Fever: The fever is Usually 102 to 105 °F (39 to 40. 5 °C) and typically lasts from three days up to one week. [4] X Research source Mohan A. et al. EPIDEMIOLOGY, CLINICAL MANIFESTATIONS, AND DIAGNOSIS OF CHIKUNGUNYA FEVER: LESSONS LEARNED FROM THE RE-EMERGING EPIDEMIC. Indian Journal of Dermatology. 2010 Jan-Mar; 55(1): 54–63. [5] X Research source The fever can be biphasic (where it disappears for a few days followed by a few days of a low-grade fever (101–102 °F or 38–39 °C). During this time, the virus accumulates in your bloodstream, spreading to different parts of the body. Arthritis (joint pain): You’ll usually notice arthritis in the small joints of the hand, wrist, ankles, and larger joints, like knees and shoulders, but not the hips. [6] X Research source Mohan A. et al. EPIDEMIOLOGY, CLINICAL MANIFESTATIONS, AND DIAGNOSIS OF CHIKUNGUNYA FEVER: LESSONS LEARNED FROM THE RE-EMERGING EPIDEMIC. Indian Journal of Dermatology. 2010 Jan-Mar; 55(1): 54–63. Up to 70% of people have pain that spreads from one joint to the next after the previous joint starts feeling better. [7] X Research source Information for Healthcare providers. Chikungunya fever. Pan American Health Organization. Jan 2014. The pain is usually worse in the morning, but improves with mild exercise. Your joints may also look swollen or feel tender to the touch and you may have inflammation of tendons (tenosynovitis). [8] X Research source Mohan A. et al. EPIDEMIOLOGY, CLINICAL MANIFESTATIONS, AND DIAGNOSIS OF CHIKUNGUNYA FEVER: LESSONS LEARNED FROM THE RE-EMERGING EPIDEMIC. Indian Journal of Dermatology. 2010 Jan-Mar; 55(1): 54–63. Joint pain usually resolves within one to three weeks, with severe pain improving after the first week. However, in some cases joint pain can continue for up to a year. Rash: Approximately 40% to 50% of patients experience a rash. The most common type is a morbilliform eruption (maculopapular). These are red rashes with small bumps overlying them that appear three to five days after the start of fever and subside within three to four days. The rash usually starts on the upper limbs followed by the face and trunk/torso. [9] X Research source Bandyopadhyay D, Ghosh S. MUCOCUTANEOUS MANIFESTATIONS OF CHIKUNGUNYA FEVER. Indian Journal of Dermatology. 2010 Jan-Mar; 55(1): 64–67. Look in the mirror with your shirt off and note any red bumpy areas over a wide area and whether they itch. Make sure to turn around to look at your backside, back of neck, and raise your arms to examine your underarms.
Raynaud’s phenomenon is a condition where there is decreased blood flow to the hands and feet in response to cold or stress on your body. Look at the tips of your fingers and note if they are cold and bluish/dark in color.
If you have underlying joint problems, like rheumatoid arthritis, you’re more prone to developing the chronic stage of chikungunya. [12] X Research source Mohan A. et al. EPIDEMIOLOGY, CLINICAL MANIFESTATIONS, AND DIAGNOSIS OF CHIKUNGUNYA FEVER: LESSONS LEARNED FROM THE RE-EMERGING EPIDEMIC. Indian Journal of Dermatology. 2010 Jan-Mar; 55(1): 54–63. Rheumatoid arthritis has been documented, rarely, after the initial infection. The average time of onset is around 10 months. [13] X Research source Bouquillard E, Combe B. A report of 21 cases of rheumatoid arthritis following Chikungunya fever. A mean follow-up of two years. Joint, Bone, & Spine Journal. 76 (2009) 654–657.
