Chikungunya Symptoms and Treatment

Chikungunya is an alphavirus infection. Its symptoms generally develop three to seven days after a bite but may occur in one to 12 days.

Most who are infected develop symptoms. In Dengue and other viruses, however, many (even half), do not develop symptoms. Some, possibly one in 10 (or fewer or more), do not have symptoms. 

Most develop a sudden high fever and joint pain. Pain often occurs in finger and toe joints that may feel like broken bones. Pain also occurs in knees, ankles, and lower back. Pain often occurs at sites of past injuries. 

Severe fatigue coupled with insomnia and muscle aches is common. Many find it difficult to get out of bed for days. Some have swollen lymph nodes, nausea, a rash (small bumps, oftentimes red).

In rare cases, a patient may have mouth ulcers, eye irritation, or even confusion (encephalitis) and difficulty breathing. There are a number of rare symptoms associated with the disease. There is a wide range in the severity of symptoms. The disease rarely results in death.

Those most vulnerable are the elderly, newborns infected at birth, and those with other diseases, such as diabetes or chronic kidney or heart problems. 

Some may be more vulnerable to other infections or medical disorders. They may develop new infections or worsened underlying medical concerns that require treatment.

Those who have been infected are likely to be free from future infections. However, some have symptoms persisting for months; others have symptoms come and go without having a new infection.

Most symptoms resolve in days or within one to two weeks, particularly for those who are younger. Fever often lasts only two to three days and ends abruptly.

Those who are younger are more likely to have short illnesses. For some, the disease lasts longer, with persistent or recurrent symptoms, especially joint aches, lasting months or even years.

The persistent disease is more common in those who are older, even over the age of 35 or 40. Those with more severe initial symptoms are more likely to have persistent symptoms. Chronic pain can affect mood in patients wanting to return to a pre-chikungunya quality of life.

Many diagnoses are based on clinical symptoms during an epidemic that often spreads explosively. However, other diseases, such as dengue, may be mistaken for chikungunya.

PCR and antibody testing can identify chikungunya (through the CDC if necessary in the US). Laboratory values showing low platelets should raise suspicion for dengue rather than chikungunya. 

There is no specific treatment. The CDC recommends rest, keeping hydrated, and controlling pain and fever with acetaminophen, ibuprofen, or naproxen. Some doctors have looked at other treatments for chronic arthritis.

Symptoms of other diseases, such as dengue, possibly malaria, or other illnesses that require treatment, may be mistaken for chikungunya. It is important to seek medical attention in this case. (Ibuprofen/Advil and Naproxen/Aleve should not be taken with Dengue.)

Sometimes chikungunya lasts and lasts. It feels like you've got it again and again. Once you're free of chikungunya, you aren't expected to get it again. What happens though is that Chikungunya can cause persistent or relapsing disease. There may be a virus that persists or continued pain from the initial joint inflammation. This may even happen after an individual has left an area with Chikungunya. It likely does not represent a new infection. Biopsies of those with the recurrent or persistent disease have sometimes shown the persistence of the virus in specific affected regions, such as muscle or joints.

There is hope for a vaccine— the vaccine is being studied (that has completed phase I trials) and appears promising. Hopefully, it will be available soon.