{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T05:55:13Z","timestamp":1791352513822,"version":"4.3.1"},"update-to":[{"DOI":"10.1371\/journal.pntd.0013548","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T00:00:00Z","timestamp":1758240000000}}],"reference-count":85,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T00:00:00Z","timestamp":1757894400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"the Second Century Fund (C2F), Chulalongkorn University"},{"name":"the Second Century Fund (C2F), Chulalongkorn University"}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:p>Chikungunya virus (CHIKV) caused significant outbreaks in Thailand during 2008\u20132009 and 2018\u20132020. Despite the COVID-19 pandemic, CHIKV continued to circulate; however, data on its epidemiological, clinical, and genetic characteristics during and after this period remains limited. This study investigated CHIKV infections in Thailand from March 2020 to December 2023. Serum samples (n\u2009=\u20091,264) were collected from patients with suspected CHIKV infection at 14 hospitals across five provinces in central, eastern, and northeastern Thailand. Samples were tested by RT-qPCR and IgM fluorescence immunoassay. CHIKV infection was confirmed in 50.5% (638\/1,264) of cases. Infections occurred across all age groups, with the highest prevalence among individuals aged \u226556 years. Clinical symptoms significantly associated with infection included myalgia, arthralgia, rash, and conjunctivitis. Rash was more frequently in individuals aged \u226415 years and was significantly associated with lower viral loads. Arthralgia was more common among older adults and was linked to later illness onset. Myalgia was least frequently reported in younger patients. Thirty-eight complete coding sequences of our Thai CHIKV strains were analyzed in phylogenetic and time-scaled trees alongside 186 global strains and 109 ECSA-IOL strains from GenBank, respectively. Genome analysis revealed that CHIKV strains circulating in Thailand during 2020\u20132023 belonged to the East\/Central\/South African\u2013Indian Ocean lineage (ECSA-IOL). These strains did not evolve from earlier ECSA-IOL variants that carried the E1-A226V mutation, which was previously detected in Thailand. Instead, all isolates carried E1-K211E and E2-V264A, along with E1-226A, likely introduced from the Indian subcontinent around 2016\u20132017. This introduction triggered a major outbreak between late 2018 and 2020, followed by sustained transmission. The 2020\u20132023 Thai strains exhibited high genetic similarity to those from neighboring countries, with multiple nonsynonymous mutations suggesting ongoing viral adaptation. Understanding CHIKV epidemiology, clinical features, and evolution supports improved surveillance, diagnostics, and public health interventions.<\/jats:p>","DOI":"10.1371\/journal.pntd.0013548","type":"journal-article","created":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T17:47:21Z","timestamp":1757958441000},"page":"e0013548","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":11,"title":["Chikungunya virus in Thailand (2020\u20132023): Epidemiology, clinical features, and genomic insights"],"prefix":"10.1371","volume":"19","author":[{"given":"Sarawut","family":"Khongwichit","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Watchaporn","family":"Chuchaona","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumeth","family":"Korkong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lakkhana","family":"Wongsrisang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thanunrat","family":"Thongmee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2337-6807","authenticated-orcid":true,"given":"Yong","family":"Poovorawan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,9,15]]},"reference":[{"key":"pntd.0013548.ref001","doi-asserted-by":"crossref","first-page":"2363","DOI":"10.1099\/vir.0.82858-0","article-title":"Changing patterns of chikungunya virus: re-emergence of a zoonotic arbovirus","volume":"88","author":"AM Powers","year":"2007","journal-title":"J Gen Virol"},{"key":"pntd.0013548.ref002","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2017-000530","article-title":"Zika, chikungunya and dengue: the causes and threats of new and re-emerging arboviral diseases","volume":"3","author":"ES Paix\u00e3o","year":"2018","journal-title":"BMJ Glob Health"},{"key":"pntd.0013548.ref003","article-title":"Persistent arthralgia and related risks factors in laboratory-confirmed cases of Chikungunya virus infection in Mexico","volume":"41","author":"E Murillo-Zamora","year":"2017","journal-title":"Rev Panam Salud Publica"},{"issue":"3","key":"pntd.0013548.ref004","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1007\/s12028-017-0413-8","article-title":"The range of neurological complications in chikungunya fever","volume":"27","author":"T Cerny","year":"2017","journal-title":"Neurocrit Care"},{"key":"pntd.0013548.ref005","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.jcv.2018.03.009","article-title":"Renal involvement in fatal cases of chikungunya virus infection","volume":"103","author":"M Mercado","year":"2018","journal-title":"J Clin Virol"},{"issue":"4","key":"pntd.0013548.ref006","doi-asserted-by":"crossref","first-page":"412","DOI":"10.3390\/pathogens11040412","article-title":"Ocular manifestations of chikungunya infection: a systematic review","volume":"11","author":"LCM da Silva","year":"2022","journal-title":"Pathogens"},{"key":"pntd.0013548.ref007","doi-asserted-by":"crossref","first-page":"390","DOI":"10.12688\/f1000research.11078.2","article-title":"Cardiovascular involvement and manifestations of systemic Chikungunya virus infection: a systematic review","volume":"6","author":"MF Alvarez","year":"2017","journal-title":"F1000Res"},{"issue":"2","key":"pntd.0013548.ref008","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.jcv.2009.06.027","article-title":"Systemic involvements and fatalities during Chikungunya epidemic in India, 2006","volume":"46","author":"BV Tandale","year":"2009","journal-title":"J Clin Virol"},{"key":"pntd.0013548.ref009","unstructured":"U.S. Food and Drug Administration. 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