Challenges in diagnosis and control of Chikungunya virus infection: A review

Subrat Kumar , Subhra Subhadra , Nirmalya Pal , Ritesh Pattnaik , Dipta Gosh

Asian Pacific Journal of Tropical Medicine ›› 2025, Vol. 18 ›› Issue (10) : 431 -442.

PDF (674KB)
Asian Pacific Journal of Tropical Medicine ›› 2025, Vol. 18 ›› Issue (10) :431 -442. DOI: 10.4103/apjtm.apjtm_525_25
Review Article
research-article
Challenges in diagnosis and control of Chikungunya virus infection: A review
Author information +
History +
PDF (674KB)

Abstract

Chikungunya virus (CHIKV) infection in humans causing severe musculoskeletal pain, fever and rashes, is transmitted by the bite of infected mosquitoes, primarily Aedes (Ae.) aegypti and Ae. albopictus. CHIKV has resulted in 18.7 million cases worldwide till 2020 and after 2004 has spread to Europe, Middle East (Saudi Arabia, Pakistan, Yemen, Egypt, Oman, Iraq, Kuwait, and Iran) and Pacific regions. This rapid spread of CHIKV emphasizes the pivotal need of enforcing control measures and examining new diagnostic methods. As the mosquito vectors (Aedes) of CHIKV are evolving, vector control methods are losing its efficacy. Further, existing serological and molecular assays to detect CHIKV show variabilities in sensitivity and specificity, leading to mis-reporting or under-reporting of CHIKV cases in affected regions. In this review article, we start by discussing CHIKV infection, followed by an introduction to currently available control and detection methods. We further highlight the challenges these methods pose and how they can be conquered by employing various easy and sustainable strategies. This review may provide valuable information for the development of novel diagnostic strategies in resource limited settings for mitigating CHIKV disease.

Keywords

Chikungunya virus / Vaccine development / Vector / Neglected tropical disease / Arbovirus / Outbreak / Emerging disease

Cite this article

Download citation ▾
Subrat Kumar, Subhra Subhadra, Nirmalya Pal, Ritesh Pattnaik, Dipta Gosh. Challenges in diagnosis and control of Chikungunya virus infection: A review. Asian Pacific Journal of Tropical Medicine, 2025, 18 (10) : 431-442 DOI:10.4103/apjtm.apjtm_525_25

登录浏览全文

4963

注册一个新账户 忘记密码

References

[1]

Vairo F, Haider N, Kock R, Ntoumi F, Ippolito G, Zumla A. Chikungunya: Epidemiology, pathogenesis, clinical features, management, and prevention. Infect Dis Clin North Am 2019; 33: 1003-1025.

[2]

de Lima Cavalcanti TYV, Pereira MR, de Paula SO, Franca RFO. A review on chikungunya virus epidemiology, pathogenesis and current vaccine development. Viruses 2022; 14: 969.

[3]

Guangdong Provincial Center For Prevention and Control. Chikungunya surveillance data in Guangdong Province. [Online]. Available from: https://cdcp.gd.gov.cn/ywdt/zdzt/yfjkkyr/yqxx/content/post_4754034.html. [Accessed on 10 September 2025].

[4]

de Roo AM, Vondeling GT, Boer M, Murray K, Postma , MJ . The global health and economic burden of chikungunya from 2011 to 2020: A model-driven analysis on the impact of an emerging vector-borne disease. BMJ Global Health 2024; 9(12): e016648. https://doi.org/10.1136/bmjgh-2024-016648.

[5]

World Health Organisation. Neglected tropical diseases factsheet. [Online]. Available from: https://www.who.int/health-topics/neglected-tropical-diseases#tab=tab_1. [Accesse on 7 January 2025].

[6]

Bartholomeeusen K, Daniel M, LaBeaud DA, Gasque P, Peeling RW, Stephenson KE, et al. Chikungunya fever. Nat Rev Dis Primers 2023; 9: 17. https://doi.org/10.1038/s41572-023-00429-2.

[7]

Chang AY, Encinales L, Porras A, Pacheco N, Reid SP, Martins KA, et al. Frequency of chronic joint pain following chikungunya virus infection: A Colombian cohort study. Arthritis Rheumatol 2018; 70: 578–584.

