Chikungunya virus pathogenesis

Abstract

Chikungunya virus (CHIKV) is a re-emerging mosquito-transmitted alphavirus. Following inoculation into the skin, CHIKV replicates locally and ultimately produces a high titer viremia that facilitates a human-mosquito-human transmission cycle. Symptoms and signs of CHIKV infection include high fever, severe joint pain, muscle pain, and rash. The acute phase of CHIKV infection typically lasts a few days to a couple of weeks. In many individuals, the musculoskeletal pain and inflammation associated with acute CHIKV infection becomes chronic and may last for months to years. In addition, atypical outcomes of CHIKV infection, including neurological involvement and death, can occur in the elderly, the young, and in the presence of certain comorbidities. The pathogenesis of acute and chronic CHIKV disease is not well understood. However, the dramatic re-emergence and global spread of CHIKV during the last 10 years has resulted in new investigations of CHIKV biology and pathogenesis in humans and animal models. In this chapter, we present the most recent advances in our understanding of acute and chronic CHIKV pathogenesis.