Explore the vast range of titles available.

Background. Rapidly spreading to new regions, including the islands of the Indian Ocean, Central Africa, and Europe, Chikungunya fever is becoming a major problem of public health. Unlike other members of the alphavirus genus, immune responses to Chikungunya virus (CHIKV) have been poorly investigated. Methods. We conducted a large ex vivo multiplex study of 50 cytokine, chemokine, and growth factor plasma profiles in 69 acutely infected patients from the Gabonese outbreak of 2007. We also assessed a phenotypic study of T lymphocyte responses during human acute CHIKV infection. Results. CHIKV infection in humans elicited strong innate immunity involving the production of numerous proinflammatory mediators. Interestingly, high levels of Interferon (IFN) α were consistently found. Production of interleukin (IL) 4, IL-10, and IFN- γ suggested the engagement of the adaptive immunity. This was confirmed by flow cytometry of circulating T lymphocytes that showed a CD8+ T lymphocyte response in the early stages of the disease, and a CD4+ T lymphocyte mediated response in the later stages. For the first time to our knowledge, we found evidence of CD95-mediated apoptosis of CD4- Tlymphocytes during the first 2 days after symptoms onset, ex vivo. Conclusions. Together, our findings suggest that strong innate immunity is required to control CHIKV infection.

Mosquito-borne viruses, or arboviruses, have been part of the infectious disease landscape for centuries, and are often, but not exclusively, endemic to equatorial and subtropical regions of the world. The past two decades saw the re-emergence of arthritogenic alphaviruses, a genus of arboviruses that includes several members that cause severe arthritic disease. Recent outbreaks further highlight the substantial public health burden caused by these viruses. Arthritogenic alphaviruses are often reported in the context of focused outbreaks in specific regions (eg, Caribbean, southeast Asia, and Indian Ocean) and cause debilitating acute disease that can extend to chronic manifestations for years after infection. These viruses are classified among several antigenic complexes, span a range of hosts and mosquito vectors, and can be distributed along specific geographical locations. In this Review, we highlight key features of alphaviruses that are known to cause arthritic disease in humans and outline the present findings pertaining to classification, immunogenicity, pathogenesis, and experimental approaches aimed at limiting disease manifestations. Although the most prominent alphavirus outbreaks in the past 15 years featured chikungunya virus, and a large body of work has been dedicated to understanding chikungunya disease mechanisms, this Review will instead focus on other arthritogenic alphaviruses that have been identified globally and provide a comprehensive appraisal of present and future research directions.

In the past decade, chikungunya—a virus transmitted by Aedes spp mosquitoes—has re-emerged in Africa, southern and southeastern Asia, and the Indian Ocean Islands as the cause of large outbreaks of human disease. The disease is characterised by fever, headache, myalgia, rash, and both acute and persistent arthralgia. The disease can cause severe morbidity and, since 2005, fatality. The virus is endemic to tropical regions, but the spread of Aedes albopictus into Europe and the Americas coupled with high viraemia in infected travellers returning from endemic areas increases the risk that this virus could establish itself in new endemic regions. This Seminar focuses on the re-emergence of this disease, the clinical manifestations, pathogenesis of virus-induced arthralgia, diagnostic techniques, and various treatment modalities.

Chikungunya virus (CHIKV) is a re-emerging alphavirus that has caused significant disease in the Indian Ocean region since 2005. During this outbreak, in addition to fever, rash and arthritis, severe cases of CHIKV infection have been observed in infants. Challenging the notion that the innate immune response in infants is immature or defective, we demonstrate that both human infants and neonatal mice generate a robust type I interferon (IFN) response during CHIKV infection that contributes to, but is insufficient for, the complete control of infection. To characterize the mechanism by which type I IFNs control CHIKV infection, we evaluated the role of ISG15 and defined it as a central player in the host response, as neonatal mice lacking ISG15 were profoundly susceptible to CHIKV infection. Surprisingly, UbE1L⁻/⁻ mice, which lack the ISG15 E1 enzyme and therefore are unable to form ISG15 conjugates, displayed no increase in lethality following CHIKV infection, thus pointing to a non-classical role for ISG15. No differences in viral loads were observed between wild-type (WT) and ISG15⁻/⁻ mice, however, a dramatic increase in proinflammatory cytokines and chemokines was observed in ISG15⁻/⁻ mice, suggesting that the innate immune response to CHIKV contributes to their lethality. This study provides new insight into the control of CHIKV infection, and establishes a new model for how ISG15 functions as an immunomodulatory molecule in the blunting of potentially pathologic levels of innate effector molecules during the host response to viral infection.

