Chikungunya is a viral infection spread by the same daytime-biting mosquito as dengue. Its defining feature is severe joint pain, which can continue for weeks or months after the fever has gone.
Overview
Chikungunya is caused by a virus carried by Aedes mosquitoes — the same mosquitoes that spread dengue, biting mainly during daylight hours. Outbreaks of both often happen in the same place at the same time.
The name comes from a word meaning 'to become contorted', describing the stooped posture of people bent over with joint pain.
Compared with dengue, chikungunya rarely causes life-threatening illness. What it does cause is joint pain severe enough to stop people working, and that pain can persist long after the infection has cleared.
There is no specific antiviral medicine. Treatment supports the body and manages pain.
Symptoms of Chikungunya
- Sudden high fever
- Severe joint pain, typically in the hands, wrists, ankles and feet, and usually on both sides of the body
- Swelling of the affected joints
- Muscle pain and headache
- Skin rash, often a few days after the fever begins
- Marked tiredness
- Joint pain and stiffness that can carry on for weeks or months after recovery
What causes it
- Infection with the chikungunya virus
- Spread by the bite of an infected Aedes aegypti or Aedes albopictus mosquito, which bite mostly in daylight
- These mosquitoes breed in clean water collected in and around homes
- It does not spread directly from person to person
Who is at higher risk
- Living in or visiting an area with an ongoing outbreak
- The monsoon and post-monsoon months
- Water collecting in pots, coolers, tyres, tanks and plant trays around the house
- Older adults and people with existing joint disease tend to have longer-lasting pain
Tests and diagnosis
These are the tests doctors commonly use. Which ones you need depends on your symptoms.
- RT-PCR test, most useful in the first week of illness
- IgM antibody test, useful from about day five onwards
- Complete blood count — helps distinguish it from dengue, where the platelet drop is usually more pronounced
- Doctors often test for dengue at the same time, because the two look alike early on and are managed differently
Treatment
- There is no specific antiviral medicine. Treatment focuses on rest, fluids and pain relief.
- Paracetamol is normally used first for fever and pain.
- Aspirin and ibuprofen-type painkillers are usually avoided until dengue has been ruled out, because of the bleeding risk in dengue. Once dengue is excluded, a doctor may add other painkillers for the joint pain.
- Gentle movement and light stretching help stiff joints. Complete rest for weeks tends to make stiffness worse.
- Cold or warm compresses on painful joints give some relief.
- If joint pain continues beyond a few weeks, see a doctor — longer-term treatment and physiotherapy can help.
Prevention
- Empty, scrub, cover or dry water containers once a week to stop mosquitoes breeding
- Use repellent during the day, since these mosquitoes bite in daylight
- Wear full-sleeved clothing and use mesh screens
- Keep coolers, overhead tanks and plant trays free of standing water
- Protect people who are already ill from further bites, which reduces spread to others
When should you see a doctor?
See a doctor for fever with severe joint pain, particularly during an outbreak, so that dengue can be tested for at the same time. Seek care promptly if you cannot keep fluids down, if you develop bleeding, or if joint pain and swelling continue for more than a few weeks.
Frequently Asked Questions
How is chikungunya different from dengue?
Both start with sudden fever from the same mosquito. Chikungunya is dominated by severe joint pain and swelling that can last months, while dengue is dominated by pain behind the eyes and body ache, and carries a risk of a dangerous drop in blood pressure. Dengue is more likely to become life-threatening. A blood test tells them apart.
How long does chikungunya joint pain last?
The fever usually settles within a week. Joint pain improves within a few weeks for most people, but a meaningful number have pain and stiffness for several months. This is well recognised and does not mean anything has gone wrong.
Can you get chikungunya twice?
It is uncommon. Infection is generally believed to give long-lasting protection against the virus.
Should I rest completely until the joint pain goes?
No. Gentle movement and light stretching usually help joints recover, while long periods of complete rest tend to increase stiffness. Ask your doctor what level of activity suits you.
Questions to ask your doctor about Chikungunya
Pick the three that matter most to you and write them down before your appointment. Consultations are short, and almost everyone forgets at least one.
- Has dengue been ruled out?
- How long should I expect the joint pain to last?
- What can I safely take for the joint pain?
- Should I rest or keep moving?
- At what point should I come back about the joints?