Research advances in chikungunya virus: Epidemiology, pathogenesis, and control

Chikungunya virus (CHIKV) is a mosquito-borne RNA virus endemic to tropical regions, where it causes recurrent outbreaks. Transmitted primarily by Aedes aegypti and Aedes albopictus mosquitoes, CHIKV has expanded from its origins in Africa to affect millions across Asia, the Americas, and East and Central Africa in recent decades. Infection results in chikungunya fever, a debilitating illness marked by acute fever and severe musculoskeletal symptoms—including persistent joint and muscle pain. These symptoms often continue for years, impairing health, quality of life, and economic productivity. Although CHIKV pathogenesis has been studied for more than half a century, no specific antiviral treatment exists to date. Clinical management remains supportive, focused on relieving symptoms and improving patient comfort. In light of its continued global spread, advancing the understanding of CHIKV pathogenesis is urgently needed. Such insights are essential for elucidating disease mechanisms and facilitating the development of effective preventive and therapeutic interventions. This review systematically summarizes the latest advances in CHIKV research, covering its epidemiology, transmission, viral replication, clinical manifestations, immunopathology, diagnosis, vaccine and antiviral development, and integrated control measures, while identifying key knowledge gaps and unmet public health needs. From a One Health perspective, it clarifies human-vector-environment links in CHIKV transmission, informs cross-disciplinary collaboration and coordinated control, advancing One Health practice against mosquito-borne diseases. • 2024–2025 CHIKV epidemiology, outbreaks and genotype evolution in China Asia. • Molecular mechanisms and inflammatory pathways of CHIKV chronic arthralgia. • Ixchiq clinical application and latest CHIKV vaccine/antiviral advances. • One Health CHIKV surveillance system with human-veterinary-environmental data.