Alphaviruses can cause rheumatic manifestations (usually polyarthralgia and/or polyarthritis) in humans. Arthritogenic alphaviruses are distributed globally and include chikungunya virus, Ross River virus, Barmah Forest virus, Sindbis virus, o'nyong nyong virus and Mayaro virus. In this Review, the authors provide an overview of these viruses, describing epidemiology, pathogenesis, disease manifestations, diagnosis and interventions. Mosquito-transmitted alphaviruses causing human rheumatic disease are globally distributed and include chikungunya virus, Ross River virus, Barmah Forest virus, Sindbis virus, o'nyong-nyong virus and Mayaro virus. These viruses cause endemic disease and, occasionally, large epidemics; for instance, the 2004–2011 chikungunya epidemic resulted in 1.4–6.5 million cases, with imported cases reported in nearly 40 countries. The disease is usually self-limiting and characterized by acute and chronic symmetrical peripheral polyarthralgia–polyarthritis, with acute disease usually including fever, myalgia and/or rash. Arthropathy can be debilitating, usually lasts weeks to months and can be protracted; although adequate attention to differential diagnoses is recommended. The latest chikungunya virus epidemic was also associated with some severe disease manifestations and mortality, primarily in elderly patients with comorbidities and the young. Chronic alphaviral rheumatic disease probably arises from inflammatory responses stimulated by the virus persisting in joint tissues, despite robust antiviral immune responses. Serodiagnosis by ELISA is the standard; although international standardization is often lacking. Treatment usually involves simple analgesics and/or NSAIDs, which can provide relief, but better drug treatments are clearly needed. However, the small market size and/or the unpredictable and rapid nature of epidemics present major hurdles for development and deployment of new alphavirus-specific interventions. Key Points Alphaviruses that cause rheumatic disease are globally distributed and cause endemic disease in various locations and, occasionally, large unpredictable epidemics The 2004–2011 outbreak of chikungunya virus was the largest ever recorded, involving 1.4–6.5 million cases, with imported cases reported in nearly 40 countries Alphaviral disease is characterized by fever, rash, and/or myalgia, and generally symmetrical and peripheral, often debilitating, polyarthralgia and/or polyarthritis, which usually lasts weeks to months The arthropathy is rarely destructive and is usually treated with simple analgesics and/or NSAIDs, although relief of symptoms is often inadequate, with better treatments needed The pathogenesis of chronic arthralgia and/or arthritis probably arises from inflammatory immune responses induced by the virus persisting in joint macrophages, despite robust antiviral immune responses Adequate attention to differential diagnoses in patients with long-term chronic disease is recommended as other rheumatic conditions might be responsible for symptoms

Key Points Chikungunya virus (CHIKV) is a mosquito-borne alphavirus that provokes arthralgia and, potentially, severe complications in humans. A multidisciplinary effort, carried out over the past 5 years, allowed a thoughtful characterization of this mysterious virus. Recently, there was an unexpectedly severe epidemic of CHIKV in countries of the Indian Ocean region. This outbreak seems to have been the result of a striking adaptation of the virus to a new arthropod, Aedes albopictus (the tiger mosquito). Analyses of isolates from this outbreak have resulted in several interesting findings regarding the clinical onset and physiopathology of this virus. Progress has also been made to further our understanding of the interactions of CHIKV with its human host, the cellular tropism of the virus and the mechanisms of triggering the innate immune response. Clinical development has also seen recent advances. Chikungunya virus is a re-emerging alphavirus that recently caused an epidemic in countries of the Indian Ocean. At the time, little was known about the biology and pathogenesis of this virus compared with other viruses, but recent multidisciplinary efforts have furthered our understanding of this pathogen and its interaction with the host. Chikungunya virus (CHIKV) is a re-emerging mosquito-borne alphavirus responsible for a recent, unexpectedly severe epidemic in countries of the Indian Ocean region. Although many alphaviruses have been well studied, little was known about the biology and pathogenesis of CHIKV at the time of the 2005 outbreak. Over the past 5 years there has been a multidisciplinary effort aimed at deciphering the clinical, physiopathological, immunological and virological features of CHIKV infection. This Review highlights some of the most recent advances in our understanding of the biology of CHIKV and its interactions with the host.

