Chikungunya: time to change the paradigm of a non-fatal disease.

Since the initial description of the first human cases the chikungunya has been considered as a non-lethal virus. Since the emergence of the global virus in 2005, it has become increasingly common in the scientific literature to describe many cases of death, including in young people without preexisting diseases. In addition, it has been observed that in settings where, for some reason, death cases are not properly reported for epidemiological surveillance, it is possible to identify mortality due to chikungunya through the excess of deaths occurring during the period of chikungunya epidemics. Even so, international public health bodies still do not recognize in their official documents the importance of chikungunya as the cause of death. We believe it is necessary to review these positions and to increase investment in research to improve knowledge about the pathophysiology of severe forms and to review investment priorities in vaccines and other forms of chikungunya prevention.