[8]

Chua CL, Sam IC, Merits A, Chan YF. Antigenic variation of East/Central/South African and Asian chikungunya virus genotypes in neutralization by immune sera. PLoS Negl Trop Dis 2016; 10(8): e0004960. https://doi.org/10.1371/journal.pntd.0004960.

[9]

Edelman R, Tacket CO, Wasserman SS, Bodison SA, Perry JG, Mangiafico JA, et al. Phase II safety and immunogenicity study of live chikungunya virus vaccine TSI-GSD-218. Am J Trop Med Hyg 2000; 62: 681-685.

[10]

Taylor A, Liu X, Zaid A, Goh LY, Hobson-Peters J, Hall RA, et al. Mutation of the N-terminal region of chikungunya virus capsid protein: Implications for vaccine design. mBio 2017; 8: e01970-16.

[11]

Muthumani K, Lankaraman KM, Laddy DJ, Sundaram SG, Chung CW, Sako E, et al. Immunogenicity of novel consensus-based DNA vaccines against chikungunya virus. Vaccine 2008; 26: 5128-5134.

[12]

Metz SW, Gardner J, Geertsema C, Le TT, Goh L, Vlak JM, et al. Effective chikungunya virus-like particle vaccine produced in insect cells. PLoS Negl Trop Dis 2013; 7: e2124.

[13]

Akahata W, Nabel GJ. A specific domain of the chikungunya virus E2 protein regulates particle formation in human cells: Implications for alphavirus vaccine design. J Virol 2012; 86: 8879-8883.

[14]

Roques , P , Fritzer A, Dereuddre-Bosquet N, Wressnigg N, Hochreiter R, Bossevot L, et al. Effectiveness of CHIKV vaccine VLA1553 demonstrated by passive transfer of human sera. JCI Insight 2022; 7: e160173.

[15]

Johnson BW, Russell BJ, Goodman CH. Laboratory diagnosis of Chikungunya virus infections and commercial sources for diagnostic assays. J Infect Dis 2016; 214: S471–S474.

[16]

Cardona-Trujillo MC, Ocampo-Cárdenas T, Tabares-Villa FA, Zuluaga-Vélez A, Sepúlveda-Arias JC. Recent molecular techniques for the diagnosis of Zika and Chikungunya infections: A systematic review. Heliyon 2022; 8(8): e10225. https://doi.org/10.1016/j.heliyon.2022.e10225.

[17]

Natrajan MS, Rojas A, Waggoner JJ. Beyond fever and pain: Diagnostic methods for Chikungunya virus. J Clin Microbiol 2019; 57: e00350-19.

[18]

Islam KU, Iqbal J. An update on molecular diagnostics for COVID-19. Front Cell Infect Microbiol 2020; 10: 560616.

[19]

Zamarina TV, Pimenova EV, Khrapova NP, Baturin AA. Current state of Chikungunya fever laboratory diagnosis (review of literature). Klin LabDiagn 2021; 66: 558-564.

[20]

Silva JVJ, Ludwig-Begall LF, de Oliveira-Filho EF, Oliveira RAS, Durães-Carvalho R, Lopes TRR, et al. A scoping review of Chikungunya virus infection: Epidemiology, clinical characteristics, viral co-circulation complications, and control. Acta Trop 2018; 188: 213-224. doi: 10.1016/j.actatropica.2018.09.003.

[21]

Waggoner JJ, Gresh L, Vargas MJ, Ballesteros G, Tellez Y, Soda KJ, et al. Viremia and clinical presentation in Nicaraguan patients infected with Zika virus, chikungunya virus, and dengue virus. Clin Infect Dis 2016; 63: 1584-1590. doi: 10.1093/cid/ciw589.

[22]

Acevedo N, Waggoner J, Rodriguez M, Rivera L, Landivar J, Pinsky B, et al. Zika virus, chikungunya virus, and dengue virus in cerebrospinal fluid from adults with neurological manifestations, Guayaquil, Ecuador. Front Microbiol 2017; 8: 42. doi: 10.3389/fmicb.2017.00042.

[23]

Economopoulou A, Dominguez M, Helynck B, Sissoko D, Wichmann O, Quenel P, et al. Atypical chikungunya virus infections: Clinical manifestations, mortality and risk factors for severe disease during the 2005-2006 outbreak on Reunion. Epidemiol Infect 2009; 137: 534–541. doi: 10.1017/S0950268808001167.

