Chikungunya Outbreaks

Chikungunya Outbreaks 2024

Chikungunya virus (CHIKV) disease outbreaks have been recorded as early as 1824 in India and recently in Thailand in 1967. As of November 2024, the World Health Organization (WHO) confirmed Chikungunya, a viral illness, has been identified in 115 countries. The U.S. Centers for Disease Control and Prevention (CDC) lists countries and territories with evidence of chikungunya virus transmission among humans within the last five years. As of November 2024, the Pan American Health Organization (PAHO) reported over 408,310 CHIKV cases and 191 related deaths in the Americas this year. In November 2024, the European Centre for Disease Prevention and Control (ECDC) reported (week 44) that outside of the Americas, CHIKV outbreaks were confirmed in Asia, Africa, Europe, India, Pakistan, Thailand, Maldives, Timor Leste, Malaysia, and Grenada in 2024.

Chikungunya Outbreaks 2023

In 2023, the ECDC reported approximately 460,000 CHIKV cases and 360-related deaths worldwide. The PAHO reported 411,548 CHIKV cases in the Americas in 2023 and 273,841 in 2022. Between 2013 and 2023, the PAHO reported more than 3.7 million CHIKV cases in the Americas. Most CHIKV patients were in Brazil, Paraguay, Argentina, and Bolivia. 

Africa Chikungunya Outbreaks

Chikungunya cases are mainly located in Africa's Sahel region's 33 million population (Senegal, The Gambia, Burkina Faso, and Mali), where ongoing or previous local transmission of CHIKVD occurred. A Review Article published in October 2024 disclosed that the incidence of Chikungunya in tropical Africa is still of major epidemiological significance. The overall pooled prevalence of chikungunya in East Africa was 20.6% (95% CI: 18.8%–22.5% and I2 = 99.62%). Subgroup analyses revealed Rwanda and Djibouti exhibited high prevalence rates of 63% and 50.4%, respectively, while Kenya and Somalia reported a moderate prevalence of 12.2%. On November 9, 2023, the U.S. CDC published a Level 2—Practice Enhanced Precautions, Travel Health Advisory, regarding chikungunya outbreaks in Burkina Faso. During 2019–2020, a large-scale chikungunya outbreak occurred in the Republic of Djibouti. 

Asia Chikungunya Outbreaks 2024

As of November 2024, the European CDC reported India (69,395), Pakistan, Thailand, Timor-Leste, Maldives, Malaysia, Bali, and Myanmar have reported CHIKV outbreaks. In 2024, the CDC published an updated Level 2—Practice Enhanced Precautions, Travel Health Advisory regarding chikungunya outbreaks. 

Brazil Chikungunya Outbreak 2024

Chikungunya outbreaks have been reported in Brazil since 2014. As of October 30, 2024, the PAHO reported over 399,000 chikungunya cases and 184 related deaths in Brazil. As of October 2024, Brazil's Ministry of Health publishes weekly Arboviruses reports highlighting CHIKV cases. On October 28, 2024, a study reported that in 2023, during the epidemic in Minas Gerais, there were 890 excess deaths attributed to Chikungunya, translating into a mortality rate of 35.1/100,000 inhabitants. In March 2024, a study conducted at the São José do Rio Preto Medical School in São Paulo State, Brazil, showed that the virus circulated in the city silently for years. An analysis of the blood samples showed that the number of chikungunya cases in proportion to the population rose from 0.35% in 2015 to 2.3% in 2019. In February 2024, The Lancet Infectious Diseases published results from a study in Brazil that concluded Chikungunya virus disease is associated with an increased risk of death for up to 84 days after symptom onset, including deaths from cerebrovascular diseases, ischaemic heart diseases, and diabetes.

Carribean Chikungunya Outbreaks

The first documented autochthonous transmission of the chikungunya virus in the Caribbean island of Saint Martin was in 2013. Since 2014, Chikungunya has been detected in Grenada, West Indies. As of October 2024, 8 cases were reported in Barbados. Between 2014 and 2021, there were 221 confirmed chikungunya cases and two deaths in Barbados. The chikungunya vaccine will be available at the Virgin Islands Health Department's Community Health Clinics throughout October 2024.

