What Is Chikungunya

What is chikungunya

The word chikungunya comes from an African language which means “to walk bent over”.¹ Chikungunya is a viral infection caused by the chikungunya virus, that is spread by mosquitoes. The symptoms usually appear after 3 to 7 days which can include headache, high fever, muscle ache, severe joint pain and rashes. The virus has affected people in countries around the world, including Asia, America, Africa, Europe, the Caribbean, and the Indian and Pacific Oceans.² While it is rarely life-threatening, and most people fully recover, some individuals might experience prolonged joint pain that can impact their quality of life. The most effective way to avoid chikungunya infection is to take preventive measures. You can protect yourself by wearing long-sleeved clothes, applying mosquito repellents and avoiding mosquito-prone areas.³ If you do get sick, rest and hydration are the keys to feeling better in due time.⁴

Causes

The chikungunya virus is spread by the bite of infected female mosquitoes belonging to the Aedes species Aedes aegypti and Aedes albopictus. The same species of mosquitoes are responsible for spreading the dengue and Zika viruses. They typically bite aggressively during the daytime.⁵

The chikungunya virus can be transmitted in two cycles:⁴

Urban transmission

This happens from human to mosquito to human. When a mosquito bites an infected person who has the chikungunya virus, it can pick up the virus. Then, when the mosquito bites someone else, it can transmit the virus to them. This is how the infection spreads. 

Sylvatic transmission 

This happens from animals to mosquitoes to humans. This is mainly found in Africa.

The chikungunya virus can be transmitted through blood. The infection can be passed on from mother to child, mostly during the second trimester.⁶ The risk of transmission is higher from the labour period to the placental (normal) delivery.⁷ The Chikungunya virus hasn't been detected in breast milk. So far, there haven't been any reported cases where babies contract the virus from breastfeeding. Since breastfeeding generally provides greater benefits to babies than the minimal risk of virus transmission, mothers should continue to breastfeed even if they are infected with the virus or live in areas where the virus is spreading.⁶

Signs and symptoms

Following a mosquito bite, the symptoms typically occur after 3 to 7 days (with a range of 2 to 12 days).³

The symptoms may include:⁸

• High fever
• Severe joint pain
• Rashes
• Headache
• Muscle pain
• Nausea 
• Fatigue

In some cases, the joint pain can be severe and extremely painful, lasting from weeks to several years.³ 

The people who are most at risk include:⁸

• Newborns who were infected during birth by their mother
• People over the age of 65 years
• People who suffer from medical issues such as diabetes, high blood pressure, and heart conditions.

The research suggests that if a person has recovered from the infection once, then they are unlikely to contract the infection again. The dengue, Zika, and chikungunya viruses are caused by the same mosquito species. The viruses often spread in the same area and can occasionally cause co-infections in the same patient.¹

Diagnosis

Clinical tests

The symptoms typically occur after a period of 3 to 7 days after being bitten by an infected mosquito. A person may experience high fever (usually > 102°F or 39°C), severe joint pain, muscle pain and rash.^{5 10} The symptoms of chikungunya are similar to zika or dengue viruses. Therefore, if a person does not experience severe joint pain, it may be misdiagnosed.³

Laboratory tests

Serology

Serological tests, such as enzyme-linked immunosorbent assays (ELISAs), can detect antibodies produced by the body's immune response to the chikungunya virus. These antibodies appear within the first week of infection and remain detectable in the body for about 2 months.¹²

Reverse transcription polymerase chain reaction (RT-PCR)

This test detects the presence of a virus in blood samples. It is most effective during the first few days of illness when the virus is actively replicating in the body. PCR tests can confirm the presence of the chikungunya virus and differentiate it from other similar viruses.³

Travel history

The Chikungunya virus is mainly prevalent in tropical and subtropical regions of the world. So it is important to tell your healthcare provider about your travel history, including the timing and locations of your travels. This aids in proper management and helps prevent the further spread of the infection.⁵