[24]

Kollef MH, Sherman G, Ward S, Fraser VJ. Inadequate antimicrobial treatment of infections: A risk factor for hospital mortality among critically ill patients. Chest 1999; 115: 462-474.

[25]

Ming CK, Thein S, Thaung U. Clinical and laboratory studies on haemorrhagic fever in Burma, 1970-1972. Bull World Health Organ 1974; 51: 227-235.

[26]

Peeling RW, Artsob H, Pelegrino JL, Buchy P, Cardosa MJ, Devi S, et al. Evaluation of diagnostic tests: Dengue. Nat Rev Micro 2010; 8: S30-8. doi: 10.1038/nrmicro2459.

[27]

Soto-Garita C, Carrera JP, López-Vergès S, Aguilar EC. Advances in clinical diagnosis and management of chikungunya virus infection. Curr Treat Options Infect Dis 2018; 10: 397-409.

[28]

Abhishek KS, Chakravarti A. Simultaneous detection of IgM antibodies against dengue and chikungunya: Coinfection or cross-reactivity? J Family Med Prim Care 2019; 8(7): 2420-2423. doi: 10.4103/jfmpc.jfmpc_365_19.

[29]

Godaert L, Bartholet S, Gazeuse Y, Brouste Y, Najioullah F, Kanagaratnam L, et al. Misdiagnosis of chikungunya virus infection: Comparison of old and younger adults. J Am Geriatr Soc 2018; 66: 1768-1772. doi: 10.1111/jgs.15492.

[30]

Simo FBN, Burt FJ, Makoah NA. Chikungunya virus diagnosis: A review of current antigen detection methods. Trop Med Infect Dis 2023; 8(7): 365. doi: 10.3390/tropicalmed8070365.

[31]

Daude MM, Manuli ER, Pereira GM, Junior ARAC, de Souza UJB, de Araujo GC, et al. Simultaneous detection of arboviruses by a multiplex RT-qPCR assay in Tocantins, a northern state of Brazil. Braz J Infect Dis 2024; 28(4): 103855. doi: 10.1016/j.bjid.2024.103855.

[32]

Webb E, Michelen M, Rigby I, Dagens A, Dahmash D, Cheng V, et al. An evaluation of global Chikungunya clinical management guidelines: A systematic review. EClinMed 2022; 54: 101672.

[33]

Rama K, de Roo AM, Louwsma T, Hofstra HS, Gurgel do Amaral GS, Vondeling GT, et al. Clinical outcomes of chikungunya: A systematic literature review and meta-analysis. PLoS Neglect Trop Dis 2024; 18(6): e0012254.

[34]

Doran C, Duits AJ, Gerstenbluth I, Tami A, Bailey A. Adaptive coping strategies among individuals living with long-term chikungunya disease: A qualitative study in Curaçao. BMJ Open 2024; 14(2): e076352.

[35]

Hucke FI, Bugert JJ. Current and promising antivirals against chikungunya virus. Front Public Health 2020; 8: 618624.

[36]

Chen LH, Fritzer A, Hochreiter R, Dubischar K, Meyer S. From bench to clinic: The development of VLA1553/IXCHIQ, a live-attenuated chikungunya vaccine. J Travel Med 2024; 31(7): taae123.

[37]

Ly H. Ixchiq (VLA1553): The first FDA-approved vaccine to prevent disease caused by Chikungunya virus infection. Virulence 2024; 15(1): 2301573.

[38]

Weber WC, Streblow DN, Coffey LL. Chikungunya virus vaccines: A review of IXCHIQ and PXVX0317 from pre-clinical evaluation to licensure. Bio Drugs 2024; 38(6): 727-742.

[39]

Flandes X, Hansen CA, Palani S, Abbas K, Bennett C, Caro WP, et al. Vaccine value profile for chikungunya. Vaccine 2024; 42(19): S9-S24.

[40]

Masum MHU, Mahdeen AA, Barua A. Revolutionizing Chikungunya vaccines: mRNA breakthroughs with molecular and immune simulations. Bioinform Biol Insights 2025; 19: 11779322251324859.

[41]

Maure C, Khazhidinov K, Kang H, Auzenbergs M, Moyersoen P, Abbas K, et al. Chikungunya vaccine development, challenges, and pathway toward public health impact. Vaccine 2024; 42(26): 126483.

