Dengue, chikungunya: Two emerging arboviruses

Dengue and chikungunya share many characteristics: they both are arboviruses (ARthropode-BOrne VIRuses), transmitted by Aedes mosquitoes. Tropical diseases first described centuries ago, they recently emerged dramatically, and their geographic area expanded: first autochthonous cases acquired in Metropolitan France were reported during the summer 2010. Clinically, they both present as fever of acute onset, associated with severe pain (headache, myalgia and arthralgia). Lastly, there is no antiviral agent available against these viruses, and the most efficient intervention is preventive, through the fight against their vectors, which poses important challenges. Main differences include i) the viruses family (alphavirus for chikungunya, flavivirus for dengue); ii) emergence patterns (gradual increase since the 1980s for dengue; massive outbreaks in the Indian Ocean islands and India in 2006 for chikungunya, followed by flat years); iii) complications (acute, with hemorrhagic signs and/or shock with capillary leak syndrome for dengue; chronic incapacitating arthralgiae for chikungunya); iv) vaccine research dynamics (intensive for dengue; limited for chikungunya). (C) 2012 Elsevier Masson SAS. All rights reserved.