Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand.
Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand.
J Biomed Sci. 2021 Dec 2;28(1):84. doi: 10.1186/s12929-021-00778-8.
Chikungunya virus (CHIKV) is a re-emerging mosquito-borne human pathogen that causes chikungunya fever, which is typically accompanied by severe joint pain. In Asia, serological evidence indicated that CHIKV first emerged in 1954. From the 1950's to 2005, sporadic CHIKV infections were attributed to the Asian genotype. However, the massive outbreak of CHIKV in India and the Southwest Indian Ocean Islands in 2005 has since raised chikungunya as a worldwide public health concern. The virus is spreading globally, but mostly in tropical and subtropical regions, particularly in South and Southeast Asia. The emergence of the CHIKV East/Central/South African genotype-Indian Ocean lineage (ECSA-IOL) has caused large outbreaks in South and Southeast Asia affected more than a million people over a decade. Notably, the massive CHIKV outbreaks before 2016 and the more recent outbreak in Asia were driven by distinct ECSA lineages. The first significant CHIKV ECSA strains harbored the Aedes albopictus-adaptive mutation E1: A226V. More recently, another mass CHIKV ECSA outbreak in Asia started in India and spread beyond South and Southeast Asia to Kenya and Italy. This virus lacked the E1: A226V mutation but instead harbored two novel mutations (E1: K211E and E2: V264A) in an E1: 226A background, which enhanced its fitness in Aedes aegypti. The emergence of a novel ECSA strain may lead to a more widespread geographical distribution of CHIKV in the future. This review summarizes the current CHIKV situation in Asian countries and provides a general overview of the molecular virology, disease manifestation, diagnosis, prevalence, genotype distribution, evolutionary relationships, and epidemiology of CHIKV infection in Asian countries over the past 65 years. This knowledge is essential in guiding the epidemiological study, control, prevention of future CHIKV outbreaks, and the development of new vaccines and antivirals targeting CHIKV.
基孔肯雅热病毒（CHIKV）是一种重新出现的蚊媒人类病原体，可引起基孔肯雅热，通常伴有严重的关节疼痛。在亚洲，血清学证据表明 CHIKV 于 1954 年首次出现。从 20 世纪 50 年代到 2005 年，散发性 CHIKV 感染归因于亚洲基因型。然而，2005 年印度和西南印度洋岛屿的大规模 CHIKV 爆发引起了人们对基孔肯雅热作为全球公共卫生关注的关注。该病毒正在全球范围内传播，但主要在热带和亚热带地区，特别是南亚和东南亚。CHIKV 东/中/南非基因型-印度洋谱系（ECSA-IOL）的出现导致南亚和东南亚发生了大规模暴发，十年来影响了超过 100 万人。值得注意的是，2016 年前的大规模 CHIKV 暴发和最近在亚洲的暴发是由不同的 ECSA 谱系驱动的。第一个重要的 CHIKV ECSA 菌株携带了白纹伊蚊适应性突变 E1：A226V。最近，亚洲又一次大规模 CHIKV ECSA 暴发始于印度，并传播到南亚和东南亚以外的肯尼亚和意大利。这种病毒缺乏 E1：A226V 突变，但在 E1：226A 背景下携带两个新的突变（E1：K211E 和 E2：V264A），增强了其在埃及伊蚊中的适应性。新型 ECSA 菌株的出现可能导致未来基孔肯雅热在地理上的分布更加广泛。本综述总结了亚洲国家目前的 CHIKV 情况，并概述了过去 65 年来亚洲国家 CHIKV 感染的分子病毒学、疾病表现、诊断、流行率、基因型分布、进化关系和流行病学。这些知识对于指导未来 CHIKV 爆发的流行病学研究、控制、预防以及针对 CHIKV 的新疫苗和抗病毒药物的开发至关重要。
