Mayaro virus: a forest virus primed for a trip to the city?

Mayaro virus (MAYV) is an emerging arthropod-borne virus (arbovirus). Infection by MAYV can produce Mayaro virus disease (MAYVD) which is usually a clinically diagnosed, acute, febrile illness associated with prolonged and painful joint inflammation and swelling. MAYVD may be clinically indistinguishable from dengue, chikungunya fever, malaria, rabies, measles or other arboviral diseases. The full spectrum of disease, sequelae, routes of infection, virus shedding and any rarer means of transmission remain undefined. MAYVD cases in humans have so far been localised to Central and South America, particularly regions in and around the Amazon basin. MAYV usually circulates in a sylvan cycle of forest mosquitoes and vertebrates, however it has also been found in more urban locations alongside anthropophilic (preferring humans) insect vectors. If transmission via anthropophilic mosquitoes becomes more efficient following viral change, or existing vectors change their habitat and biting habits, the risk of urban establishment and further spread into non-forested areas will grow. Surveillance, testing and vector control remain key to monitoring and preventing global spread and establishment. The possibility of MAYV becoming further urbanized is worthy of note, consideration and action to ensure MAYV does not spread beyond the forests and establish in the world's cities.