Chikungunya Fever Guide

What are the Symptoms of Chikungunya Fever?

Chikungunya typically starts with one or more of the following symptoms - chills, fever, vomiting, nausea, head ache and joint pain. The fever can reach upto 104 degree celsius. The attack is sudden and sometimes it is accompanied with rashes. Severe joint pain is the main and the most problematic symptom of Chikungunya. In some infections, no symptoms are seen and this behavior is seen predominantly in children.

After the mosquito bite it takes one to 12 days before the symptoms are seen. In many cases the only differentiating factor for symptoms is the acute joint pain. Some of the physical symptoms of Chikungunya include,

  • Redness in eye and difficulty in looking at light.
  • Severe fever with headache and joint pain.
  • Rashes may also appear usually on limbs and trunks.

Clinical Features in Chikungunya

Common Infrequent Seen in Children (Rare in Adults)
Fever
Arthralgia (joint pain)
Backache
Headache
Rash
Stomatitis (sore mouth)
Oral ulcers
Hyperpigmentation (skin spots)
Exfoliative dermatitis (peeling of skin)
Photophobia
Retro-orbital pain
Vomiting
Diarrhoea
Meningeal syndrome
Acute encephalopathy

Chikungunya symptoms are similar to diseases such as Dengue, Malaria and Leptospirosis and hence misdiagnosis can occur in areas where chikungunya is not common. Chikungunya was known as Dengue fever for a long time. When it comes to symptoms, there is little difference between Chikungunya and Dengue. In some patients, symptoms of Chikungunya may persist for years.

Diagnosis of Chikungunya

Chikungunya is diagnosed by ELISA blood test. Blood test is the only reliable way to identify Chikungunya since the symptoms are similar to much more deadly dengue fever. Also co-occurance of these diseases are seen in many places.

Chikungunya is confirmed when symptoms such as fever and joint pain seen along with one of the following,

  • Four fold HI(Haemagglutination Inhibition) antibody difference in paired serum samples. This turns positive within 5 to 8 days of infection.
  • Detection of IgM antibodies. These antibodies persist upto 6 months of infection, but currently there is no commercial tests available.
  • Virus isolation from serum.
  • Detection of virus nucleic acid in serum by RT-PCR. This needs to be conducted within 5 days of infection.

WHO Criteria for Chikungunya Diagnosis

  1. Clinical criteria: acute onset of fever >38.5°C and severe arthralgia/arthritis not explained by other medical conditions.
  2. Epidemiological criteria: residing or having visited epidemic areas, having reported transmission within 15 days prior to the onset of symptoms.
  3. Laboratory criteria: at least one of the tests mentioned above.

Next : Treatment of chikungunya fever