Infectious Diseases Travelers' Health Chikungunya Symptoms and Treatment By Megan Coffee, MD twitter linkedin Megan Coffee, MD, PhD, is a clinician specializing in infectious disease research and an attending clinical assistant professor of medicine. Learn about our editorial process Megan Coffee, MD Medically reviewed by Medically reviewed by Anju Goel, MD, MPH on September 08, 2020 linkedin Anju Goel, MD, MPH, is a board-certified physician who specializes in public health, communicable disease, diabetes, and health policy. Learn about our Medical Review Board Anju Goel, MD, MPH on September 08, 2020 Print 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 affected individuals (as much as half), do not develop symptoms. Some, possibly one in 10 (or fewer or more), do not have symptoms. James Gathany / CDC 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 people have swollen lymph nodes, nausea, or 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, but 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 people with dengue 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 protected from future infections. However, some people have symptoms persisting for months, while others have symptoms come and go without having a new infection. How Long Does It Last? 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 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. Diagnosis 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. Polymerase chain reaction, or 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. Treatment 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 used for chronic arthritis. Symptoms of other diseases, such as dengue, malaria, or other illnesses that require treatment, may be mistaken for chikungunya. It is important to seek medical attention in this case. Advil (ibuprofen) and Aleve (naproxen) 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. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Cunha RVD, Trinta KS. Chikungunya virus: clinical aspects and treatment - a review. Mem Inst Oswaldo Cruz. 2017;112(8):523–531. doi:10.1590/0074-02760170044 Centers for Disease Control and Prevention. Chikungunya virus: symptoms, diagnosis, & treatment. Updated December 17, 2018. Prince HE, Seaton BL, Matud JL, Batterman HJ. Chikungunya virus RNA and antibody testing at a National Reference Laboratory since the emergence of Chikungunya virus in the Americas. Clin Vaccine Immunol. 2015;22(3):291-7. doi:10.1128/CVI.00720-14 Ozden S, Huerre M, Riviere JP, et al. Human muscle satellite cells as targets of Chikungunya virus infection. PLoS ONE. 2007;2(6):e527. doi:10.1371/journal.pone.0000527 Chang LJ, Dowd KA, Mendoza RN, Saunders JG, Sitar S, Plummer, NP. Safety and tolerability of chikungunya virus-like particle vaccine in healthy adults: a phase 1 dose-escalation trial. The Lancet. 2014:384(9959). doi:10.1016/S0140-6736(14)61185-5