Chikungunya in the western hemisphere: a review of the 2014 epidemic, the potential long-term impact, and research opportunities

ABSTRACT

OBJECTIVE: The objective of this paper is to present a comprehensive review of the impact of the recent chikungunya virus outbreaks in island nations, including the Caribbean, and explore the potential for further study of the epidemiology and pathogen-host interactions of this emerging virus. DESIGN AND METHODS: We conducted a review of the current literature and data on multiple facets of chikungunya including acute disease outbreaks, epidemiological and clinical data, comparisons of diagnostic techniques, and virologic strains. RESULTS: Outbreaks of chikungunya (CHIKV) on island nations have seen high attack rates with corresponding increased morbidity and mortality. Severe, persistent and relapsing arthritis and tenosynovitis is common among chikungunya patients. CONCLUSION: Comprehensive surveillance of chikungunya virus is required by the linking of epidemiologic, molecular and immunologic data with information on ecological patterns and vector prevalence if the incidence of chikungunya is to be reduced and prevented. More data on the disease spectrum and persistence in the Caribbean nations, the viral strain, and the incidence rates are sorely needed. Because CHIK can only be prevented by preventing mosquito bites, more research needs to be done locally in Caribbean nations to determine the optimal strategies of Aedes vector control and public health education with subsequent behavior change.