Chikungunya Symptoms, Causes, Prevention and Treatment

What is chikungunya?

Chikungunya is a virus-borne disease or viral disease that is transmitted to humans by the bite of Aedes Aegypti mosquito and Aedes albopictus mosquito. Chikungunya can’t be transferred among humans through close contact or any other medium. It always requires vectors to transform the chikungunya virus from one person to another and mosquito are the most common vector for spreading the chikungunya virus.

The most common symptom of chikungunya fever is high fever and joint pain. The intensity of pain is very high during chikungunya fever.

Till now no vaccine or antiviral drug has been developed to treat chikungunya. All the treatment is focused to relieve the patient symptoms like high fever, joint pain, headache, nausea, fatigue, and rashes.

Where is Chikungunya found?

Chikungunya was first discovered in 1952 in southern Tanzania and now it has spread to more than 40 countries in Asia, Europe, America, etc. In most of cases, if you are affected by chikungunya your body develops antibodies against chikungunya and there are less chances to get infected with the chikungunya again.

Chikungunya is most common in areas that have poor management of mosquitos, receive huge rainfall, or are near the seashore. Deaths are very rare from chikungunya and are common when other health issues are associated with a person.

Earlier chikungunya patients were only found in Africa and Asia, but now almost half of the population lives in areas that are prone to chikungunya virus.

How is chikungunya spread?

Chikungunya virus can’t be transferred from one person to another directly and always require a vector or medium to transfer the virus. Chikungunya is mainly transmitted from person to another by Aedes mosquito species, mainly Aedes aegypti & Aedes albopictus. Both species are also responsible to transfer other viruses like Dengue, Typhoid, and Zika virus.

The female Aedes Aegypti is responsible for the transmission of chikungunya virus because she needs human blood for her eggs and metabolism.

When a mosquito bites any chikungunya-infected person, it picks up the virus in with in, and next when it bites the healthy person in transmits the virus into healthy person’s bloodstream. Once the virus enters the human body it can take up 3 days to 6 days to show symptoms.

If you have any viral infection especially Dengue, Typhoid, Chikungunya or Zika virus. Take preventive measures to avoid new mosquito bites to break the chain of viruses from yourself. In fact, avoid traveling when you are affected by this viral disease.

Other methods by which Chikungunya can transfer from person to person are-

Blood Transmission- When the blood of an infected person is transmitted to a healthy person.
During childbirth- If the mother is diagnosed with Chikungunya during childbirth it can transfer to a newborn baby.
Organ transplant- During organ transplant there are chances of viral transfer from an infected to a healthy body.

What are the signs & symptoms of chikungunya?

Once the mosquito bites a healthy person with an infected virus it takes up to 3 to 4 days to show up the chikungunya symptoms. Symptoms start from high fever, headache, and joint pain. Most people who are infected with the chikungunya virus will possess the symptoms up to 35% of people will show up the symptoms while other will remain asymptomatic.

The most common symptoms of chikungunya fever are below-

High Fever – A person affected by chikungunya fever gets a very high fever suddenly exceedingly more than 39 degree Celsius in most cases. It requires proper monitoring and fever medicines at regular intervals of time (usually after every 6 to 8 hours) to control the fever.
Joint and Muscle Pain — People infected with chikungunya fever get affected by multiple joint pains (arthralgia). The severity of joint pain can be very high and unbearable, and it can last up to several weeks or even months.
Muscle pain (myalgia) is also a common symptom of chikungunya fever and often combines with joint pain becoming very uncomfortable for the affected people. The severity of muscle pain can be high in some cases.
Rash—Many people develop flat, red spots or small bumps on the skin usually within 4 to 5 days after getting infected with the chikungunya virus. The rashes may last up to weeks in some cases or go away within a week once the virus is gone.
Headache – Episodic cluster headaches are experienced by the infected persons from chikungunya, the severity of pain can be moderate to high and headache episodes can be chronic in nature.
Fatigue – Patients infected with chikungunya fever also report weakness, fatigue, dullness, and malaise as common symptoms. These symptoms may persist even after other symptoms are resolved and can last up to a few weeks or months.
Swelling of Joints – Swelling of smaller joints especially hands, feet, ankles, wrists, and elbow is common in chikungunya fever and increase the severity of pain in joints.
Nausea & Vomiting

People at risk from chikungunya fever are new-born babies which are infected around the time of birth and old age group of people (above 50) who have developed other medical conditions like obesity, high blood pressure, diabetes, heart diseases, or AIDS etc.

Most of the people who are infected with chikungunya fever start feeling better within a week, and their recovery speeds up. Joint and muscle pain can last longer up to several months even after the virus is eliminated.

Death from chikungunya is very rare and is mostly reported when the person is suffering from any other illness.

What are the causes of chikungunya

Chikungunya is caused by chikungunya virus known as CHIKV. Chikungunya Virus or CHIKV is a single-stranded RNA virus.

This virus is primarily transferred to humans with a mosquito bite.

Note– An infected person can’t transmit the virus to another person directly even new-born babies do not get infected with the chikungunya virus during breastfeeding. The most important vector responsible for the transformation of viruses is the mosquito.

Female mosquito feed on an infected person and picks up the virus. Once the virus is withheld with a mosquito, it can be easily transferred to healthy humans upon biting.

Other methods by which chikungunya can be transmitted are

Vertical Transmission- During childbirth, an infected mother can transmit the virus to new-born baby also known as perinatal transmission.
Blood Transfusion- Infected person’s blood or its products can transmit the virus to another person during a blood transfusion.
Organ Transplantation – Organs of the infected person when transplanted to another person, such as liver, kidney, or corneas can transmit the virus.
Laboratory Exposure– Laboratory workers or health workers who are handling the samples of the CHIKV virus or caring for the infected person have a risk to get exposed to the virus and acquiring it such as accidental needlestick injuries, etc.

