title: Global emergence of Alphaviruses that cause arthritis in humans.
abstract: Arthropod-borne viruses (arboviruses) may cause severe emerging and re-emerging infectious diseases, which pose a significant threat to human and animal health in the world today. These infectious diseases range from mild febrile illnesses, arthritis, and encephalitis to haemorrhagic fevers. It is postulated that certain environmental factors, vector competence, and host susceptibility have a major impact on the ecology of arboviral diseases. Presently, there is a great interest in the emergence of Alphaviruses because these viruses, including Chikungunya virus, O'nyong'nyong virus, Sindbis virus, Ross River virus, and Mayaro virus, have caused outbreaks in Africa, Asia, Australia, Europe, and America. Some of these viruses are more common in the tropics, whereas others are also found in temperate regions, but the actual factors driving Alphavirus emergence and re-emergence remain unresolved. Furthermore, little is known about the transmission dynamics, pathophysiology, genetic diversity, and evolution of circulating viral strains. In addition, the clinical presentation of Alphaviruses may be similar to other diseases such as dengue, malaria, and typhoid, hence leading to misdiagnosis. However, the typical presence of arthritis may distinguish between Alphaviruses and other differential diagnoses. The absence of validated diagnostic kits for Alphaviruses makes even routine surveillance less feasible. For that purpose, this review describes the occurrence, genetic diversity, clinical characteristics, and the mechanisms involving Alphaviruses causing arthritis in humans. This information may serve as a basis for better awareness and detection of Alphavirus-caused diseases during outbreaks and in establishing appropriate prevention and control measures.
authors.affiliation: Department of Clinical Microbiology, Virology, Umeå University, Umeå, Sweden; olivia.lwande@umu.se; wesulaolivia@gmail.com.
authors.forename: Olivia Wesula
authors.initials: OW
authors.lastname: Lwande
authors.affiliation: Veterinary Services Department, Kenya Wildlife Service, Nairobi, Kenya.
authors.forename: Vincent
authors.initials: V
authors.lastname: Obanda
authors.affiliation: Swedish Defence Research Agency, CBRN Defence and Security, Umeå, Sweden.
authors.forename: Göran
authors.initials: G
authors.lastname: Bucht
authors.affiliation: Earth Observation Unit, International Centre of Insect Physiology and Ecology, Nairobi, Kenya.
authors.forename: Gladys
authors.initials: G
authors.lastname: Mosomtai
authors.affiliation: IGAD Climate Prediction and Application Centre (ICPAC), Nairobi, Kenya.
authors.forename: Viola
authors.initials: V
authors.lastname: Otieno
authors.affiliation: Department of Clinical Microbiology, Infectious Diseases, Umeå University, Umeå, Sweden.
authors.forename: Clas
authors.initials: C
authors.lastname: Ahlm
authors.affiliation: Department of Clinical Microbiology, Virology, Umeå University, Umeå, Sweden.
authors.forename: Magnus
authors.initials: M
authors.lastname: Evander
keywords: Mayaro; O'nyong'nyong; Ross River; Sindbis; arthritis; chikungunya