Chikungunya disease is transmitted by the Aedes mosquito and is common in Africa, India, Pakistan, Nepal, Guam, Southeast Asia, New Guinea, China, Mexico, South and Central America, islands in the Caribbean, Indian Ocean and Pacific, and limited areas of Europe. Limited local transmission has been identified in Florida, Puerto Rico, and the US Virgin Islands. Chikungunya virus is an alphavirus in the Togavirus family.
Symptoms and Signs of Chikungunya Disease
Chikungunya disease is an acute febrile illness followed by more chronic polyarthritis that can persist for months or years and be severe and disabling. Other symptoms may include headache, muscle pain, joint swelling, or rash. Death is extremely rare.
Diagnosis of Chikungunya Disease
Chikungunya disease is suspected in patients who live in or have traveled to endemic areas if they develop sudden fever and arthralgias.
Chikungunya virus RNA can be detected using RT-PCR. Serologic testing for virus specific IgM can be done for those presenting more than 7 days following onset of symptoms.
Dengue and Zika viruses are transmitted by the same mosquitoes and have similar clinical features as chikungunya disease and should be considered (Centers for Disease Control and Prevention (CDC): Chikungunya Virus). It is important to rule out dengue virus infection, because proper clinical management of dengue can improve outcome.
Treatment of Chikungunya Disease
Treatment of chikungunya disease is symptomatic. Treatment for symptoms can include rest, fluids, and use of analgesics and antipyretics. Nonsteroidal anti-inflammatory drugs can be used to help with acute fever and pain. However, in dengue-endemic areas, to reduce the risk of hemorrhage, acetaminophen is the preferred first-line treatment for fever and joint pain until dengue can be ruled out.
Prevention of Chikungunya Disease
Prevention of chikungunya disease involves avoiding mosquito bites. No vaccine is currently available.
The following English-language resource may be useful. Please note that THE MANUAL is not responsible for the content of this resource.
Centers for Disease Control and Prevention: Chikungunya Virus: For Healthcare Providers: Information on prevention, clinical presentation, diagnosis, and treatment
Pan American Health Organization/World Health Organization: Epidemiological Alert:Chikungunya increase in the Region of the Americas. 13 February 2023, Washington, D.C. PAHO/WHO 2023
Bartholomeeusen K, Daniel M, LaBeaud DA, et al: Chikungunya fever. Nat Rev Dis Primers 9(1):17, 2023. Published 2023 Apr 6. doi:10.1038/s41572-023-00429-2
Drugs Mentioned In This Article
|Drug Name||Select Trade|
|7T Gummy ES, Acephen, Aceta, Actamin, Adult Pain Relief, Anacin Aspirin Free, Apra, Children's Acetaminophen, Children's Pain & Fever , Comtrex Sore Throat Relief, ED-APAP, ElixSure Fever/Pain, Feverall, Genapap, Genebs, Goody's Back & Body Pain, Infantaire, Infants' Acetaminophen, LIQUID PAIN RELIEF, Little Fevers, Little Remedies Infant Fever + Pain Reliever, Mapap, Mapap Arthritis Pain, Mapap Infants, Mapap Junior, M-PAP, Nortemp, Ofirmev, Pain & Fever , Pain and Fever , PAIN RELIEF , PAIN RELIEF Extra Strength, Panadol, PediaCare Children's Fever Reducer/Pain Reliever, PediaCare Children's Smooth Metls Fever Reducer/Pain Reliever, PediaCare Infant's Fever Reducer/Pain Reliever, Pediaphen, PHARBETOL, Plus PHARMA, Q-Pap, Q-Pap Extra Strength, Silapap, Triaminic Fever Reducer and Pain Reliever, Triaminic Infant Fever Reducer and Pain Reliever, Tylenol, Tylenol 8 Hour, Tylenol 8 Hour Arthritis Pain, Tylenol 8 Hour Muscle Aches & Pain, Tylenol Arthritis Pain, Tylenol Children's, Tylenol Children's Pain+Fever, Tylenol CrushableTablet, Tylenol Extra Strength, Tylenol Infants', Tylenol Infants Pain + Fever, Tylenol Junior Strength, Tylenol Pain + Fever, Tylenol Regular Strength, Tylenol Sore Throat, XS No Aspirin, XS Pain Reliever|