Abstract
Chikungunya fever is an acute febrile illness caused by the chikungunya virus (CHIKV), which is transmitted to humans by Aedes mosquitoes. Although chikungunya fever is rarely fatal, patients can experience debilitating symptoms that last from months to years. Here we comprehensively assess the global distribution of chikungunya and produce high-resolution maps, using an established modelling framework that combines a comprehensive occurrence database with bespoke environmental correlates, including up-to-date Aedes distribution maps. This enables estimation of the current total population-at-risk of CHIKV transmission and identification of areas where the virus may spread to in the future. We identified 94 countries with good evidence for current CHIKV presence and a set of countries in the New and Old World with potential for future CHIKV establishment, demonstrated by high environmental suitability for transmission and in some cases previous sporadic reports. Aedes aegypti presence was identified as one of the major contributing factors to CHIKV transmission but significant geographical heterogeneity exists. We estimated 1.3 billion people are living in areas at-risk of CHIKV transmission. These maps provide a baseline for identifying areas where prevention and control efforts should be prioritised and can be used to guide estimation of the global burden of CHIKV.
Highlights
Recent emergence and re-emergence of chikungunya virus (CHIKV) in several regions globally underscores the importance of implementing and strengthening surveillance systems for rapid and accurate case identification [1]
We identified peer-reviewed evidence to confirm CHIKV presence based on seroprevalence studies, polymerase chain reaction (PCR) confirmation, case reports and local outbreaks
Based on evidence from all available sources, we identified 94 countries with good or better evidence consensus on CHIKV presence from which 47% were in Asia and Africa and 44% in the Americas
Summary
Recent emergence and re-emergence of chikungunya virus (CHIKV) in several regions globally underscores the importance of implementing and strengthening surveillance systems for rapid and accurate case identification [1]. CHIKV causes an acute febrile illness with severe arthralgia [2]. It is a mosquito-borne pathogen of the genus Alphavirus and transmitted to and between humans by Aedes mosquitoes with four circulating genotypes [3,4]. In the eastern part of Africa CHIKV is sustained in an enzootic, sylvatic cycle that involve arboreal mosquito vectors and non-human primates [5]. CHIKV and dengue share the same primary vector Ae. aegypti and occasional co-infection has been reported [7]. There are no antiviral agents or treatments for chikungunya fever (CHIK), but candidate vaccines are under development [9]
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