Central America Chikungunya Outbreaks

In October 2024, 195 Chikungunya cases in Central America were reported in Belize, Guatemala (81), and Costa Rica. The PAHO said Chikungunya has been reported in Mexico since 2014. 

Europe Chikungunya Outbreaks

As of November 2024, the European CDC assessment for CHIKV outbreaks was low, but a non-travel-associated CHIKV case has been reported. Past autochthonous outbreaks of CHIKV in mainland EU/EEA have occurred between June and November. Aedes albopictus is found in most of Europe. Travel-associated outbreaks led to CHIKV transmission in Italy in 2007 and 2017. Italy's National Institute of Health, Epidemiology for Public Health reported 14 travel-related Chikungunya cases as of November 2024.

As of September 10, 2024, 21 imported chikungunya cases were reported in 11 France departments colonized by Aedes albopictus. According to the ECDC Communicable Disease Threats Report in September 2024, France (Department of La Réunion) reported three autochthonous (local) cases of CHIKV. The last major chikungunya virus disease epidemic in La Réunion was 2005–2006.

India Chikungyna Outbreaks

Chikungunya disease was initially reported in India in 1963. As of 2024, every part of the country has become endemic to the disease. As of late August 2024, India's health department had reported 69,395 CHIKV cases this year (Maharashtra 2,643, Mumbai). Pune's National Institute of Virology (NIV) studies patient samples to determine if Chikungunya virus variants are causing more cases in 2024. According to a study published in 2023, India reported the most CHIKV cases (200,064) in South Asia. In 2024, the U.S. CDC stated that the Chikungunya vaccination may be considered for certain visitors and long-term residents in India. In 2023, about 1.3 million U.S. travelers visited India.

Maldives Chikungunya Outbreak

Local authorities reported elevated chikungunya activity in multiple areas in the Maldives, with 389 cases reported in 2024. The U.S. CDC says there has been evidence of CHIKV transmission in the Maldives within the last five years. A previous significant chikungunya outbreak occurred in 2019 when 1,736 cases were reported. On May 28, 2024, the CDC issued a Level 2 - Practice Enhanced Precautions, Travel Health Advisory for the Maldives.

Pakistan Chikungunya Outbreak

As of October 2024, 2.447 CHIKVD cases have been reported in Pakistan.

South America Chikungunya Outbreaks

Chikungunya was first reported in Argentina in 2016. The PAHO issued an Epidemiological Alert in 2023, saying the current CHIKV season expansion is beyond the historical areas of transmission reported since 2014. The PAHO reported in December 2023, 256,000 probable and confirmed chikungunya cases in Brazil. According to data from the Brazilian Vigilance Health Secretary, the three Brazilian states with the most CHIKV cases were Pernambuco, São Paulo, and Paraíba in 2022. And in 2021, in São Paulo, Brazil's most populous state, cases increased from 468 to 18,156 compared to 2020. Chikungunya clusters with the highest risk were initially located in Brazil's northeast, dispersed to the central-west and coastal areas of São Paulo and Rio de Janeiro (2018–2021), and then increased in the northeast (2019–2021).

In 2024, 768 Chikungunya cases have been reported in Argentina. The PAHO reported 1,746 CHIKV cases in Argentina in 2023. A recent study traced the evolution of the chikungunya virus in Argentina, 2016-2023.

The first case of Chikungunya in Bolivia was reported in early 2015. As of October 2024, over 418 cases had been reported. In 2023, 1,455 cases were reported, with no deaths, representing an 8-fold increase in patients compared to the same period in 2022.

This study focused on seven years after the 2014-2015 CHIKV outbreak in Piedecuesta, Colombia, concluded in October 2024, determine the incidence of post-chikungunya chronic rheumatism (pCHIK-CR) and its impact on quality of life and chronic fatigue in adults. Chronic fatigue prevalence increased from 8.6% in without rheumatic disease patients to 25% in non-inflammatory pain, likely degenerative, and 54.6% in pCHIK-CR cases. 

