Quantitative risk assessment of the pathways of chikungunya emergence

Background/Question/Methods Chikungunya virus is an emerging infectious disease that has occurred as sporadic outbreaks throughout the 20^th century, and most recently several linked epidemics have occurred in Kenya, the islands of the Indian ocean, including Réunion and Mauritius, the Indian sub-continent, with a minor epidemic in Italy, as well as several imported cases in the U.S. and France. Chikungunya is spread much like Dengue, by Ae. aegypti and Ae. albopictus, but is an RNA Alphavirus; while mortality rates appear low, morbidity rates are high, and symptoms, similar to Dengue, include fever, rash, and nausea, but distinctive from Dengue includes painful arthralgia that may last for months. The dengue-like features suggest that the disease could have severe effects on human health globally.

Results/Conclusions We perform a quantitative risk of assement of the risk of various emergence routes – international air travel and trade, including transportation of mosquitoes, as potential routes for this latest global epidemic, and discuss the potential and issues of Chikungunya as an emerging infectious disease. Preliminary conclusions suggest that air travel provides substantial risk of globalizing Chikungunya, and that trade contributes less risk. Questions remain, however, about Chikungunya's ability to establish as an endemic disease in new locales, and we suggest actions that could substantially reduce the risk, and locales that may be of particular concern.