The Times of India reported in September 2024 that cases of chikungunya in children were symptomatic of a “shift” in epidemiology. Case numbers have increased and are more frequently requiring hospitalisation, particularly among children. While these changes are cause for concern for some infectious disease experts, they are careful to emphasise the need for thorough research. Indeed, the increase in cases may be attributed to improved surveillance efforts.
Cases in children
The latest report suggests that in Maharashtra, a populous state in the west of India, cases have exceeded 2,600 since the start of the year. This is a 50% increase on the previous year, and the disease is “increasingly” affecting children, some of whom require time in intensive care. Dr Sachin Shah, neonatologist at Surya Hospital in Pune, is concerned by the number of children suffering:
“In my OPD for older children, it is the most common complaint this week.”
Five newborns were diagnosed with chikungunya in Pune, two of whom acquired it from their mothers. Dr Shah described high-grade fever, elevated liver function, and low appetite among the symptoms. One neonate developed a “life-threatening disorder” characterised by hyper-inflammation. Infectious disease specialist at H N Reliance Hospital in Girgaum notes the change in severity among patients who are admitted to hospital.
“Chikungunya has acquired a notorious edge this year.”
This change is also observed by Dr Anita Mathew, infectious disease specialist at Fortis Hospital, Mulund, who has had patients require ICU attention.
“The extreme symptoms are new to Mumbai, but are not unknown in medical literature.”
Is this new?
While some experts are questioning this “shift” in disease, others are wary of sounding the alarm. Dr Radhakrishna Pawar of the state health department acknowledged the change in clinical appearance but urged further investigation.
“We need to study it in detail before making such claims.”
Furthermore, while cases have increased, Dr Pawar noted that they do not reach the numbers required to qualify as an outbreak or epidemic.
Vaccine access
Although there is a licensed chikungunya vaccine to address the “significant unmet medical need” presented by chikungunya, Valenva’s IXCHIQ is only currently approved in the United States, Europe, and Canada. However, Valneva is “focussed on expanding the vaccine’s label and access”, working with CEPI to support access in LMICs, post-marketing trials, and potential label extensions.
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