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Detection and genomic characterization of a travel-associated ECSA lineage chikungunya virus infection in Mexico.

BACKGROUND: In 2013, chikungunya virus (CHIKV), a re-emerging Aedes-borne virus, was introduced into the Americas. This led to synchronous epidemics across the region associated mainly with the Asian lineage, which eventually subsided. Resurgent outbreaks have been recorded since, principally in South America, largely driven by the East-Central-South-African (ECSA) lineage. In 2025, more than 300,000 CHIKV suspected cases were reported in Brazil and Cuba. CASE SUMMARY: In November 2025, a healthy adult male traveling from Cuba arrived in Merida, Mexico, and shortly after presented febrile symptoms consistent with an arboviral infection. CHIKV infection was diagnosed by RT-qPCR. Though the infection was mild, the patient developed a rash on the abdomen and neck that persisted for up to a month, with further inflammation of the joints of the left leg. Phylogenetic analysis of the viral genome indicated placement within the ECSA lineage, clustering with other contemporaneous virus genomes sampled from Brazil that belong to a recently described clade II within the country, in which viral genomes from Cuba also cluster. CONCLUSION: We identify a travel-associated ECSA lineage CHIKV case in Mexico. This viral lineage has not previously been detected in the country. This finding highlights the risk for subsequent local transmission and is consistent with reports of the presence of this lineage in Cuba. Ten years since the last CHIKV epidemic in Mexico, strengthened surveillance is required to anticipate potential local outbreaks within the region.

ECSA

Chikungunya virus in Thailand (2020-2023): Epidemiology, clinical features, and genomic insights.

Chikungunya virus (CHIKV) caused significant outbreaks in Thailand during 2008-2009 and 2018-2020. Despite the COVID-19 pandemic, CHIKV continued to circulate; however, data on its epidemiological, clinical, and genetic characteristics during and after this period remains limited. This study investigated CHIKV infections in Thailand from March 2020 to December 2023. Serum samples (n = 1,264) were collected from patients with suspected CHIKV infection at 14 hospitals across five provinces in central, eastern, and northeastern Thailand. Samples were tested by RT-qPCR and IgM fluorescence immunoassay. CHIKV infection was confirmed in 50.5% (638/1,264) of cases. Infections occurred across all age groups, with the highest prevalence among individuals aged ≥56 years. Clinical symptoms significantly associated with infection included myalgia, arthralgia, rash, and conjunctivitis. Rash was more frequently in individuals aged ≤15 years and was significantly associated with lower viral loads. Arthralgia was more common among older adults and was linked to later illness onset. Myalgia was least frequently reported in younger patients. Thirty-eight complete coding sequences of our Thai CHIKV strains were analyzed in phylogenetic and time-scaled trees alongside 186 global strains and 109 ECSA-IOL strains from GenBank, respectively. Genome analysis revealed that CHIKV strains circulating in Thailand during 2020-2023 belonged to the East/Central/South African-Indian Ocean lineage (ECSA-IOL). These strains did not evolve from earlier ECSA-IOL variants that carried the E1-A226V mutation, which was previously detected in Thailand. Instead, all isolates carried E1-K211E and E2-V264A, along with E1-226A, likely introduced from the Indian subcontinent around 2016-2017. This introduction triggered a major outbreak between late 2018 and 2020, followed by sustained transmission. The 2020-2023 Thai strains exhibited high genetic similarity to those from neighboring countries, with multiple nonsynonymous mutations suggesting ongoing viral adaptation. Understanding CHIKV epidemiology, clinical features, and evolution supports improved surveillance, diagnostics, and public health interventions.

Humans

Autochthonous chikungunya virus (CHIKV) outbreak in the province of Modena, Emilia-Romagna region, Italy, August to October 2025: epidemiology, clinical features and virological findings.

Between 10 August and 31 October 2025, 343 cases (306 confirmed and 37 probable) of symptomatic autochthonous chikungunya virus (CHIKV) infection were notified in eight municipalities in the province of Modena, Emilia-Romagna region, northern Italy. The infection was diagnosed by detection of CHIKV RNA in blood and urine samples, and by detection of IgM antibodies against CHIKV. Most common symptoms were arthralgia (n = 326) and fever (n = 317). No fatalities were reported. Chikungunya virus RNA was detected in 39 (14.8%) of 263 pools of Aedes albopictus mosquitoes, thereby confirming local vector-borne transmission. Sequences from 11 case samples and two mosquito pools were whole genome sequenced. The viral strain belonged to the East/Central/South African (ECSA) lineage 2 and was closely related to the strains circulating in Reunion Island in 2024-25. The public health response included rapid vector control measures, reinforced epidemiological surveillance and multidisciplinary coordination between public health authorities and clinicians, laboratories and entomologists. This was one of the largest autochthonous CHIKV outbreaks ever recorded in a temperate European region. It highlights the critical importance of integrated, multidisciplinary preparedness and response for arboviral threats in non-endemic areas.

Humans