Chikungunya: a paradigm of emergence and globalization of vector-borne diseases

Chikungunya (CHIK) fever is a tropical arboviral disease responsible for acute polyarthritis which can last for weeks to months. In 2007, the chikungunya virus (CHIKV) reached Europe. Since the beginning of this outbreak, several million cases of chikungunya virus disease have occurred in autochthonous populations and in travelers who were diagnosed after they returned home from epidemic areas. CHIKV, usually transmitted by Aedes aegypti mosquitoes, has now been repeatedly associated with a new vector, Aedes albopictus (the "Asian tiger mosquito"), which has spread into tropical areas previously occupied predominantly by A aegypti, and has dispersed worldwide. Because CHIKV could spread throughout the world, all physicians should be prepared to encounter this arboviral infection, which represents a paradigm for emerging arboviral infections. In this article, the authors review different aspects of this reemerging and fascinating disease, focusing on clinical aspects and lessons from the recent large-scale outbreaks.