Management and treatment

• Symptomatic Treatment: Currently, there are no antiviral medicines or vaccines available for the treatment of chikungunya. The symptoms can be managed by providing supportive care. This may involve rest, drinking lots of fluids, and over-the-counter pain relievers like acetaminophen or paracetamol to reduce fever and ease joint pain. NSAIDs (non-steroidal anti-inflammatory drugs) like ibuprofen can also be used but with caution. Always consult your healthcare provider before consuming any drugs⁹
• Hydration: Patients should drink lots of fluids because fever and sweating can cause dehydration. Oral rehydration solutions, water, and clear fluids can help maintain hydration levels¹
• Rest: Rest is essential to allow the body to recover and fight the virus effectively¹
• Physical Therapy: The symptoms include severe joint pain which can cause discomfort and mobility issues. Physical therapy and gentle exercises can help to improve these conditions and reduce stiffness. However, it is important that these exercises be done under the guidance of a healthcare professional to avoid worsening the condition¹
• Avoid Mosquito Bites: Preventing further mosquito bites is crucial to prevent the spread of the disease. Using mosquito repellents, wearing long-sleeved clothing, and using bed nets can help minimise exposure to mosquitoes³ 
• Medical Consultation: If you suspect you have chikungunya or experience severe symptoms, it's essential to consult a healthcare professional for proper diagnosis and appropriate management. They can guide appropriate treatments based on the severity of your condition

FAQs

What are the 3 main symptoms of chikungunya?

The most common symptoms of chikungunya include severe joint pain and high fever (usually > 102°F or 39°C). Other symptoms may include muscle pain, rashes, headache, nausea and chronic fatigue.⁵

What are the main causes of chikungunya?

Chikungunya is a viral infection caused by the chikungunya virus that is spread by mosquitoes. The chikungunya virus is spread by the bite of infected female mosquitoes belonging to the Aedes species, notably Aedes aegypti and Aedes albopictus. The word chikungunya comes from an African language, meaning “to walk bent over”.¹

Is chikungunya a serious disease?

Most people who contract chikungunya can fully recover, but the elderly, young children and people with pre-existing health conditions may develop more severe symptoms and complications.⁸ In rare cases, chikungunya can lead to more serious complications such as chronic joint pain, neurological issues, and even death, although fatalities are quite uncommon.⁵ Prevention is crucial to avoiding chikungunya infection. This involves using mosquito repellents, wearing protective clothing, and eliminating mosquito breeding sites around your living environment. If you suspect you have chikungunya or are experiencing symptoms, it's essential to seek medical attention for proper diagnosis and management. As with any illness, the severity of the disease can vary from person to person, so it's best to consult with a healthcare professional if you have concerns.¹¹

What is chikungunya called in English?

The chikungunya virus was first discovered in 1952 on the Makonde Plateau in East Africa. The word “chikungunya” comes from the African language, meaning “that which bends up”, “to become contorted”, or “to walk bent over”.¹ This describes the condition one faces after suffering from severe joint pain, which makes it difficult to move. The virus has affected people in various countries around the world, including Asia, America, Africa, Europe, and the Caribbean, Indian and Pacific Oceans.²

Can chikungunya be cured?

Currently, there are no antiviral medicines or vaccines available for the treatment of chikungunya. The symptoms can be managed by providing supportive care. This may involve rest, drinking lots of fluids, and over-the-counter pain relievers like acetaminophen or paracetamol to reduce fever and ease joint pain. NSAIDs (non-steroidal anti-inflammatory drugs) like ibuprofen can also be used but with caution. Always consult your healthcare provider before taking any medication.⁵

Is chikungunya worse than dengue?

Dengue and chikungunya are different viral infections caused by separate viruses, but the same mosquito type, i.e. Aedes mosquito. Dengue fever results from the dengue virus, primarily transmitted by Aedes mosquitoes like Aedes aegypti. Its symptoms range from mild to severe and include high fever, headaches, joint and muscle pain, and potential bleeding issues. Chikungunya, on the other hand, results from the chikungunya virus, also transmitted by Aedes mosquitoes. Its symptoms, such as high fever, joint pain, muscle pain, and fatigue, resemble those of dengue, with a particular emphasis on severe and prolonged joint pain. Although transmitted by the same mosquito types, these infections can show distinct symptoms, with dengue showing bleeding tendencies and chikungunya exhibiting intense joint discomfort.¹⁰

Summary

Chikungunya is a virus transmitted by mosquitoes, particularly from the Aedes species; when a person becomes infected, they might experience symptoms like high fever, severe joint pain, muscle aches, and a rash. While it's not usually fatal, the joint pain can be quite intense and last for a while, affecting daily life. To avoid getting infected, it's essential to protect yourself from mosquito bites. This can be done by using mosquito repellent, wearing long sleeves and pants, and getting rid of places where mosquitoes breed. There is no specific medicine or vaccine for chikungunya, so treatment focuses on relieving the symptoms with rest, fluids, and pain relievers. Public health measures are crucial to prevent outbreaks and keep communities safe from this virus.