Myalgia (muscle/back pain) Headache Sore throat discomfort Abdominal pain Constipation Swollen lymph nodes in the neck
Leptospirosis: Notice if your calf muscles (the muscles behind your leg below your knees) ache or hurt when you walk. You should also look in the mirror to see if the white part of your eye is bright red (subconjunctival hemorrhage). This is caused by the eruption of tiny blood vessels. Recall if you were around farm animals or water since the contaminated animals can spread this disease in the water or soil. Dengue fever: Note if you came into contact with mosquitoes or have bites that occurred in tropical climates like Africa, South America, Central America, Caribbean, India and southern parts of North America. Dengue is more prevalent in these areas. Look in the mirror for bruising of the skin, bleeding or redness around the white of your eyes, bleeding from the gums of your mouth and repeated bloody noses. Bleeding is the biggest difference between dengue fever and chikungunya. Malaria: Note if you came into contact with mosquitoes or bites from known source areas such as South America, Africa, India, Middle East, and Southeast Asia. Pay attention to whether you feel cold and shiver, then have fevers and then sweating. This can last from six to 10 hours. You may experience relapses of these phases. Meningitis: Look for local outbreaks in highly congested areas or facilities. If you were in the area you may have gotten the disease. Check your temperature for a fever and note if you have neck stiffness or pain/discomfort when moving your neck. Severe headaches and feeling tired/confused may accompany the disease. You may also have a rash that consists of red, brown, or purple small dots that can become larger blotches or even blisters. This rash is commonly located on the trunk, legs, and on the palms and soles. Rheumatic fever: Rheumatic fever usually occurs after a streptococcal infection such as strep throat. It is not caused by mosquito bites. This happens more commonly in children five to 15 years old. Check your child for multiple joint pains that can migrate (as one joint gets better another joint hurts) and fever-like in chikungunya. But, noticeable differences in your child will be uncontrollable or jerky body movements (chorea); small, painless nodules under the skin; and a rash. The rash will be flat or slightly elevated with jagged edges (erythema marginatum) and will appear blotchy or circular with a darker pink ring and lighter area inside the ring. [15] X Research source Guidelines on clinical management of chikungunya fever. World Health Organization. October 2008.
Fever for more than five days or above 103 °F (39°C) Dizziness (possibly due to a neurological issue or dehydration) Cold fingers or toes (Raynaud’s) Bleeding from mouth or under skin (this can be Dengue) Rash Joint pain, redness, stiffness, or swelling Low urine output (this can be from dehydration that can lead to kidney damage)
Viral cultures will also look for growth. These are usually used within the first 3 days of illness, when the virus is rapidly growing. [18] X Trustworthy Source World Health Organization Health information and news provided by the World Health Organization Go to source [19] X Trustworthy Source Centers for Disease Control and Prevention Main public health institute for the US, run by the Dept. of Health and Human Services Go to source RT-PCR (reverse transcriptase polymerase chain reaction) methods use virus-specific gene coding proteins to replicate specific genes of chikungunya. If it is chikungunya, then the lab will see higher than normal chikungunya genes displayed on a computerized graph. [20] X Trustworthy Source World Health Organization Health information and news provided by the World Health Organization Go to source
Apply a cold pack to reduce pain and inflammation. You can use a bag of frozen vegetables, packaged steak, or an ice pack. Wrap the frozen back in a towel and apply it to painful areas. Avoid applying a frozen pack or ice directly to your skin, which could cause tissue damage.
If you have pre-existing liver or kidney issues consult your doctor before taking paracetamol/acetaminophen. Talk to your pediatrician or pharmacist for dosing for children. Do not take aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDS) like ibuprofen, naproxen, etc. Chikungunya can mimic other mosquito-borne diseases like dengue which can cause excessive bleeding. Aspirin and NSAIDS can thin your blood and increase the bleeding. Your doctor must rule out Dengue first. Your doctor may recommend NSAIDs for the joint symptoms after ruling out Dengue. If you have unbearable joint pain or no relief after your doctor has advised you to take NSAIDs, your doctor may prescribe you hydroxychloroquine 200 mg orally once a day or chloroquine phosphate 300 mg once per day for up to 4 weeks.
