Chikungunya virus outbreak in China and treatment measures

Wei Miao^1*

¹Beijing UJTBio Co. LTD, Beijing, China.

*Correspondence:

Wei Miao; Email: mwx@vjtbio.com

Abstract

Chikungunya virus (CHIKV) is a single-stranded positive-sense RNA virus in the Togaviridae family. In 2025, CHIKV outbreaks in China were mainly imported cases, in Guangdong, Yunnan, and Hainan provinces. The virus primarily infects macrophages, epithelial cells, and other cell types, triggering a cytokine storm that leads to excessive immune responses and subsequent tissue and organ damage. There are no effective therapeutic or prophylactic measures for CHIKV infection, and clinical management remains limited to supportive care. This study aimed to identify safe and effective pharmacological treatments to inhibit CHIKV replication and alleviate the resulting cytokine storm. After reviewing researches on the structure, life cycle of CHIKV, and efficacious compounds against RNA viruses in the past, ivermectin and vitamin D showed promising future to control CHIKV infection. Ivermectin, a broad-spectrum antiviral agent, suppresses CHIKV replication in in vitro models. During the coronavirus disease 2019 pandemic, ivermectin improved patient survival rates, particularly when administered in early infection. Its efficacy surpassed other anti-COVID19 drug such as azvudine, without liver injury concerns. Vitamin D exerts immunomodulatory effects by enhancing immune defense mechanisms, reducing pro-inflammatory cytokine production, and promoting macrophage autophagy; these processes facilitate the clearance of intracellular viral proteins and prevent cytokine storm onset. The combined administration of ivermectin and vitamin D achieves three key therapeutic effects: inhibition of CHIKV replication, enhancement of macrophage autophagy to eliminate intracellular viral proteins, and suppression of the pro-inflammatory cytokine storm. Both compounds are from nature with extensive clinical application and are recognized for their high safety profiles. Ivermectin and vitamin D have better efficacy than currently used anti-viral drug azvudine in COVID-19 trials with much lower costs for social health systems, therefore, holds promising potential for addressing CHIKV outbreaks and pandemics.

Keywords: Chikungunya virus, cytokine storm, ivermectin, autophagy, vitamin D