Chikungunya Virus 2025: An Integrated Review of Epidemiology, Virology, Pathogenesis, Clinical Spectrum, Diagnostics and Vaccine Development

Aedes aegypti and Aedes albopictus mosquito bites can infect people with the chikungunya virus (CHIKV), an alphavirus that causes chikungunya, an arboviral disease. In the past two decades, the chikungunya virus has resurfaced as a contagious illness in Africa, Asia, the Indian Ocean Islands, Europe, and the Americas; 119 countries and territories have reported locally transmitted cases of chikungunya virus disease up to 2024. The geographic distribution of chikungunya virus disease is expanding to include a wider geographic distribution and an increased risk of introduction and subsequent spread of the virus through mosquito vectors to an increasing population at risk of infection. Once infected through the bite of an infected mosquito, replication of the virus leads to the onset of symptoms such as fever, severe joint pain and swelling, myalgias, and rash as a result of the body's immune response to the infection. Most people infected with chikungunya virus disease make a full recovery within a period of weeks; however, a small percentage of people may develop prolonged arthralgia or chronic arthritis lasting for months or even years. While both the live-attenuated vaccine IXCHIQ and the virus-like fragment vaccine VIMKUNYA have been approved for use, the former's license has recently been revoked due to safety issues. Recent chikungunya fever outbreaks have led to active and continuous research into the disease, resulting in a better and deeper understanding of the disease and its pathogenesis. In this review article, we highlight the recent advances up to 2025 in the epidemiology, transmission, virology, pathogenesis, clinical manifestations, diagnosis, and vaccines for chikungunya virus disease.