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Chikungunya

Chikungunya is a mosquito-borne disease due to infection by the chikungunya virus. Chikungunya is a word in Kimakonde, a language spoken in southeast Tanzania and northern Mozambique, where it was first recognized, meaning "to become contorted." It describes the posture of patients suffering from severe joint and muscle pains. The disease was first found in Africa and spread later to Asia, Europe, and the Americas. Chikungunya symptoms are similar to Dengue and Zika, making misdiagnosis common; an accurate diagnosis is essential if you think you may have the condition. There is no vaccine or medication specific to the virus causing chikungunya.

Transmission

The Chikungunya virus does not spread by direct human-to-human transmission. Its transmission modes are as follows.

1. Viral transmission occurs through a mosquito bite. When a mosquito bites an infected person, it carries the virus and passes it to a second uninfected person. Infected people should protect themselves from getting more mosquito bites to prevent more transmission.
2. In-utero transmission
3. Intrapartum transmission
4. Contact with infected blood in a lab.

In-utero viral transmission can occur during the second trimester but is rare. Intrapartum transmission during childbirth can happen if the mother is infected. However, she can continue breastfeeding without passing the virus through breast milk. Breastfeeding is highly encouraged even in the area with chikungunya outbreaks because its benefits outweigh the risk of infection.

Laboratory blood-borne transmission can occur if there is personnel exposure to infected blood.

Symptoms

After a bite by an infected mosquito, the incubation period takes 3–7 days before symptoms develop.

• Sudden high fever
• Joint pain and swelling
• Muscle pain 
• Headache and nausea
• Pink eyes
• Rash 

The symptoms usually resolve within one week, except joint and muscle pain which can be severe and persist for several months or years.

Usually, chikungunya does not cause severe conditions or death. However, if you have hypertension, diabetes, heart disease, or are 65 and above, you have an increased risk of severe symptoms.

When to seek medical care

Seek medical attention as soon as you develop the symptoms or think you may be infected, especially if you just returned from the area with ongoing viral outbreaks.  

Diagnosis

Your doctor will ask you if you have traveled to a viral outbreak area, do a physical exam, and order blood tests to check if you have chikungunya, dengue, or Zika viruses. 

Treatment

Currently, there is no medication specifically for the virus causing chikungunya. The best treatment is to rest and take drugs for symptom relief. 

• See a doctor to rule out dengue fever. If you have dengue fever, you cannot take aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) because they increase the risk of bleeding. 
• Take medications such as paracetamol and acetaminophen to lower fever and pain. 
• Protect yourself from getting new mosquito bites during the first week of chikungunya illness because infected mosquitoes can further spread the disease. 

Prevention

There is no vaccine to prevent chikungunya. Mosquito is the only vector that transmits the disease among humans. Avoiding getting a mosquito bite is the best protection especially if you travel to an area with known chikungunya outbreaks.

• Protect yourself by wearing a long-sleeved shirt and long pants. 
• Apply an insect repellent containing picaridin or DEET.
• Use mosquito netting.
• Get rid of stagnant water around where you live.
• Refrain from traveling to the area with chikungunya outbreaks if you are pregnant, have a medical condition such as hypertension, heart disease, or diabetes, or are 65 or older.

Article by
Dr Rapeephan R.Maude

A doctor specializing in infectious disease
Doctor profile