Chikungunya Viral Arthritis Comes to the United States

Signs and Symptoms

 “The incubation period may be about five to seven days. Fever and joint pain are the most common symptoms. There may also be headache, rash, and muscle aches,” said Layden. Symptoms start abruptly, and the fever may be quite high. A maculopapular rash occurs in about 50% of cases. Some people may have lymphadenopathy, nausea, vomiting, and conjunctivitis.1,2

In most cases, symptoms will clear spontaneously in seven to 10 days.2 

“In about 5 to 10% of cases, joint pain and swelling may last for months or years. In these patients, the infection mimics rheumatoid arthritis, although there is no evidence that the infection triggers or becomes rheumatoid arthritis,” said Hamer.

Diagnosis and Treatment

Health care providers can diagnose CHIKV with direct detection of the virus using polymerase chain reaction (PCR) or serology detection of CHIKV IgM and IgG antibodies, but the tests may need to be sent to the CDC or to a state health department laboratory. [1,2] “PCR can detect the virus in the first few days. IgM and IgG can be detected after four to five days,” said Hamer.

“Treatment is supportive. With rest, fluids, and NSAIDs, most people will be better in seven to 10 days,” says Layden. CHIKV does not respond to any antiviral therapy. Although researchers have started to develop a vaccine, there is not one available at this time.1,2 “In areas where the infection has been common, doctors have used disease-modifying antirheumatic drugs for long-lasting joint symptoms,” added Hamer.