologic bone loss. Proc Natl Acad Sci U S A, 111(16), 6040–6045. https://doi.org/10.1073/pnas.1318859111.
Da Costa, V. G., Saivish, M. V., Sinhorini, P. F., Nogueira, M. L., & Rahal, P. (2024). A meta-analysis of Chikungunya virus in neurological disorders. Infectious Diseases Now, 54(5), 104938.
Dass, S., Ngui, R., Gill, B. S., Chan, Y. F., Wan Sulaiman, W. Y., Lim, Y. A. L., Mudin, R. N., Chong, C. K., Sulaiman, L. H., & Sam, I.-C. (2021). Spatiotemporal spread of chikungunya virus in Sarawak, Malaysia. Transactions of The Royal Society of Tropical Medicine and Hygiene, 115(8), 922–931. https://doi.org/10.1093/trstmh/trab053.
de Souza, W. M., Fumagalli, M. J., de Lima, S. T. S., Parise, P. L., Carvalho, D. C. M., Hernandez, C., de Jesus, R., Delafiori, J., Candido, D. S., Carregari, V. C., Muraro, S. P., Souza, G. F., Simões Mello, L. M., Claro, I. M., Díaz, Y., Kato, R. B., Trentin, L. N., Costa, C. H. S., Maximo, A. C. B. M.,…Weaver, S. C. (2024). Pathophysiology of chikungunya virus infection associated with fatal outcomes. Cell host & microbe, 32(4), 606–622.e608. https://doi.org/https://doi.org/10.1016/j.chom.2024.02.011.
Diallo, M., Thonnon, J., Traore-Lamizana, M., & Fontenille, D. (1999). Vectors of Chikungunya virus in Senegal: current data and transmission cycles. Am J Trop Med Hyg, 60(2), 281–286. https://doi.org/10.4269/ajtmh.1999.60.281.
Dupont-Rouzeyrol, M., Caro, V., Guillaumot, L., Vazeille, M., D'Ortenzio, E., Thiberge, J. M., Baroux, N., Gourinat, A. C., Grandadam, M., & Failloux, A. B. (2012). Chikungunya virus and the mosquito vector Aedes aegypti in New Caledonia (South Pacific Region). Vector Borne Zoonotic Dis, 12(12), 1036–1041. https://doi.org/10.1089/vbz.2011.0937.
Goncalves, W. A., de Sousa, C. D. F., Teixeira, M. M., & Souza, D. G. (2025). A brief overview of chikungunya-related pain. European Journal of Pharmacology, 994, 177322. https://doi.org/https://doi.org/10.1016/j.ejphar.2025.177322.
Hakami, A. R., Alshamrani, A. A., Alqahtani, M., Alraey, Y., Alhefzi, R. A., Alasmari, S., Makkawi, M., Dobie, G., Mir, M., Alshahrani, M., Dera, A., Alfaifi, M., Al Shahrani, M., Matari, A., & Asiry, A. E. (2021). Detection of chikungunya virus in the Southern region, Saudi Arabia. Virology Journal, 18(1), 190. https://doi.org/10.1186/s12985-021-01660-7.
Hakami, A. R., Alshamrani, A. A., Alqahtani, M., Alraey, Y., Alhefzi, R. A., Alasmari, S., Makkawi, M., Dobie, G., Mir, M., Alshahrani, M., Dera, A., Alfaifi, M., Al Shahrani, M., Matari, A., & Asiry, A. E. (2021). Detection of chikungunya virus in the Southern region, Saudi Arabia. Virology Journal, 18(1), 190. https://doi.org/10.1186/s12985-021-01660-7.
Harapan, H., Michie, A., Mudatsir, M., Nusa, R., Yohan, B., Wagner, A. L., Sasmono, R. T., & Imrie, A. (2019). Chikungunya virus infection in Indonesia: a systematic review and evolutionary analysis. BMC Infect Dis, 19(1), 243. https://doi.org/10.1186/s12879-019-3857-y.
Horwood, P. F., Reimer, L. J., Dagina, R., Susapu, M., Bande, G., Katusele, M., Koimbu, G., Jimmy, S., Ropa, B., Siba, P. M., & Pavlin, B. I. (2013). Outbreak of chikungunya virus infection, Vanimo, Papua New Guinea. Emerg Infect Dis, 19(9), 1535–1538. https://doi.org/10.3201/eid1909.130130.
Kamal, M., Kenawy, M. A., Rady, M. H., Khaled, A. S., & Samy, A. M. (2018). Mapping the global potential distributions of two arboviral vectors Aedes aegypti and Ae. albopictus under changing climate. PLoS One, 13(12), e0210122. https://doi.org/10.1371/journal.pone.0210122.
