Chikungunya is an infection linked to a arbovirus transmitted by mosquitoes of the genre Aedes, mainly A. aegypti, present in tropical and subtropical regions. Recently, a mutation in the virus facilitated its transmission via A. albopictus (alias mosquito mosquito), which adapts to more temperate regions, hence an expansion of the virus in certain regions of the world. These mosquitoes are involved in the transmission of other arboviroses such as dengue, infection by zika virus and yellow fever (1 to3).
An often symptomatic infection, with polyarticular involvement which sometimes persists for several months
Chikungunya is a most often symptomatic infection. After an incubation of a few days, the acute phase is characterized by a high fever and important joint pain predominant at the extremities (wrists, fingers, ankles). There are sometimes other disorders such as headache, edema, myalgia, rashes (1.3,4).
The virus is present in blood for 5 to 10 days. In a cohort study, it was found more than a month after an acute blood infection, saliva, urine, sperm and vaginal secretions. A risk of transmission of infection through these various fluids is not excluded (3).
Clinical evolution is often spontaneously favorable. The fever disappears in 3 to 10 days and joint pain in several weeks (1.3 to 5).
In about a third of cases, joint pain becomes chronic, persisting more than three months (2 to 5).
Complications are rare. They occur mainly in people over the age of 65 and in those with chronic condition such as diabetes, immunosuppression or cardiovascular condition. Complications are mainly neurological (including meningoencephalitis, Guillain-Barré syndrome, myelitis), cardiovascular (including cardiovascular decompensations, aticular fibrillations, myocarditis), hepatic (acute hepatitis), renal (renal insufficiencies) or (2.4.6).
A delivery in the acute phase of infection, when the virus is present in the blood (viremic), exposes to a transmission of the mother’s virus to the newborn in half of the cases, with a high risk of serious or even mortal chikungunya in the newborn (3.5).
Chikungunya mortality is estimated at 1 for 1,000 infected people. It mainly concerns newborns and elderly or immunocompromised people (4).
After healing, acquired immunity seems to last all life (3,4).
Prevention: Community fight against mosquitoes and personal protection against bites
At the community level, the prevention of infection is based on the anti -actoral struggle aimed at destroying the populations of mosquitoes which transmit the disease, and their larval lodges. At the individual level, the main preventive measure is the protection against mosquito bites (long clothes, mosquito nets, repellents), both in uninfected people and in infected people who can contaminate mosquitoes during the viremic period (1.4).
In mid-2025, we do not know any antiviral treatment of chikungunya. Treatment is symptomatic. It is based in particular on adequate hydration and paracetamol (4,7).
A risk emerge in France
The chikungunya virus was identified for the first time in Tanzania in 1952. Epidemia was first reported in Africa and Asia, especially in India. A large -scale epidemic raised on Reunion Island in the years 2005 and 2006. It affected around 35 % of the island’s population. It was the source of significant disorganizations, including care, due to the large number of people with no previous immunity and being sick at the same time. A new epidemic began in August 2024. Between January and mid-June 2025, around 53,750 confirmed cases of Chikungunya were reported. 572 patients were hospitalized for Chikungunya for more than 24 hours. 23 people died from chikungunya, most of them aged 65 or over and with comorbidities. The study of accountability in chikungunya of 27 other deaths, including those of two children under 6 months old, was in progress in mid-June 2025. The epidemic reached Mayotte at the end of May 2025 with a total of 882 cases confirmed in mid-June 2025, 23 of which led to hospitalization (7 to9).
In France in France, in 2024, 83 Aboriginal cases (that is to say, occurring in people who have not recently traveled in an epidemic area) were identified in Provence-Alpes-Côte d’Azur, Occitanie and Auvergne-Rhône-Alpes regions. An indigenous case was reported for the first time in Île-de-France. Early 2024, A. albopictus was present in 81 departments out of 96. Thus, a risk of extended indigenous transmission of the infection is plausible in France. During 2024, 35 cases imported from chikungunya were identified, including 1 case of defegue-chikungunya co-infection. They were mainly returning from Côte d’Ivoire or India. Between 1is January and May 20, 2025, 950 cases imported from Chikungunya were identified, most of them from the meeting (10 to 12).
An attenuated agent vaccine
The chikungunya virus has a simple simple RNA. RNA is at the origin of the synthesis of viral proteins, including the NSP3 protein (for: not structural protein 3, in English), involved in particular in viral replication (3).
MI-2024, a first chikungunya vaccine was authorized in the European Union in adults and adolescents from the age of 12 (a). It is an attenuated virus vaccine, obtained from the isolated strain on Reunion Island in 2006. The NSP3 protein of this virus was genetically modified to alleviate virulence, by deletion of amino acids on the 5 ‘side of the virus RNA sequence, hence the name of the viral strain Δ5NSP3 (3.13).
The Attenuated chikungunya vaccine Is it effective in preventing infections and their complications? Does he slow down the transmission in an epidemic situation? What is his interest in travelers in endemic zone? What are its side effects?
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