Reappearance of Chikungunya, Formerly Called Dengue, in the Americas

Scott B. Halstead

Disclosures

Emerging Infectious Diseases. 2015;21(4):557-561. 

In This Article

Abstract and Introduction

Abstract

After an absence of ≈200 years, chikungunya returned to the American tropics in 2013. The virus is maintained in a complex African zoonotic cycle but escapes into an urban cycle at 40- to 50-year intervals, causing global pandemics. In 1823, classical chikungunya, a viral exanthem in humans, occurred on Zanzibar, and in 1827, it arrived in the Caribbean and spread to North and South America. In Zanzibar, the disease was known as kidenga pepo, Swahili for a sudden cramp-like seizure caused by an evil spirit; in Cuba, it was known as dengue, a Spanish homonym of denga. During the eighteenth century, dengue (present-day chikungunya) was distinguished from breakbone fever (present-day dengue), another febrile exanthem. In the twentieth century, experiments resulted in the recovery and naming of present-day dengue viruses. In 1952, chikungunya virus was recovered during an outbreak in Tanzania, but by then, the virus had lost its original name to present-day dengue viruses.

Introduction

Chikungunya has returned to the Americas after an absence of ≈200 years. The return of this viral exanthem was first recognized on St. Martin, in the Caribbean, in December 2013, and as of January 9, 2015, the US Centers for Disease Control and Prevention reported that the disease had been identified in 42 countries or territories in the Caribbean, Central America, South America, and North America. A total of 1,094,661 suspected and 26,606 laboratory-confirmed chikungunya cases have been reported (http://www.cdc.gov/chikungunya/geo/americas.html). The return of chikungunya virus to the Americas provides an opportunity to revisit the epidemiology of this zoonotic togavirus from Africa and to contrast it with that of dengue viruses, flaviviruses that are maintained as zoonoses in Southeast Asia. All of these viruses can be transmitted by Aedes aegypti and Ae. albopictus mosquitoes in an urban cycle. In the course of history, a remarkable name change has taken place because of the similarities between the clinical syndromes caused by dengue and chikungunya virus infections. The story of how the term dengue was originally applied to what we now call chikungunya and then subsequently applied to what we now call dengue should be well known by persons who deal with these 2 similar, but crucially different, global diseases. For more details on the name switch, the reader should consult the historical account by Carey.[1]

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