Kraemer, M. U., Sinka, M. E., Duda, K. A., Mylne, A. Q., Shearer, F. M., Barker, C. M., Moore, C. G., Carvalho, R. G., Coelho, G. E., Van Bortel, W., Hendrickx, G., Schaffner, F., Elyazar, I. R., Teng, H. J., Brady, O. J., Messina, J. P., Pigott, D. M., Scott, T. W., Smith, D. L.,…Hay, S. I. (2015). The global distribution of the arbovirus vectors Aedes aegypti and Ae. albopictus. Elife, 4, e08347. https://doi.org/10.7554/eLife.08347.
Lagowski, W., Grodzka, O., & Domitrz, I. (2025). Atypical neurological symptoms at high altitude: a systematic literature review. Travel Medicine and Infectious Disease, 66, 102867. https://doi.org/https://doi.org/10.1016/j.tmaid.2025.102867.
Morrison, T. E. (2014). Reemergence of chikungunya virus. J Virol, 88(20), 11644–11647. https://doi.org/10.1128/jvi.01432-14.
Mudurangaplar, B., & Peerapur, B. V. (2015). Seroepidemiological survey of chikungunya in and around the regions of Bijapur (Vijayapura-North Karnataka). Journal of Clinical and Diagnostic Research: JCDR, 9(5), DC01.
Nasif, M. A. O., Haider, N., Muntasir, I., Qayum, M. O., Hasan, M. N., Hassan, M. R., Khan, M. H., Sultana, S., Ferdous, J., Prince, K. T. P., Rudra, M., Rahman, M., Alam, A. N., & Shirin, T. (2025). The reappearance of Chikungunya virus in Bangladesh, 2024. IJID Regions, 100664. https://doi.org/https://doi.org/10.1016/j.ijregi.2025.100664.
Nelson, J., Waggoner, J. J., Sahoo, M. K., Grant, P. M., & Pinsky, B. A. (2014). Encephalitis caused by Chikungunya virus in a traveler from the Kingdom of Tonga. J Clin Microbiol, 52(9), 3459–3461. https://doi.org/10.1128/jcm.01288-14.
Nguyen, A., Lee, P., Rodriguez, E. K., Chahal, K., Freedman, B. R., & Nazarian, A. (2025). Addressing the growing burden of musculoskeletal diseases in the ageing US population: challenges and innovations. The Lancet Healthy Longevity, 100707. https://doi.org/https://doi.org/10.1016/j.lanhl.2025.100707.
Nguyen, T. V., Ngwe Tun, M. M., Cao, M. T., Dao, H. M., Luong, C. Q., Huynh, T. K. L., Nguyen, T. T. T., Hoang, T. N. D., Morita, K., Le, T. Q. M., Pham, Q. D., Takamatsu, Y., & Hasebe, F. (2023). Serological and Molecular Epidemiology of Chikungunya Virus Infection in Vietnam, 2017-2019. Viruses, 15(10). https://doi.org/10.3390/v15102065.
Palepu, S., Elbuluk, N., & Taylor, S. (2025). Application of patient-reported outcomes in dermatology clinical trials: A comprehensive review of quality of life, mental health, and symptom measures. JAAD Reviews, 4, 133–140. https://doi.org/https://doi.org/10.1016/j.jdrv.2025.03.009.
Pedersen, M., Engedal, M. S., Larsen, M. T., Kornblit, B. T., Lomborg, K., & Jarden, M. (2024). Living with a chronic hematological malignancy: Perspectives on PRO-based management of symptoms. European Journal of Oncology Nursing, 73, 102713. https://doi.org/https://doi.org/10.1016/j.ejon.2024.102713.
Peters, J., Runnels, G., Lauinger, A., Murphy, T., Griffith, A., & Slicho, T. (2025). A review of osteopathic and related manipulative treatments for improving symptoms of gastrointestinal distress in neurological disorders. International Journal of Osteopathic Medicine, 100766. https://doi.org/https://doi.org/10.1016/j.ijosm.2025.100766.
Phuklia, W., Kasisith, J., Modhiran, N., Rodpai, E., Thannagith, M., Thongsakulprasert, T., Smith, D. R., & Ubol, S. (2013). Osteoclastogenesis induced by CHIKV-infected fibroblast-like synoviocytes: a possible interplay between synoviocytes and monocytes/macrophages in CHIKV-induced arthralgia/arthritis. Virus Res, 177(2), 179–188. https://doi.org/10.1016/j.virusres.2013.08.011.
Pouriayevali, M. H., Rezaei, F., Jalali, T., Baniasadi, V., Fazlalipour, M., Mostafavi, E., Khakifirouz, S., Mohammadi, T., Fereydooni, Z., Tavakoli, M., Azad-Manjiri, S., Hosseini, M., Ghalejoogh, M., Gouya, M. M., Failloux, A. B., & Salehi-Vaziri, M. (2019). Imported cases of Chikungunya virus in Iran. BMC Infect Dis, 19(1), 1004. https://doi.org/10.1186/s12879-019-4637-4.
Puntasecca, C. J., King, C. H., & LaBeaud, A. D. (2021). Measuring the global burden of chikungunya and Zika viruses: A systematic review. PLoS Negl Trop Dis, 15(3), e0009055. https://doi.org/10.1371/journal.pntd.0009055.
