What Causes Chikungunya?

Chikungunya is a mosquito-borne viral disease transmitted primarily by the Aedes aegypti and Aedes albopictus mosquitoes—the same vectors responsible for dengue and Zika.

It is endemic in parts of Africa, India, Pakistan, Nepal, Guam, Southeast Asia, New Guinea, China, Mexico, Central and South America, the Caribbean islands, the Indian Ocean, and the Pacific Islands. Limited local transmission has also been documented in Florida, Puerto Rico, and the U.S. Virgin Islands.

The disease is caused by the Chikungunya virus (CHIKV), an alphavirus belonging to the Togaviridae family.

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Symptoms of Chikungunya

Chikungunya presents as an acute febrile illness, followed by chronic polyarthritis or polyarthralgia, which can persist for months or even years, often becoming severe and disabling.

Other symptoms may include:

• Headache

• Muscle pain

• Joint swelling

• Skin rash

Rarely, cases of primary lymphoma have been reported in association.

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Diagnosis

Doctors should suspect Chikungunya in patients who develop sudden fever and joint pain after living in or traveling to endemic regions.

• Laboratory confirmation can be done by detecting CHIKV RNA using RT-PCR.

• After 7 days of symptom onset, serologic tests for anti-CHIKV IgM antibodies can also be performed.

Because dengue virus and Zika virus share the same mosquito vectors and overlapping clinical features, they must be considered in the differential diagnosis. Importantly, ruling out dengue is essential, as proper management of dengue can significantly improve outcomes.

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Treatment

Currently, there is no specific antiviral treatment for Chikungunya. Management is primarily supportive and symptom-based:

• Rest and adequate hydration

• Antipyretics and pain relievers (acetaminophen preferred in dengue-endemic areas to minimize bleeding risk)

• Nonsteroidal anti-inflammatory drugs (NSAIDs) may help reduce fever and joint pain but should be used cautiously until dengue has been excluded

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Prevention

Prevention of Chikungunya focuses on reducing mosquito bites and vaccination.

• Vector control: Use mosquito repellents, bed nets, and eliminate standing water where mosquitoes breed.

• Vaccination: In 2023, the U.S. Food and Drug Administration (FDA) approved the first Chikungunya vaccine for individuals aged 18 years and older who are at high risk of exposure—such as international travelers and laboratory workers.

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✅ In summary: Chikungunya is a mosquito-borne disease with potentially long-lasting joint complications. While there is no cure, supportive care, prevention of mosquito bites, and now vaccination play critical roles in reducing the disease burden.