India faces world's highest long-term risk from chikungunya: Study

A global BMJ study using machine learning maps shows India could face the greatest long-term impact of chikungunya, with millions at risk of chronic disability

India could face the world’s highest long-term burden of chikungunya, with millions at risk of infection and chronic disability each year, according to one of the most detailed global mappings of the disease to date, published in BMJ Global Health.

The study, titled Global, regional and national burden of chikungunya: force of infection mapping and spatial modelling study, used machine learning models to predict that over 5 million Indians may be affected annually, underscoring a far greater threat than previously recognised.

What is chikungunya?

Chikungunya is a mosquito-borne viral illness spread by Aedes aegypti and Aedes albopictus mosquitoes, which are the same insects that transmit dengue. The infection causes sudden high fever and crippling joint pain, often so severe that patients struggle to walk.

 

 

According to Cleveland Clinic, an American nonprofit academic medical centre, while most people recover from the initial illness in a few weeks, about half of patients continue to suffer from long-term joint pain and disability.

How big is the global burden?

The study predicts an average of 14.4 million chikungunya infections worldwide each year in regions already reporting the virus. But if environmental conditions allow the disease to spread to new areas, that number could rise to 34.9 million cases annually.

 

In terms of health impact, this translates into up to 2.3 million disability-adjusted life years (DALYs) lost globally every year.

Why is India at the highest risk?

According to the analysis, India and Brazil together account for nearly half of chikungunya’s global health burden. India alone could see over 12 million infections a year in the worst-case scenario.

 

The chronic phase of the disease, which includes long-lasting joint pain and rheumatic arthritis, makes up more than half of this burden, especially among adults aged between 40 and 60.

 

Researchers point out that India’s large population, widespread mosquito vectors, and climatic conditions make it particularly vulnerable.

 

One of the findings of the study is that high transmission risk is not confined to tropical regions. Machine learning models showed that parts of Africa, Latin America, Asia, and even areas beyond the tropics could face outbreaks. This expansion is being driven by climate change, global travel, and changing mosquito habitats.

Are there vaccines or treatments available?

Currently, there is no specific antiviral treatment for chikungunya. Care is limited to rest, hydration, and pain management.

 

However, two vaccines, Ixchiq (by Valneva Austria GmbH) and Vimkunya (by Bavarian Nordic), have been approved in countries such as the United States, Canada, Europe, and the United Kingdom. Regulatory approval from Indian authorities is still pending.   In India, Bharat Biotech’s chikungunya vaccine candidate, BBV87, has successfully completed preclinical and Phase I trials in India and is now undergoing Phase II/III evaluation, and as of September 2025, it has been cleared for Phase III in India.

What does this mean for India’s public health system? 

With millions at risk annually, India could face a massive healthcare and economic strain from chikungunya’s long-term disability burden. Public health experts stress the need for:

• Enhanced surveillance systems to detect outbreaks early
• Vector control measures such as eliminating mosquito breeding sites
• Preparedness for vaccine rollout once it becomes widely available
• Public awareness campaigns on prevention and early care

Researchers warn that chikungunya is not just another mosquito-borne fever, it is a disease that can rob people of mobility and productivity for years. If India does not act swiftly, it risks carrying the heaviest long-term burden of chikungunya worldwide.

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This content is for informational purposes only and is not a substitute for professional medical advice.