Chikungunya virus (CHIKV) is a mosquito-borne alphavirus that, following its recent, nearly worldwide spread, is now endemic to most tropical and subtropical regions. It can cause explosive outbreaks in humans, especially when it expands to new regions with naïve populations. Although CHIKV most famously causes crippling and often chronic arthritis, there are reports of fatal outcomes following CHIKV infection. Together with William de Souza (now of the University of Kentucky), the WRCEVA has conducted a comprehensive, systematic characterization of fatal and non-fatal CHIKV infections in Brazil from 2015-2023. We report a case-fatality ratio of 0.8 deaths per 1,000 cases with fatal outcomes characterized by multiorgan failure, neurological involvement, hemodynamic disorders, and immune dysregulation. This research brings attention to understudied aspects of CHIKV pathology and provides critical targets for the identification of prognostic biomarkers as well as medical countermeasure development.

Link: https://doi.org/10.1016/j.chom.2024.02.011