Chikungunya is an emerging disease spread by Aedes aegypti
and Aedes albopictus
mosquitoes found across Africa, Asia and the Americas. Currently there are three genotypes of chikungunya virus: West African, East-Central-South African and Asian. Each genotype has contributed to outbreaks over time but in 2004, the ECSA and Asian genotypes began to expand significantly leading to increased cases worldwide. Increased human movement, urbanization and a mutation in the ECSA genotype which increases the ease of vector transmission all likely contributed to the explosion in cases. In acute disease, chikungunya infection can lead to high fever, profound joint pain and a rash similar to dengue virus. A key difference to dengue is the chronic, debilitating arthritis that can develop in up to 30-40% of cases and can lead to severe morbidity. It's global distribution, potentially severe consequences and lack of preventive vaccines make it a significant threat to deployed Service Members in endemic areas.
In Thailand, multiple chikungunya outbreaks have been reported throughout the years with over 10,000 cases in 2020 alone. Working with local academic institutions and pharmaceutical partners, AFRIMS participates in ongoing efforts to define the incidence and prevalence of the disease and develop clinical study sites to validate testing platforms and vaccine candidates. AFRIMS is uniquely situated for this work given the endemic nature of chikungunya in Thailand and has made significant contributions to the scientific literature about this emerging pathogen. AFRIMS's research unit in Cebu City, Philippines
, also contributed vital information about the ratio of symptomatic to asymptomatic disease, revealing much higher rates of the latter than previously thought. This research and other similar studies at AFRIMS sites across southeast Asia, combined with the testing capabilities, infrastructure support and clinical experience, make AFRIMS a key partner in the future control of chikungunya.
The primary departments at AFRIMS involved with this research are Entomology
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