Chikungunya virus at a crossroads: Emergence, interventions, and global health strategies.

Chikungunya virus (CHIKV) has re-emerged as a major arboviral threat across 104 countries, situating nearly 2.8 billion people at risk. This review summarizes evidence on CHIKV epidemiology, molecular evolution, and public health challenges, with an emphasis on the observed expansion. Climate change, international travel, and the spread of Aedes vectors are driving the transmission of CHIKV into temperate regions, exemplified by the first large outbreak in Guangdong, China, in 2025. Adaptive viral mutations, waning population immunity, and urbanization are further accelerating epidemic growth. Although acute infections are often self-limiting, this review highlights the substantial burdens on low- and middle-income countries. Advances include two licensed vaccines (IXCHIQ and VIMKUNYA) and emerging point-of-care diagnostics; yet biomedical innovation alone remains insufficient. Thus, we also conclude that surveillance, vector control, risk mitigation, equity-focused policy, and coordinated global investment are essential to prevent the establishment of endemicity and its wider spread.