Rapid Epidemic Expansion of Chikungunya Virus East/Central/South African Lineage, Paraguay

C hikungunya is a mosquitoborne disease caused by the chikungunya virus (CHIKV), a singlestranded positive-sense RNA virus belonging to the family Togaviridae (1), which is transmitted to humans through the bite of infected Aedes aegypti and Ae. albopictus mosquitoes. This disease is generally an acute, self-limiting illness characterized by fever and severe joint pain, although persistent or relapsing joint pain can occur (1). Atypical and severe manifestations (including meningoencephalitis) have been reported, and death is usually associated with older ages and other underlying diseases. Mother-to-child transmission of CHIKV occurs, and neonatal disease can be severe, with neurologic, myocardial, or hemorrhagic complications (1).