Chikungunya Virus: What Do You Need To Know?

Chikungunya is a viral infection transmitted to humans by the bite of infected mosquitoes, particularly Aedes aegypti and Aedes albopictus [1]. The name “Chikungunya” means “to become contorted” in the Makonde language, referring to the bent posture resulting from severe joint pain [1]. The disease is caused by the chikungunya virus (CHIKV), an alphavirus belonging to the Togaviridae family [2].

Chikungunya has caused major outbreaks in Africa, Asia, Europe, and the Americas, with the first documented case in 1952 in Tanzania [1]. It is important to note that Chikungunya is not spread from person to person through direct contact, saliva, or airborne droplets [1].

Where is Chikungunya Prevalent?

Chikungunya is commonly found in tropical regions of Africa and Asia, where it has become a significant public health problem [1]. Endemic areas include parts of India, Southeast Asia, and several African countries. In recent years, outbreaks have occurred in temperate regions, such as Europe and the Americas, primarily due to the spread and colonisation of Aedes mosquitoes in these areas [1]. According to the World Health Organization (WHO), CHIKV has been detected in over 110 countries across Asia, Africa, Europe, and the Americas [1].

Chikungunya Causes

Chikungunya is primarily caused by the chikungunya virus (CHIKV), which is transmitted through Aedes mosquitoes. Environmental factors and regions where these mosquitoes thrive significantly influence the spread of the virus.

1. Mosquito-Borne Virus

The virus is transmitted when an infected Aedes mosquito bites a human. During outbreaks, infected humans serve as the primary reservoir for the virus [1]. The mosquito itself becomes infected by feeding on a viremic (virus-containing) person, completing the cycle of transmission.

2. Environmental Factors and Regions

Aedes mosquitoes, primarily Aedes aegypti and Aedes albopictus, are responsible for transmitting diseases such as dengue and chikungunya. These mosquitoes breed in stagnant water and are most active during the day [3]. Regions with warm climates and high humidity, such as parts of Africa, Asia, and the Indian subcontinent, are particularly susceptible to outbreaks [1].

3. Other Factors

• Similar Viruses: Dengue, Zika, and Chikungunya share the same mosquito vectors and overlapping symptoms, which can complicate initial diagnosis [4].
• Blood Transmission: Rarely, CHIKV can be transmitted through blood exposure in clinical or laboratory settings, though this is uncommon [5].
• Mother-to-Child Transmission: Vertical transmission can occur, especially during delivery, and may result in severe neonatal illness, including fever, rash, and meningoencephalitis (inflammation of the brain and its surrounding membranes) [5].

Symptoms of Chikungunya

The most common symptoms of chikungunya include an abrupt onset of fever and severe joint pain [1]. Additional symptoms may involve headaches, vomiting, nausea, back pain, and skin rashes. Chikungunya symptoms can be divided into two stages: acute and chronic. Let’s delve into each stage in detail.

1. Acute Stage

Symptoms usually begin between 3–7 days after a mosquito bite [1]. The acute phase lasts up to 10 days and is characterised by:

• High fever >39°C [1]
• Severe joint pain and swelling, especially in wrists, fingers, ankles, and knees [1]
• Headache, muscle pain, fatigue, and nausea
• Maculopapular rash, often on the face and trunk [5]
• Gastrointestinal symptoms such as vomiting or diarrhoea
• Short-term confusion in elderly patients

The fever often resolves within a week, but joint symptoms may persist for several weeks [5].

Chikungunya’s high fever is a key symptom that is also commonly observed in viral fevers. If you are experiencing such symptoms, it’s crucial to seek medical attention to obtain a correct diagnosis, as symptoms overlap with other serious mosquito-borne diseases like Dengue.

2. Chronic Stage

Up to 60% of patients may experience joint pain lasting weeks to months, especially older adults and those with pre-existing joint disease [6].

• Chikungunya-associated arthritis is the most common chronic manifestation [5]
• Difficulty walking or using hands due to joint inflammation
• Fatigue and depression may also be present

Diagnosis of Chikungunya

1. Blood Test

The standard way for a lab to diagnose a virus is to test blood for the virus, viral RNA (genetic material), virus-specific immunoglobulin (Ig) M, and virus-neutralising antibodies [7].

