The Burden of Chikungunya in India: An Overview of Clinical, Epidemiological, and Public Health Challenges

Chikungunya virus (CHIKV) is an arbovirus of significant public health concern, primarily transmitted by Aedes mosquitoes. A review of literature from sources such as PubMed, SCOPUS, and Web of Science indicates that India has faced several outbreaks in recent decades, characterised by high morbidity, an economic burden, and long-term complications. The virus’s re-emergence after periods of low transmission exposes weaknesses in surveillance, vector control, and community awareness. The increasing burden of chikungunya can be attributed to factors such as urbanisation, population movement, climate change, and a weak healthcare infrastructure. Diagnosing the disease is further complicated by symptoms that overlap with those of dengue and Zika, leading to frequent underreporting and misidentification. While outbreaks, especially in densely populated urban areas, rarely result in fatalities, the debilitating joint pain commonly associated with the virus can persist for months, significantly impacting quality of life and productivity. Epidemiological studies indicate cyclical patterns of transmission, typically aligning with the monsoon seasons and ineffective vector management. Various challenges, including gaps in diagnostics, limited laboratory capacity, and insufficient reporting systems, hinder timely responses to outbreaks. This review aims to provide a comprehensive summary of the epidemiology, clinical manifestations, immunological characteristics, challenges in surveillance, and public health impacts of chikungunya in India, with a focus on recent trends and future research needs. Challenges include limited vaccine availability and implementation, a lack of community awareness, insufficient funding, inconsistent vector control efforts, underutilisation of molecular diagnostics such as reverse transcription-polymerase chain reaction (RT-PCR), and weak surveillance systems that lead to underreporting and delayed outbreak responses. To mitigate the long-term burden of chikungunya, it is essential to strengthen surveillance, expand diagnostic facilities, invest in research on the virus's origin and vaccine development, and implement community-based vector control measures.