As of early August, more than half a million cases of chikungunya virus infection had been reported in the Americas. The rapid spread is probably attributable to a lack of population immunity and the broad distribution in the Americas of vectors capable of transmitting the virus. In December 2013, the first local transmission of chikungunya virus in the Western Hemisphere was reported, beginning with autochthonous cases in Saint Martin. Since then, local transmission has been reported in 31 countries or territories throughout the Americas, including locations in the United States and its territories (Florida, Puerto Rico, and the U.S. Virgin Islands) (see figure). As of August 8, 2014, a total of 576,535 suspected and laboratory-confirmed chikungunya cases had been reported in the Americas, a case count that had nearly doubled over the previous month (see interactive graphic, available with the full text of this article at . . .

Chikungunya is an arboviral disease transmitted by aedes mosquitoes. The virus was first isolated in 1953 in Tanzania. Chikungunya virus is a member of the genus Alphavirus and the family Togaviridae. The disease typically consists of an acute illness characterised by fever, rash, and incapacitating arthralgia. The word chikungunya, used for both the virus and the disease, means “to walk bent over” in some east African languages, and refers to the effect of the joint pains that characterise this dengue-like infection. Chikungunya is a specifically tropical disease, but it is geographically restricted and outbreaks are relatively uncommon. It is only occasionally observed in travellers and military personnel. More than 266 000 people have been infected during the ongoing outbreak in Réunion, in which Aedes albopictus is the presumed vector. In the ongoing Indian outbreak, in which Aedes aegypti is the presumed vector, 1 400 000 cases of chikungunya were reported during 2006. The reasons for the re-emergence of chikungunya on the Indian subcontinent, and for its unprecedented incidence rate in the Indian Ocean region, are unclear. Plausible explanations include increased tourism, chikungunya virus introduction into a naive population, and viral mutation.

Characterizing the circulation of Mayaro virus (MAYV), an emerging arbovirus threat, is essential for risk assessment but challenging due to cross-reactivity with other alphaviruses such as chikungunya virus (CHIKV). Here, we develop an analytical framework to jointly assess MAYV epidemiology and the extent of cross-reactivity with CHIKV from serological data collected throughout French Guiana (N = 2697). We find strong evidence of an important sylvatic cycle for MAYV with most infections occurring near the natural reservoir in rural areas and in individuals more likely to go to the forest (i.e., adult males) and with seroprevalences of up to 18% in some areas. These findings highlight the need to strengthen MAYV surveillance in the region and showcase how modeling can improve interpretation of cross-reacting assays. Mayaro virus (MAYV) is an emerging arbovirus, but cross-reactivity with other alphaviruses makes analysis of its epidemiology difficult. Here, the authors develop an analytical framework to assess MAYV epidemiology and find evidence for an important sylvatic cycle and seroprevalences of up to 18% in some areas of French Guiana.

The surveillance and detection of zoonotic pathogens in animals is essential for predicting disease transmission pathways and the risks of spillover, but challenges include the costs, ethics and technical expertise required for vertebrate trapping, serum sampling and antibody or virus screening. Surveillance using haematophagous arthropods as a sampling tool offers a unique opportunity to obtain blood samples from a wide range of vertebrate species, allowing the study of host-mosquito associations, and host exposure to pathogens. We explored vertebrate diversity and potential Ross River virus (RRV) transmission pathways by analysing blood-fed mosquitoes collected in Brisbane, Australia. Host origins were identified using barcode sequencing, and host exposure to RRV was assessed using a modified plaque reduction neutralisation test. In total, 480 blood-fed mosquitoes were collected between February 2021 and May 2022. The host origins of 346 (72%) bloodmeals were identified, with humans (73%) and cattle (9%) comprising the dominant hosts. RRV seroprevalence was high in both vertebrate species with evidence of RRV exposure in 70% (21/30) of cattle and 52% (132/253) of humans. This is a novel, non-invasive method of estimating seroprevalence in vertebrate host populations. Our results highlight the potential of blood-fed mosquitoes to provide species-specific insights into pathogen transmission dynamics.