A viral culture may identify the virus during the first three days of sickness. Viral RNA can often be detected in serum using a reverse transcription-polymerase chain reaction (RT-PCR) test during the acute phase of illness [1]. So, patients whose samples were taken during the acute phase and came back negative for antibodies should have samples taken during the convalescent phase (the later stage of an infectious disease or illness) to rule out the diagnosis [7].

Some of the lab findings often seen are:

• Leukopenia: A decrease in the number of white blood cells in the blood [5].
• Mild Thrombocytopenia: Deficiency of platelets in the blood [5].
• A slight increase in C-reactive protein (CRP) levels [5]: This occurs in response to inflammation in the body.
• Hepatic Cytolysis: An elevation in liver enzymes [5].
• Lymphopenia: Occurs when your blood does not contain enough white blood cells, specifically lymphocytes [5].

2. Physical Exam

• Joint swelling, tenderness, and stiffness are noted [5].
• While not routine for diagnosis, X-rays may reveal joint space narrowing or erosions in the chronic stage [5].
• Similarly, MRI can detect early inflammatory changes in chronic arthritis cases [5].

Treatment of Chikungunya

Currently, there is no specific antiviral medicine to kill the chikungunya virus. Treatment mainly focuses on supportive care—relieving symptoms and helping the body recover [1]:

• Fever and Pain Relief: Doctors usually recommend paracetamol (acetaminophen) to reduce fever and joint pain. It is critically important that aspirin and other Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), like ibuprofen, should be avoided until dengue fever is definitively ruled out due to the serious risk of bleeding complications [1].
• Rest and Hydration: Getting enough rest and drinking plenty of fluids are essential for recovery [1].
• Joint Pain Management: In some individuals, joint pain can persist for weeks or months. Healthcare providers may prescribe anti-inflammatory medicines or other treatments to manage this pain safely, especially in the chronic phase after a diagnosis is confirmed [5].

Always consult a doctor before taking any medication, especially if you have other health conditions or if there is any doubt about the diagnosis.

Prevention of Chikungunya

No Vaccine Available: Currently, there is no commercially licensed vaccine available for Chikungunya [8]. Prevention focuses entirely on mosquito control and personal protection [1].

1. Preventive Measures

• Avoid travel to outbreak areas, if possible [1].
• Eliminate stagnant water in containers, drains, and tyres (potential mosquito breeding sites) [1].
• Use mosquito nets, window screens, and air conditioning [1].
• Apply approved mosquito repellents (containing DEET, picaridin, or IR3535) as directed on the label [1].
• Wear long-sleeved clothing [1].
• Use permethrin-treated clothing and gear when outdoors [1].

2. Wear Protective Clothing

• Cover up with long sleeves and pants.
• Wearing loose-fitting clothes may help reduce skin exposure.
• When you go outside in the morning or evening (when Aedes mosquitoes are most active), wear clothes treated with permethrin.
• Permethrin is an insecticide used to treat clothing, shoes, bed nets, and camping gear to kill or repel insects such as mosquitoes and ticks [1].
• Use insect and mosquito repellents.

Chikungunya is a debilitating mosquito-borne illness with no specific antiviral treatment. While most patients recover within weeks, a significant number may suffer from persistent joint pain. Early diagnosis, supportive care, and prevention of mosquito bites remain the cornerstones of managing the disease. If you suspect you may have Chikungunya, consult your doctor for appropriate tests and care.

Frequently Asked Questions (FAQs)

How long does the chikungunya virus stay in the body?

The chikungunya virus usually clears from the blood (viremia) within about 7 to 10 days after symptom onset [5]. However, antibodies remain in the body for months, which helps confirm past infection.

Can chikungunya cause death?

Death from chikungunya is rare [1]. Severe illness is more likely in older adults, newborns, and people with underlying chronic health conditions such as diabetes, hypertension, or weakened immunity [1].

Is chikungunya similar to dengue?

