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Chikungunya is a rare viral infection transmitted by the bite of an infected mosquito. It is characterized by a rash, fever, and severe joint pain (arthralgias) that usually lasts for three to seven days. Because of its effect on the joints, Chikungunya has been classified among the Arthritic Viruses. It primarily occurs in tropical areas of the world.
The early symptoms of Chikungunya include fever, headache, and joint pain (arthralgias) that may be so severe that they may be disabling. The knees, elbows, wrists, ankles, and/or fingers are generally effected. Joint pain increases with movement and is worse in the morning. However, it may take several weeks before the symptoms improve. Chikungunya is not associated with permanent joint damage.
Other symptoms may include abnormal sensitivity to light (photophobia), sore throat, lack of appetite (anorexia), and vomiting. Backache and rash on the face and neck are also common in people with Chikungunya. Occasionally the membranes that line the eyes may become inflamed (conjunctivitis) and lymph glands may become swollen (lymphadenopathy). The fever usually subsides before the 10th day.
Chikungunya is an infectious tropical disease caused by a virus that belongs to the group of A arboviruses. It is transmitted by various species of mosquitoes. Monkeys may also be infected with this virus. Some cases of this infection appear to have occurred through casual human to human contact, but it is not known how it is transmitted among humans.
Chikungunya is a viral disease that affects males and females in equal numbers. It primarily affects children and young adults in Africa, Southeast Asia, and India. A large outbreak of Chikungunya occurred in Tanganyika, Africa in 1953. This disorder is rare outside of tropical areas of the world.
Symptoms of the following disorders can be similar to those of Chikungunya. Comparisons may be useful for a differential diagnosis:
O'Nyong-Nyong Virus is an infectious disease that first appeared in Africa in the late 1950's. The symptoms are similar to those of Chikungunya and include fever, joint pain, and skin rashes. People with O'Nyong-Nyong Virus usually have swollen lymph nodes. Typically the fever is short in duration and the joint pain is mild.
Mayaro Virus is an infectious disease that first appeared in South America (Brazil and Bolivia). It is characterized by fever, chills, severe headache, muscle pain, and dizziness. Pain and swelling occur in the small joints, wrists, fingers, ankles, and/or toes. The symptoms are similar to those of Chikungunya.
Ross River Virus is an infectious disease characterized by fever, swollen painful joints, and skin rashes. It first occurred in Australia in 1928. Symptoms include headache, muscle pain, nausea, and vomiting. Some people may experience tenderness on the palms of the hands and soles of the feet. The knees are commonly swollen and painful. A skin rash typically begins on the cheeks and forehead and spreads to the trunk, arms, and legs.
The diagnosis of Chikungunya may be confirmed by a specialized blood test that detects immune responses to the virus (ELISA test). The symptoms of Chikungunya improve spontaneously after several weeks. There is no specific treatment. However, bed rest and antiinflammatory medications (i.e., ibuprofen) may be useful. As with other viral diseases, antibiotics are not effective in treating this disease.
Information on current clinical trials is posted on the Internet at www.clinicaltrials.gov. All studies receiving U.S. government funding, and some supported by private industry, are posted on this government web site.
For information about clinical trials being conducted at the NIH Clinical Center in Bethesda, MD, contact the NIH Patient Recruitment Office:
Tollfree: (800) 411-1222
TTY: (866) 411-1010
For information about clinical trials sponsored by private sources, contact:
Research is being conducted to develop a live attenuated vaccine that would protect against Chikungunya. For more information about these disorders, contact the World Health Organization (WHO) listed in the Resources section below.
Bennett JC, Plum F. Eds. Cecil Textbook of Medicine. 20th ed. W.B. Saunders Co., Philadelphia, PA; 1996:1806t, 1809.
Beers MH, Berkow R., eds. The Merck Manual, 17th ed. Whitehouse Station, NJ: Merck Research Laboratories; 1999:1304t.
Markoff L. Alphaviruses. In: Mandell GL, Bennett JE, Dolan R. Eds. Mandell, Douglas and Bennett's Principles and Practice of Infectious Diseases. 4th ed. Churchill Livingstone Inc. New York, NY; 1995:1455-59.
Khan aH, Morita K, Parquet Md Mdel C, et al. Complete nucleotide sequence of chikungunya virus and evidence for an internal polyadenylation site. J Gen Virol. 2002;83:3075-84.
Mackenzie JS, Chua KB, Daniels PW, et al. Emerging viral diseases of Southeast Asia and the Western Pacific. Emerg Infect Dis. 2001;7(3 Suppl):497:504.
Pile JC, Henchal EA, Christopher GW, et al. Chikungunya in a North American traveler. J Travel Med. 1999;6:137-39.
McClain DJ, Pittman PR, Ramsburg HH, et al. Immunological interference from sequential administration of live attenuated alphavirus vaccines. J Infect Dis. 1998;177:634-41.
Adebajo AO, Rheumatic manifestations of tropical diseases. Curr Opin Rheumatol. 1996;8:85-89.
McGill PE. Viral infections: alpha-viral arthropathy. Baillieres Clin Rheumatol. 1995;9:145-50.
Chikungunya Fever among U.S. Peace Corps Volunteers - Republic of the Philippines. MMWR Weekly. 1986;35:573-74.
FROM THE INTERNET
Chikungunya (S27): Alphavirus. nd. 9pp.
Tropical diseases: Chikungunya. nd. 1p.
Chikungunya Virus. nd. 1p.
Chikungunya fever: essential data. 1999:3pp.
Report last updated: 2009/05/11 00:00:00 GMT+0