[42]

Kilburn K, Meltzer MI, Jeon S, Adhikari BB, Lindsey N, Hills SL, et al. Cost-effectiveness of chikungunya vaccination with the live attenuated vaccine in US territories. Npj Vaccines 2025; 10(1): 172.

[43]

Kolimenakis A, Heinz S, Wilson ML, Winkler V, Yakob L, Michaelakis A, et al. The role of urbanisation in the spread of Aedes mosquitoes and the diseases they transmit—A systematic review. PLoS Neglect Trop Dis 2021; 15(9): e0009631.

[44]

Knoblauch S, Mukaratirwa RT, Pimenta PF, de A Rocha AA, Yin MS, Randhawa S, et al. Urban Aedes aegypti suitability indicators: A study in Rio de Janeiro, Brazil. Lancet Planet Health 2025; 9(4): e264-e273.

[45]

Cevidanes A, Goiri F, Barandika JF, Vázquez P, Goikolea J, Zuazo A, et al. Invasive Aedes mosquitoes in an urban—peri-urban gradient in northern Spain: Evidence of the wide distribution of Aedes japonicus. Parasit Vectors 2023; 16(1): 234.

[46]

Dharmamuthuraja D, Rohini PD, Lakshmi MI, Isvaran K, Ghosh SK, Ishtiaq F. Determinants of Aedes mosquito larval ecology in a heterogeneous urban environment-a longitudinal study in Bengaluru, India. PLoS Neglect Trop Dis 2023; 17(11): e0011702.

[47]

Wilke ABB, Vasquez C, Carvajal A, Medina J, Chase C, Cardenas G, et al. Proliferation of Aedes aegypti in urban environments mediated by the availability of key aquatic habitats. Sci Rep 2020; 10(1): 12925.

[48]

Zhang X, Mei H, Nie P, Hu X, Feng J. Future climate predicts range shifts and increased global habitat suitability for 29 Aedes mosquito species. Insects 2025; 16(5): 476.

[49]

Liu Z, Zhang Q, Li L, He J, Guo J, Wang Z, et al. The effect of temperature on dengue virus transmission by Aedes mosquitoes. Front Cell Infect Microbiol 2023; 13: 1242173.

[50]

Nie P, Feng J. Niche and range shifts of Aedes aegypti and Ae. albopictus suggest that the latecomer shows a greater invasiveness. Insects 2023; 14(10): 810.

[51]

Radici A, Hammami P, Cannet A, L’Ambert G, Lacour G, Fournet F, et al. Aedes albopictus is rapidly invading its climatic niche in France: Wider implications for biting nuisance and arbovirus control in Western Europe. Glob Change Biol 2025; 31(8): e70414.

[52]

Liu Q, Shen H, Gu L, Yuan H, Zhu W. Chikungunya virus in Europe: A retrospective epidemiology study from 2007 to 2023. PLoS Neglect Trop Dis 2025; 19(3): e0012904.

[53]

Hu J, Horton BP, Yeo TW, Sung JJ, Steve YHL. Mosquito and global dengue cases in a warming world. BMJ Global Health 2025; 10(5): e014688.

[54]

Montenegro-Quinonez CA, Louis VR, Horstick O, Velayudhan R, Dambach P, Runge-Ranzinger S. Interventions against Aedes/dengue at the household level: A systematic review and meta-analysis. EBioMed 2023; 93: 104660.

[55]

Pérez-Guerra CL, Rosado-Santiago C, Ramos SA, Marrero KM, González-Zeno G, Miranda-Bermúdez J, et al. Community perceptions on challenges and solutions to implement an Aedes aegypti control project in Ponce, Puerto Rico (USA). PLoS One 2023; 18(4): e0284430.

[56]

Hossain MJ, Das M, Islam MW, Shahjahan M, Ferdous J. Community engagement and social participation in dengue prevention: A cross‐sectional study in Dhaka City. Health Sci Rep 2024; 7(4): e2022.

[57]

Gopalan RB, Babu BV, Sugunan AP, Murali A, Ma MS, Balasubramanian R, et al. Community engagement to control dengue and other vector-borne diseases in Alappuzha municipality, Kerala, India. Pathog Glob Health Pathogens 2021; 115(4): 258-266.