Rodrigues Faria, N., Lourenço, J., Marques de Cerqueira, E., Maia de Lima, M., Pybus, O., & Carlos Junior Alcantara, L. (2016). Epidemiology of Chikungunya Virus in Bahia, Brazil, 2014-2015. PLoS Curr, 8. https://doi.org/10.1371/currents.outbreaks.c97507e3e48efb946401755d468c28b2.
Ross, R. W. (1956). The Newala epidemic. III. The virus: isolation, pathogenic properties and relationship to the epidemic. J Hyg (Lond), 54(2), 177–191.https://doi.org/10.1017/s0022172400044442.
Roy, E., Shi, W., Duan, B., & Reid, S. P. (2020). Chikungunya Virus Infection Impairs the Function of Osteogenic Cells. mSphere, 5(3). https://doi.org/10.1128/mSphere.00347-20.
Sam, I.-C., Kümmerer, B. M., Chan, Y.-F., Roques, P., Drosten, C., & AbuBakar, S. (2015). Updates on Chikungunya Epidemiology, Clinical Disease, and Diagnostics. Vector-Borne and Zoonotic Diseases, 15(4), 223–230. https://doi.org/10.1089/vbz.2014.1680.
Sam, I.-C., Kümmerer, B. M., Chan, Y.-F., Roques, P., Drosten, C., & AbuBakar, S. (2015). Updates on Chikungunya Epidemiology, Clinical Disease, and Diagnostics. Vector-Borne and Zoonotic Diseases, 15(4), 223–230. https://doi.org/10.1089/vbz.2014.1680.
Sanyaolu, A., Okorie, C., Badaru, O., Wynveen, E., White, S., Wallace, W., Akl, J., Freeze, A., Kamel, A., & Madonna, M. (2016). Chikungunya epidemiology: a global perspective. SM J Public Health Epidemiol, 2(2), 1028.
Sengupta, S., Mukherjee, S., Haldar, S. K., Bhattacharya, N., & Tripathi, A. (2020). Re-emergence of Chikungunya virus infection in Eastern India. Brazilian Journal of Microbiology, 51(1), 177–182. https://doi.org/10.1007/s42770-019-00212-0.
Sharif, N., Sarkar, M. K., Ferdous, R. N., Ahmed, S. N., Billah, M. B., Talukder, A. A., Zhang, M., & Dey, S. K. (2021). Molecular Epidemiology, Evolution and Reemergence of Chikungunya Virus in South Asia. Front Microbiol, 12, 689979. https://doi.org/10.3389/fmicb.2021.689979.
Sofyantoro, F., Frediansyah, A., Priyono, D. S., Putri, W. A., Septriani, N. I., Wijayanti, N., Ramadaningrum, W. A., Turkistani, S. A., Garout, M., Aljeldah, M., Al Shammari, B. R., Alwashmi, A. S. S., Alfaraj, A. H., Alawfi, A., Alshengeti, A., Aljohani, M. H., Aldossary, S., & Rabaan, A. A. (2023). Growth in chikungunya virus-related research in ASEAN and South Asian countries from 1967 to 2022 following disease emergence: a bibliometric and graphical analysis. Global Health, 19(1), 9. https://doi.org/10.1186/s12992-023-00906-z.
Tomar, S. J., Alagarasu, K., More, A., Nadkarni, M., Bachal, R., Bote, M., Patil, J., Venkatesh, V., Parashar, D., & Tandale, B. V. (2022). Decadal Change in Seroprevalence of Chikungunya Virus Infection in Pune City, India. Viruses, 14(5). https://doi.org/10.3390/v14050998.
Weaver, S. C. (2014). Arrival of chikungunya virus in the new world: prospects for spread and impact on public health. PLoS Negl Trop Dis, 8(6), e2921. https://doi.org/10.1371/journal.pntd.0002921.
Wimalasiri-Yapa, B., Stassen, L., Huang, X., Hafner, L. M., Hu, W., Devine, G. J., Yakob, L., Jansen, C. C., Faddy, H. M., Viennet, E., & Frentiu, F. D. (2019). Chikungunya virus in Asia - Pacific: a systematic review. Emerg Microbes Infect, 8(1), 70–79. https://doi.org/10.1080/22221751.2018.1559708.
Yactayo, S., Staples, J. E., Millot, V., Cibrelus, L., & Ramon-Pardo, P. (2016). Epidemiology of Chikungunya in the Americas. The Journal of Infectious Diseases, 214(suppl_5), S441–S445. https://doi.org/10.1093/infdis/jiw390.
Yan, R., Hu, Y., Yang, J., Wang, H., Wang, Y., & Song, G. (2025). Depressive symptoms trajectories and cardiovascular disease in Chinese middle-aged and older adults: A longitudinal cohort study. Journal of Affective Disorders, 380, 456–465. https://doi.org/https://doi.org/10.1016/j.jad.2025.03.154.
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