Chikungunya

Chikungunya virus was originally an African illness and means ‘that which bends up” in the Makonde language of East Africa. For many years chikungunya was confined mainly to Africa but in the last decade has exploded through Asia and is now moving thru from the Caribbean to Central and South America.

1. The incubation period of chikungunya disease ranges from 2-12 days, typically 3-7days.
2. Symptoms include sudden onset of a fever, typically lasting from a few days to a week, sometimes up to ten days, usually above 39°C and sometimes reaching 40°C (104°F).
3. The fever is associated with severe joint pain or stiffness. A maculopapular (red bumps) rash, muscle pain, headache, fatigue, nausea or vomiting may also be present. Inflammation of the eyes occurs in some.
4. Typically, fever lasts for two days and then ends abruptly but may be biphasic (resolves and then returns later). Headache, insomnia and an extreme degree of prostration (feeling wiped out and requiring bedrest) last for a variable period, usually about 5-7 days.
5. The severity of joint complaints in chikungunya may be severe and may persist for weeks, months or years in some individuals. The French have found that 80-90% of patients have some joint complaints at 3 months and 5% develop chronic joint complaints that persist for years.

Deaths from chikungunya mainly occur in elderly individuals with comorbid illness. The one group to be concerned about are pregnant women who may transmit chikungunya to their infant if they become infected just before giving birth, this has caused a small number of deaths in infected neonates.