In 2024, Paraguay reported over 2,700 cases. As of 2023, the PAHO reported 115,000 CHIKV cases in Paraguay. The U.S. CDC Advisory Committee on Immunization Practices workgroup presented an UPDATE AND OBSERVATIONS ON A LARGE CHIKUNGUNYA OUTBREAK IN PARAGUAY on June 22, 2023. From October 2022 to June 3, 2023, 167,239 chikungunya cases were reported. The CDC Health Alert Network issued CDCHAN-00487 on March 2, 2023,  confirming that the Ministry of Health in Paragusaidted 71,478 suspected chikungunya cases in Paraguay since the outbreak began in October 202. Currently, the East/Central/South African (ECSA) chikungunya genotype is circulating; it was first identified in 2018 during an outbreak in the Amambay department and was again identified in samples from 2022 in the Metropolitan Area of Asunción. As a result, an outbreak in Paraguay and surrounding countries is possible. In addition, the CDC reissued a Watch - Level 1, Practice Usual Precautions notice on April 6, 2023, confirming an outbreak of Chikungunya in Paraguay's Asunción metropolitan area.

Spain Chikungunya Outbreaks

Grenada, Spain, reported CHIKVD cases in September 2024.

United Kingdom Chikungunya

As of September 2024, Travel-associated chikungunya cases have been reported in the U.K. A Travel Health Pro and International Health Regulations team reported in the Clinical and Emerging Infections Directorate, U.K. Health Security Agency (UKHSA) summarises Chikungunya cases in England, Wales, and Northern Ireland between 2015 and 2022. In 2023, laboratories in England have a statutory duty to notify the U.K. Health Security Agency (UKHSA) of the identification of the chikungunya virus.

United States Chikungunya Cases 2024

As of November 2024 (Week 43), the U.S. Centers for Disease Control and Prevention (CDC) reported 138 chikungunya cases in Territories and non-U.S. residents in 2024, led by Massachusetts (20), New Hampshire, California, Colorado, Illinois, and New York. The Texas Department of State Health Services reported (11) chikungunya cases as of October 2024. The CDC reported 118 chikungunya cases nationwide in 2023. From 2006 to 2023, 4,590 travel-related CHIKV cases were reported in the U.S., in areas such as Florida and Puerto Rico. 

Chikungunya Vaccines

As of November 2024, the U.S. FDA had authorized one chikungunya vaccine. 

Chikungunya Disease

Chikungunya is a viral disease transmitted to humans through the bites of mosquitoes infected with the chikungunya virus (CHIKV), according to the U.S. Centers for Disease Control and Prevention (CDC) Yellow Book 2024.

In September 2024, an Original Article reported even after a year, Chikungunya fever-affected people experience damage to their physical and mental health, positive screening for depression risk was 13.5 times more likely in chronically affected, and patients with chronic chikungunya fever 76 times higher risk of walking impairments. In April 2024, the journal Cell Host & Microbe published results from a study, Pathophysiology of chikungunya virus infection associated with fatal outcomes, that suggests the chikungunya virus crosses the bloodbrain barrier, contributing to central nervous system infections.

The Lancet Infectious Diseases published results from a study in February 2024 investigating the risk of death in people infected with Chikungunya two years after the first symptoms of the disease. Between 2015 and 2018 in Brazil, Chikungunya virus disease was associated with an increased risk of death for up to 84 days after symptom onset. The Lancet Infectious Diseases researchers published a study on February 8, 2024, the found Chikungunya virus disease is associated with an increased risk of death for up to 84 days after symptom onset, including deaths from cerebrovascular diseases, ischaemic heart diseases, and diabetes. Data from 2015 to 2018 in Brazil revealed the incidence rate ratio (IRR) of death within seven days of chikungunya symptom onset was 8.40 (95% CI 4·83–20·09) as compared with the unexposed group and decreased to 2.26 in 57–84 days, and 1,05 at 85–168 days, with IRR close to 1 and wide CI in the subsequent periods.

Chikungunya Carrying Mosquitoes

Over thousands of years, mosquito bites have caused more human suffering than any other organism. People can become infected with the chikungunya virus when mosquitoes feed on another infected person and bite them. During the first few days of illness, people infected with the virus have high enough levels of virus in their blood (viremia) to transmit the virus to mosquitoes. A recent study published by the Royal Society indicates that disease-carrying mosquitoes are expanding their range by an average of 6.5 meters of elevation and have moved polewards by 4.7 km annually.