Both are mosquito-borne viral infections spread by Aedes mosquitoes. Chikungunya often causes intense and longer-lasting joint pain (arthralgia), while dengue is more commonly linked with low platelets, bleeding, and risk of complications like shock [4].

What is a chikungunya PCR test?

A chikungunya PCR test is a diagnostic method that detects the genetic material (RNA) of the chikungunya virus in a patient’s blood. This test helps confirm the presence of the virus during the early (acute) stages of infection when the virus is circulating in the blood [1].

How many days does chikungunya last?

Chikungunya symptoms, such as fever and acute joint pain, typically last for 7 to 10 days. However, persistent joint pain and fatigue can last for weeks to months in some cases [6].

What is the fastest way to cure chikungunya at home?

There is no specific cure for chikungunya [1]. The fastest way to manage symptoms at home involves plenty of rest, staying hydrated, and taking pain relievers such as acetaminophen (Paracetamol) to alleviate fever and joint pain. Supportive care helps alleviate symptoms until the body recovers.

Can Chikungunya be transmitted from person to person?

No, chikungunya cannot be transmitted from person to person through casual contact, saliva, or airborne droplets [1]. It is primarily spread through the bites of infected Aedes mosquitoes.

What is a Chikungunya rash?

A chikungunya rash is a common symptom that appears as maculopapular (flat or slightly raised) red spots or blotches on the skin of the face and trunk. It typically occurs in conjunction with fever and joint pain during the course of the infection [5].

Can we eat eggs during Chikungunya?

Yes, you can eat eggs during chikungunya. Eggs are a good source of protein and nutrients that can support the body’s recovery and are safe to consume unless a patient has a pre-existing egg allergy.

What is Chikungunya supportive therapy?

Chikungunya supportive therapy involves managing symptoms with rest, hydration, and pain relievers like acetaminophen. There is no specific antiviral treatment, so supportive care focuses on alleviating fever, joint pain, and other symptoms [1].

Can Chikungunya cause long-term health issues?

Yes, chikungunya can cause long-term health issues. Some patients experience persistent joint pain, arthritis, and fatigue for months or, in rare cases, years after the acute phase of the infection has resolved [6].

Is there a vaccine for Chikungunya?

Currently, there is no commercially approved and widely available vaccine for chikungunya [8]. Prevention focuses on avoiding mosquito bites and controlling mosquito populations to prevent the transmission of diseases.

References

[1] World Health Organization. (2024, February 21). Chikungunya. Retrieved November 2, 2025, from https://www.who.int/news-room/fact-sheets/detail/chikungunya

[2] Freppel, W., Silva, L. A., Stapleford, K. A., & Herrero, L. J. (2024). Pathogenicity and virulence of chikungunya virus. Virulence, 15(1). https://doi.org/10.1080/21505594.2024.2396484

[3] Centers for Disease Control and Prevention. (2024, May 22). Chikungunya Virus Transmission. Retrieved November 2, 2025, from https://www.cdc.gov/chikungunya/transmission/index.html

[4] Ojeda Rodriguez, J. A., Haftel, A., & Walker, I. I. I. (2021). Chikungunya Fever. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK534224/

[5] Peters, K. (2024, February 13). Chikungunya: Clinical Presentation and Treatment. Retrieved November 2, 2025, from https://www.uptodate.com/contents/chikungunya-clinical-presentation-and-treatment

[6] Simon, F., Constant, S., Murall, C., & Tricou, V. (2024). Persistent joint pain after Chikungunya virus infection: A meta-analysis. PLoS Neglected Tropical Diseases, 18(4). https://doi.org/10.1371/journal.pntd.0012173

[7] Centers for Disease Control and Prevention. (2024, May 22). Chikungunya Virus Diagnosis. Retrieved November 2, 2025, from https://www.cdc.gov/chikungunya/geo/diagnosis.html

[8] European Centre for Disease Prevention and Control. (2024, October 28). Chikungunya – Annual Epidemiological Report 2024. Retrieved November 2, 2025, from https://www.ecdc.europa.eu/en/publications-data/chikungunya-annual-epidemiological-report-2024