Chikungunya Virus and Chikungunya Fever: From Molecular Etiology to New Global Prevention and Control Strategies

Abstract Chikungunya fever is an acute viral infectious disease caused by the Chikungunya virus (CHIKV) and transmitted by Aedes mosquitoes. Since its first discovery in Tanzania in 1952, CHIKV has caused multiple large-scale outbreaks worldwide, posing a serious threat to public health. CHIKV belongs to the genus Alphavirus in the family Togaviridae. Its genome is a single-stranded positive-sense RNA, encoding 4 non-structural proteins (nsP1-4) and 5 structural proteins (C, E3, E2, 6K, E1). In recent years, adaptive mutations (such as E1-A226V) occurring in the virus during evolution have significantly enhanced its ability to infect and transmit through the vector Aedes mosquitoes, leading to the continuous expansion of its epidemic range. This review systematically summarizes the molecular virological characteristics, genomic evolution rules, pathogenic mechanisms (especially new findings related to joints and the nervous system) of CHIKV, as well as the latest diagnostic technologies, including CRISPR/Cas system-based rapid detection methods and probe-capture metagenomic sequencing. In terms of clinical management, it focuses on interpreting the Diagnosis and Treatment Protocol for Chikungunya Fever (2025 Edition) and a number of expert consensuses, emphasizing the efficacy and safety of integrated traditional Chinese and Western medicine treatment, and points out that non-steroidal anti-inflammatory drugs should be avoided. Although there is currently no specific antiviral drug, progress has been made in the research and development of drugs targeting key links in the viral life cycle and host factors. At the same time, a variety of candidate vaccines (including live attenuated vaccines, virus-like particle vaccines, mRNA vaccines, etc.) have entered preclinical or clinical research stages, showing good application prospects. Finally, combined with the Technical Guidelines for the Prevention and Control of Chikungunya Fever (2025 Edition), this article analyzes the challenges faced by China in preventing local transmission caused by imported epidemics, and proposes a comprehensive prevention and control strategy centered on "eliminating stagnant water, eradicating mosquitoes, and preventing mosquito bites", integrating monitoring and early warning, rapid response, multi-departmental collaboration, and public education. Facing the continuous evolution and global spread of CHIKV, strengthening basic research, drug and vaccine development, and the construction of public health systems are the keys to addressing this threat in the future.