[58]

Sánchez-González L, Adams LE, Saavedra R, Little EM, Medina NA, Major CG, et al. Assessment of community support for Wolbachia-mediated population suppression as a control method for Aedes aegypti mosquitoes in a community cohort in Puerto Rico. PLoS Neglect Trop Dis 2021; 15(12): e0009966.

[59]

Sharma SK, Dua VK, Sharma VP. Field studies on the mosquito repellent action of neem oil. Southeast Asian J Trop Med Public Health 1995; 26(1): 180-182.

[60]

Reyes-Perdomo C, Escobar D, Galo L, Urrutia O, Vizcaino RL, Lenhart A, et al. Insecticide resistance status and high frequency of kdr mutations in Aedes aegypti in Tegucigalpa, Honduras. Parasit Vectors 2025; 18(1): 321.

[61]

Zhang Y, Wang D, Shi W, Zhou J, Xiang Y, Guan Y. Resistance to pyrethroids and the relationship between adult resistance and knockdown resistance (kdr) mutations in Aedes albopictus in dengue surveillance areas of Guizhou Province, China. Sci Rep 2024; 14(1): 12216.

[62]

Estep AS, Sanscrainte ND, Farooq M, Lucas KJ, Heinig RL, Norris EJ, et al. Impact of Aedes aegypti V1016I and F1534C knockdown resistance genotypes on operational interventions. Sci Rep 2025; 15(1): 10146.

[63]

Keumeni CR, Yougang AP, Njiokou F, Clarke SE, Lines J, Wondji C, et al. Association of knockdown resistance mutations with pyrethroid resistance in Aedes aegypti, a major arbovirus vector in Cameroon. Parasit Vectors 2025; 18(1): 296.

[64]

Malijan RPB, Angeles JR, Apilado AMA, Ammugauan MAT, Salazar FV. Insecticide resistance in Aedes aegypti from the national capital region of the Philippines. Insects 2024; 15(10): 782.

[65]

Mendis BAN, Peiris V, Harshani WAK, Fernando HSD, De Silva BGDNK. Fine-scale monitoring of insecticide resistance in Aedes aegypti (Diptera: Culicidae) from Sri Lanka and modeling the phenotypic resistance using rational approximation. Parasit Vectors 2024; 17(1): 18.

[66]

World Health Organization. Manual for monitoring insecticide resistance in mosquito vectors and selecting appropriate interventions. [Online]. Available from: https://www.who.int/publications/i/item/9789240051089. [Accessed on 10 September 2025].

[67]

Lim A, Shearer FM, Sewalk K, Pigott DM, Clarke J, Ghouse A, et al. The overlapping global distribution of dengue, chikungunya, Zika and yellow fever. Nature Commun 2025; 16(1): 3418.

[68]

Torres PMA, de La Roque DGL, Policastro LR, Chagas LBMO, Giomo DB, Gentil DCD, et al. Simultaneous dengue and chikungunya coinfection in endemic area in Brazil: Clinical presentation and implications for public health. Res Sq Research Square 2024; rs-3.rs-4277561. doi: 10.21203/rs.3.rs-4277561/v1.

[69]

World Health Organization. Disease outbreak news: Chikungunya-Sudan. [Online]. Available from: https://www.who.int/emergencies/disease-outbreak-news/item/2024-DON518. [Accessed on 11 September 2025].

[70]

Sani LM, Riyanti R, Istinaroh N, My TN, Van Tong H, Oktarianti R, et al. Diagnostic challenges of arboviral infections and dengue virus serotype distribution in febrile patients in East Java, Indonesia. IJID 2025; 14: 100512.

[71]

de França Cirilo MV, Pour SZ, de Fatima Benedetti V, Farias JP, Fogaça MMC, da Conceição Simões R, et al. Co-circulation of Chikungunya virus, Zika virus, and serotype 1 of dengue virus in Western Bahia, Brazil. Front Microbiol Frontiers Microbiol 2023; 14: 1240860.

[72]

Salazar Flórez JE, Restrepo BN, Freitas LP, Carabali M, Jaramillo Ramírez GI, Balaguera CG, et al. Spatio-temporal analysis of the distribution and co-circulation of dengue, chikungunya, and Zika in Medellín, Colombia, from 2013 to 2021. PLoS Neglect Trop Dis 2025; 19(9): e0013470.

PDF (674KB)

0

Accesses

0

Citation

Detail

Sections
Recommended

/