Epidemiology, transmission dynamics, treatment strategies, and future perspectives on Oropouche virus

Oropouche virus (OROV), a mosquito-borne pathogen primarily found in the Amazon basin, has attracted increasing attention due to its expanding geographical spread and recurrent outbreaks. First identified in 1955, OROV causes Oropouche fever, a febrile illness with clinical features that often overlap with those of other arboviral infections, posing significant diagnostic challenges. Arboviruses such as dengue, chikungunya, zika, and yellow fever also circulate in the same regions of South and Central America, further complicating the clinical differentiation of OROV from these infections. The primary vector for OROV in urban areas is Culicoides paraensis midges, but the virus also maintains a sylvatic transmission cycle involving Aedes serratus and Coquillettidia venezuelensis mosquitoes, along with wild vertebrate reservoirs such as sloths, non-human primates, and birds. Moreover, in 2024, over 10,000 OROV cases were reported including in previously unaffected regions with Brazil recording 5,407 cases since 2015, while recent fatalities linked to severe coagulopathy, liver failure, and adverse pregnancy outcomes remain under investigation. Currently, no specific antiviral treatments are available for OROV, and the diagnostic tools are limited, highlighting the urgent need for improved management strategies. Given the increasing number of OROV cases, there is a clear need to strengthen surveillance efforts and accelerate the development of vaccines and therapeutic interventions. This review delves into the multi-faceted approach to control OROV, incorporating surveillance, antiviral therapy, and vaccine development to mitigate the impact of this emerging pathogen. Furthermore, it provides a comprehensive overview of the epidemiology and future potential antiviral candidates and challenges in current therapeutic approaches.