Diagnosis of Chikungunya

Diagnosis of chikungunya requires the physical examination of patients and laboratory testing to rule out the possibility of other viral fevers like Dengue, Typhoid, Malaria.

Your healthcare expert will ask you a few questions regarding your travel history, and a description of symptoms like joint pain, fever, etc. He/she will examine you physically to check the rashes etc. Once done your medical expert will collect your blood sample and will advise for the blood tests (laboratory testing)

Below are the steps to diagnose chikungunya –

Patient’s physical examination, Medical History, and Travel History

Your Medical advisor will enquire about your recent travel history to check if chikungunya is common over there and possible exposure to mosquitos. He will also perform a physical examination to measure fever, analysis of rashes, and inquire about muscle and joint pain on other complications or symptoms.

Blood Tests – Blood tests can help the diagnosis of chikungunya. Blood tests are used to find the presence of chikungunya virus-specific antibodies. Chikungunya virus antibodies normally start developing by the end of the first week of the illness.

ELISA (enzyme-linked immunosorbent assays) tests or RT-PCR are used to diagnose chikungunya.

It is important to perform laboratory testing (blood tests) for an accurate and definitive diagnosis of chikungunya as the symptoms are similar to other diseases like Dengue, Zika.

Clinical evaluation of patients and laboratory testing should be done by a qualified healthcare expert.

Prognosis of chikungunya

Most of individuals get fully recovered from the chikungunya infection and the prognosis of chikungunya is very good. However, duration of recovery and symptoms vary from person to person. Most people recover from chikungunya infection within several weeks or months but in some cases, people complain about lingering joint pains, muscle pains, or other symptoms.

It might take a few months or years to get rid of all symptoms especially if you are diagnosed with other medical conditions like diabetes, heart problems, blood sugar levels or if the age group is above 50.

It is important to note that few people or certain populations like new-born babies, pregnant women, and elderly individuals are at increased risk of developing severe complications from chikungunya. These people require regular monitoring and intensive care for a speedy recovery from Chikungunya virus.

Treatment of chikungunya

So far, there has been no specific vaccine has been developed to treat chikungunya because it is a viral infection caused by chikungunya virus (CHIKV).

Antibiotics are not effective in chikungunya virus. Treatment includes medications for the symptoms like high fever, joint pain, vomiting, etc.

Apart from medications below are the common approaches used to treat chikungunya –

Rest – Adequate rest & proper sleep is necessary for a speedy recovery and refuel energy. Proper rest also helps in the management of reducing joint pain and fatigue.
Pain Relief – Pain killer medicines like acetaminophen(paracetamol) and Non-steroidal anti-inflammatory drugs (NSAIDS) are used to manage the fever and relieve pain.

Note – Do not take aspirin or NSAIDS until dengue is ruled out because these drugs add the complications and can lead to risk of bleeding.

Hydration – Drinking plenty of water, ORS (oral rehydration Solution) and eating fluid rich fruits is necessary to increase the fluid count which is lost due to high fever, sweating and other symptoms.
Physical exercise or Physical therapy – Physical therapy or exercise is required in case of severe joint pain.
Preventing Mosquito bites.

Prevention Of chikungunya

As we know, there is no specific vaccine or drug to treat chikungunya. So it is necessary to follow preventive measure to avoid mosquito bites to lower the risk of chikungunya fever. Below are some of the common methods that can be used to prevent chikungunya virus—

If you are living in an area, which is prone to chikungunya, always wear long sleeves cloths, long pants and other clothes which cover the skin and have minimal exposure of the skin.
Use insect repellents inside the home and nearby surroundings regularly to kill mosquitos and avoid there further development.
Cover your bed with insecticide-treated mosquito nets while sleeping.
Always wear mosquito netting over your face and neck if you work in areas prone to mosquitos.
Try to avoid traveling to places which have chikungunya or any other virus outbreak.

Prevention of chikungunya primarily focuses on avoiding the mosquito bites which require reducing the population of mosquitos around you.

Below are some common methods to lower the risk of Mosquito bites

Eliminate or clean up the Mosquito breeding sites – Sites where mosquito breeds like standing water should be eliminated. If you have any water source near or within your house, make sure you are not having any standing water over them.
Use insect repellents such as DEET or other approved ingredients for skin and clothing.
Stay in well-screened areas or air-conditioned areas to reduce the risk of mosquito bites.
Seek immediate medical attention if you suspect you are diagnosed with chikungunya fever.

Frequently Asked Questions

Q1. What are the 5 symptoms of chikungunya?

Ans. Most common 5 symptoms of chikungunya are-

High Fever
Joint pain
Muscle pain
Headache
Nausea, Vomiting

Q2. Is chikungunya a serious disease?

Ans. Chikungunya is not life-threatening however, it can add complication if you have other medical history like diabetes, blood sugar levels, pneumonia etc. Young children, pregnant women, old age people are at higher risk of getting infected with chikungunya.

Q3. Can chikungunya be cured?

Ans. No effective vaccine has been developed so far to treat chikungunya virus only symptomatic treatment is carried out for patients.

Q4. Is chikungunya a communicable disease?

Ans. Chikungunya can be transmitted through a mosquito bite from an infected person to a healthy one. It can’t be transmitted directly by coming in contact with an infected person.

Q5. Which joint pain is experienced in chikungunya?

Ans. Pain in smaller joints like ankles, wrists, elbows, hips, etc is experienced during chikungunya and even after the viral is eliminated.

Q6. How much rest is required in Chikungunya?

Ans. Rest is an important factor in getting a speedy recovery from chikungunya. Rest up to 10 days or more is required to get fully recover from chikungunya.