Disease- Introduction and burden

Chikungunya

Introduction
Chikungunya is a disabling and debilitating zoonotic disease of humans caused by the Chikungunya virus which is transmitted by infected Aedes species mosquitoes.1 Treatment is supportive and there are no specific / licensed antiviral treatment and vaccines, although a number of vaccine candidates and mAbs are in clinical trials.1,2,3,4

Disease burden

Global
In the past 5 years, there is an alarming and unprecedented increase in spread to over 100 countries across Asia, Africa, Europe, and the Americas. 5 As per European Centre for Disease Prevention and Control (ECDC) data, 113,052 cases and 14 deaths have been reported in 2022.6 Most of the new cases have been reported by 5 countries namely Brazil, India, Paraguay,
Malaysia, and Guatemala.6

Canada
Over the course of 2014, there has been a rapid increase in the number of chikungunya cases detected.43 As of 9th December 2014, the country had 320 confirmed and 159 probable cases which was the largest yearly number of chikungunya cases everdocumented.7 Cases underestimated due to missed diagnoses and undetection of mild disease.7 Contributing factors were travel to the Caribbean and outbreaks in Asia-Pacific regions.7

United States
Beginning in 2014 in United States, chikungunya virus disease cases were reported among U.S. travellers returning from affected areas in the Americas.8 Local transmission was identified in Florida, Texas, Puerto Rico, and the U.S. Virgin lslands.8

Inference
Canadians travelling as well as returning back from chikungunya endemic/ affected regions are at high risk of getting infected with the virus. Although a number of prophylactic and therapeutic agents are in clinical trials, none of them have been approved or commercialized till date.

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(4):1003-1025. doi:10.1016/j.idc.2019.08.006.
  2. Jin J, Simmons G. Antiviral Functions of Monoclonal Antibodies against Chikungunya Virus. Viruses. 2019;11(4):305. Published 2019 Mar 28. doi:10.3390/v11040305.
  3. Tharmarajah K, Mahalingam S, Zaid A. Chikungunya: vaccines and therapeutics. FtoooRes.2017;6:2114. Published 2017 Dec 8. doi:10.126 88/hoooresearch.12461.1.
  4. Hucke FIL, Bestehorn-Willmann M, Bugert JJ. Prophylactic strategies to control chikungunya virus infection. Virus Genes. 2021;57(2):133-150 . doi:10.1007/s11262-020-01820-x.
  5. DeFilippis VR. Chikungunya Virus Vaccines: Platforms, Progress, and Challenges. Curr Top Microbiol lmmunol. 2022;435:81-106. doi:10.100 7 /82_2019_175.
  6. Chikungunya worldwide overview. https://www.ecdc.europa.eu/en/chikungunya-monthly. Last accessed 15th July 2022.
  7. Drebot MA, Holloway K, Zheng H, Ogden NH. Travel-related chikungunya cases in Canada, 2014. Can Commun Dis Rep. 2015;41(1):2-5. Published 2015 Jan 8. doi:10.14745/ ccdr.v41io1ao1.
  8. Chikungunya in the US. https://www.cdc.gov/chikungunya/geo/chikungunya-in-the-us.html. Last accessed 16th July2022.