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Chikungunya fever

Mary Elizabeth Wilson, MD
Section Editor
Martin S Hirsch, MD
Deputy Editor
Elinor L Baron, MD, DTMH


Chikungunya is an arthropod-borne virus (arbovirus) endemic to West Africa that causes acute febrile polyarthralgia and arthritis. The name chikungunya is derived from a local language of Tanzania meaning "that which bends up" or "stooped walk" because of the incapacitating arthralgia caused by the disease.

Multiple outbreaks beyond West Africa have been described. Since 2004, chikungunya has spread broadly, causing massive outbreaks with explosive onset in the Indian Ocean region, India, and other parts of Asia [1-3]. Chikungunya had traditionally been perceived as a tropical disease until an outbreak in Italy in 2007. In addition, thousands of cases have been identified in travelers returning from outbreak areas [4]. The distribution of mosquito vectors capable of transmitting chikungunya virus is wide; since late 2013, chikungunya virus infections have spread widely in the Americas [5,6].


The United States Centers for Disease Control (CDC) maintains a page with reported current or previous local transmission of chikungunya virus.

Endemic areas — Chikungunya virus is endemic in parts of West Africa, where it appears to be maintained in a cycle involving humans, Aedes mosquitoes, primates, and perhaps other animals [7,8]. Serosurveys of humans in parts of West Africa have identified antibodies to chikungunya virus in 35 to 50 percent of the population in the absence of recognized outbreaks.

Spread and resurgence — Chikungunya virus spreads by means of travel of infected individuals between regions where competent mosquitoes exist for perpetuation of local transmission [6]. Imported cases have been described in many Asian and European countries as well as in the Americas and Australia [9-16]. Rapid spread in some locations may also be related to a viral mutation that enhances replication efficiency in the Aedes albopictus mosquito. (See 'Transmission' below and 'Mutation of virus and vector replication' below.)


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Literature review current through: Nov 2016. | This topic last updated: Thu Jul 28 00:00:00 GMT+00:00 2016.
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