Global burden of chikungunya virus infections and the potential benefit of vaccination campaigns

The first vaccine against chikungunya virus (CHIKV) has now been licensed; however, due to a limited knowledge of the underlying global burden, its potential to reduce disease burden remains unknown. We used data from seroprevalence studies, observed cases and mosquito distributions to quantify the underlying CHIKV burden in 180 countries and territories, and we explored the potential impact of vaccination campaigns. We estimate that 104 countries have experienced CHIKV transmission, covering 2.8 billion people, and that, in epidemic settings, the mean duration between outbreaks is 6.2 years, with 8.4% of the susceptible population infected per outbreak. Globally, there are 35 million annual infections, mainly in Southeast Asia, Africa and the Americas. Assuming a vaccine efficacy against disease of 70% and a protection against infection of 40%, vaccinating 50% of individuals over 12 years of age in places and times where the virus circulates would avert 4,436 infections, 0.34 deaths and 17 disability-adjusted life years per 100,000 doses used. These findings highlight the global burden of chikungunya and the potential of CHIKV vaccination campaigns.