Chikungunya marches on, at a cost Save

Chikungunya is a mosquito-borne arboviral disease and an emerging global public threat.  This analysis recent trends and the disability-adjusted life years (DALYs) and direct and indirect costs using a data-driven simulation model. The main outcome was the number of cases, along with the DALY burden, and costs of acute and chronic chikungunya.

Over the last 10 years they found a total of 18.7 million chikungunya cases from 110 countries, causing 1.95 million DALYs. Most of this burden was found in the Latin American and Caribbean region. The total economic burden caused by chikungunya over these 10 years was estimated at $2.8 billion in direct costs and $47.1 billion in indirect costs worldwide. 

Long-term chronic illness accounted for the most cost and DALYs.

The University of Minnesotas Center for Infectious Disease Research (CIDRAP) and Policy review of this article points out several important factors:

• The first documented outbreak occurred in Tanzania in 1952. 
• Primary vectors: Aedes aegypti and Aedes albopticus mosquitoes
• Chikungunya causes fever, severe joint pain, rash, and fatigue. Most cases are self-limited, but chronic disease (neurologic cardiovascular, rheumatologic) may lead to poor outcomes.
• Chikungunya prevalence is likely underestimated owing to misdiagnosis, poor testing, and low healthcare access.
• Globalization, urbanization, and climate change have significantly increased the risk of "explosive, unpredictable" outbreaks 

For US citizens the greatest risk of chikungunya infection arises with travel to the Caribbean and Latin America.  Vaccines are not yet available.