THE CHIKUNGUNYA PANDEMIC IN LATIN AMERICA: LEARNING ON THE FLY

Abstract

Chikungunya virus (CHIKV) emerged in the Americas in late 2013 as a cause of extensive acute and chronic morbidity. More than 2.9 million suspected cases of chikungunya (CHIK) were reported the following year, including severe cases and deaths. High disease attack rates were reported in areas such as in the Dominican Republic, (41%) or Suriname (90.4%), and the transmission peak was reached within 3 months. Disease burden of chikungunya remains unclear owing to inadequate disease surveillance and underdiagnosis. Virus evolution, globalization, and climate change may further CHIKV spread. No approved vaccine or antiviral therapeutics exist. Early detection and appropriate management could reduce the burden of severe atypical and chronic arthritic disease. Improved surveillance and risk assessment are needed to mitigate the impact of chikungunya.Due to the occurrence of unexpected clinical features and complications, newer CHIK case definitions had to be developed for the Americas.The experience with the CHIK pandemic in the region allowed for a better understanding of the epidemiology and clinical spectrum of the disease. The lessons learned will help the Americas not only to better comprehend the acute and chronic phases of the disease, but also to improve the follow up of at-risk population groups.