Chikungunya in Latin America (2020–2025): Epidemiological Burden, Clinical Impact, and Public Health Priorities

Abstract

Chikungunya virus (CHIKV) has maintained sustained transmission in Latin America since its introduction in 2013, generating recurrent outbreaks and a significant clinical, social, and economic burden. Between 2020 and 2025, more than 2.8 million suspected cases were reported, with Brazil contributing the highest morbidity and disability-adjusted life years (DALYs). Acute infection is characterized by sudden-onset fever, severe polyarthralgia, myalgia, headache, and a maculopapular rash. Approximately 40% of patients develop chronic arthropathy, which may persist for months or years, affecting functional capacity and quality of life. The diagnostic accuracy is challenged by the co-circulation of dengue and Zika, necessitating combined molecular and serological approaches. Management remains primarily supportive, utilizing NSAIDs, corticosteroids, and, in select cases, disease-modifying antirheumatic drugs (DMARDs) to manage persistent inflammation. Transmission dynamics are driven by climatic variability, rapid urbanization, high densities of Aedes aegypti and Aedes albopictus, and increased human mobility. Considerable disparities exist in public health capacity across the region: Brazil has implemented robust surveillance and vector control, while Nicaragua, Bolivia, and parts of Peru face substantial limitations that delay outbreak detection and response. Although the Ixchiq vaccine was recently approved in high-income settings, access remains extremely limited in Latin American countries with endemic regions. Strengthening genomic surveillance, integrating vector control with urban development policies, expanding equitable access to vaccination, and improving long-term care for chronic post-CHIKV sequelae are essential priorities. Future efforts should focus on genotype-specific transmission modeling, evaluating vaccine effectiveness in endemic populations, and coordinating cross-border data sharing to enhance early outbreak detection and regional preparedness.