Sit on a chair. Extend one leg parallel to the floor and hold for 10 seconds before lowering your leg with the sole flat on the floor. Do the same with the other leg. Repeat this several times a day, doing two to three sets of 10 repetitions per leg. Try standing on your toes with both feet close together and place your heels up and down, up and down. Turn to your side. Raise one leg upwards for a second before bringing it down atop your other leg. Do this 10 times for that leg. Then, turn to the other side, and repeat. Do a set of 10 raises for each leg several times a day. You can also do your own low-impact aerobic exercise. The idea is not to do aggressive movements or use weights.
Be careful using antihistamines, as they can make you drowsy. Don’t drive or operate machinery after taking them. Soaking in a warm bath with added colloidal oatmeal can help soothe your skin. Persistent hyperpigmented spots can be treated with hydroquinone-based products. This will help whiten or lighten the spots. [23] X Research source Bandyopadhyay D, Ghosh S. MUCOCUTANEOUS MANIFESTATIONS OF CHIKUNGUNYA FEVER. Indian Journal of Dermatology. 2010 Jan-Mar; 55(1): 64–67. Since a variety of liquids and creams are available to treat skin irritation, you may want to ask your doctor’s advice about what to use.
Eupatorium perfoliatum 200C: This is the number one homeopathic remedy for chikungunya. It is a plant-based extract that you should use while experiencing the symptoms. It can relieve symptoms and joint pain. To use, take six drops at full strength for a month, while symptoms exist. Echinacea: This is a flower-based extract used to treat chikungunya symptoms by improving your immune system’s effectiveness. Take 40 drops a day, divided into three daily doses.
The chikungunya virus can invade heart tissue causing inflammation (myocarditis), which causes abnormal heart rhythms.
If you experience nerve damage starting from the legs or arms, you may have Guillain Barre syndrome. Look for decreased sensation, reflexes, and movement on both sides of your body. Also notice pain on both sides of the body that feels sharp, burning, numbness or pins and needles sensation. This can gradually progress higher up the body and potentially lead to breathing troubles from nerves that supply your respiratory muscles. [27] X Research source Lebrun G. et al. Guillain-Barré Syndrome after Chikungunya Infection. Journal of Emerging Infectious Diseases. 2009 Mar; 15(3): 495–496. If you have trouble breathing or any of the above symptoms, seek emergency care immediately. [28] X Research source Lebrun G. et al. Guillain-Barré Syndrome after Chikungunya Infection. Journal of Emerging Infectious Diseases. 2009 Mar; 15(3): 495–496.
If you have trouble seeing objects straight ahead (central vision) and if the colors of objects you see everyday look duller, you may have neuroretinitis. [29] X Research source Mohan A. et al. EPIDEMIOLOGY, CLINICAL MANIFESTATIONS, AND DIAGNOSIS OF CHIKUNGUNYA FEVER: LESSONS LEARNED FROM THE RE-EMERGING EPIDEMIC. Indian Journal of Dermatology. 2010 Jan-Mar; 55(1): 54–63.
If untreated, hepatitis can lead to liver failure.
Your doctor or emergency provider will perform more accurate lab tests and measurements to detect kidney function and give you IV fluids if you are dehydrated.
Walking or being outside after daylight hours. Though mosquitoes can bite anytime, peak chikungunya activity is during daylight hours. Wearing long sleeve clothing to protect your body as much as possible from mosquitoes. Try wearing light-colored clothing to easily detect mosquitoes and other bugs on your clothing. Sleeping in a bed/mosquito net at night to protect from mosquitoes while sleeping. Using repellents with more than 20% DEET. Other active ingredients to use include oil of eucalyptus, Picaridin, and IR3535. Generally the higher the active ingredient, the longer it works.
