title: Chikugunya and zika virus dissemination in the Americas: different arboviruses reflecting the same spreading routes and poor vector-control policies.
abstract: This review gathers the most recent investigations about chikungunya and zika viruses in America and would help in creating new research approaches.
  
  
  
  Clinical descriptions of chikungunya fever have been performed in the American outbreak observing that fever, polyarthalgia, myalgia and rash are the most common symptoms in the acute phase, while chronic arthralgia has persisted in 37-90% of small cohorts. The Asian origin of American strains of chikungunya virus (CHIKV) and zika virus (ZIKV) evidences a dissemination route in common and both are being transmitted by Aedes aegypti. Regarding zika fever, the association of congenital malformations with previous ZIKV exposure of pregnant women and potential sexual transmission of ZIKV are the most important discoveries in the New World.
  
  
  
  Massive outbreaks of chikungunya fever in 2014 and then followed by zika fever epidemics of lower magnitude in the next year throughout the American continent have their origins in Asia but may have used Pacific Islands as a path of dissemination. Reports of chronic arthralgia have been little described in the continent and more research is needed to measure the economic and health impact in patients who contracted CHIKV before. On the contrary, zika is menacing newborns' health because of its link with congenital microcephaly and sexual health by prolonged presence of viral particles in semen and urine.
authors.affiliation: aCentro Regional de Investigación en Salud Pública, Instituto Nacional de Salud Pública, Tapachula, Chiapas bCentro de Investigación y Desarrollo en Ciencias de la Salud, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León cFacultad de Ciencias Biológicas, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, Nuevo León dCentro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico *Ildefonso Fernández-Salas and Esteban E. Díaz-González contributed equally to this study.
authors.forename: Ildefonso
authors.initials: I
authors.lastname: Fernández-Salas
authors.forename: Esteban E
authors.initials: EE
authors.lastname: Díaz-González
authors.forename: Hugo
authors.initials: H
authors.lastname: López-Gatell
authors.forename: Celia
authors.initials: C
authors.lastname: Alpuche-Aranda
mesh_terms: D000569:Americas / Q000453:epidemiology; D065632:Chikungunya Fever / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission / Q000821:virology; D002646:Chikungunya virus; D004196:Disease Outbreaks / Q000517:prevention & control / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D011247:Pregnancy; D000071244:Zika Virus; D000071243:Zika Virus Infection / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission / Q000821:virology