Chikungunya is a viral illness transmitted to humans primarily through mosquito bites. The name “chikungunya” originates from the Kimakonde language of southern Tanzania, meaning “to bend up,” which describes the stooped posture often adopted by individuals suffering from severe joint pain, a hallmark symptom. It is caused by the chikungunya virus (CHIKV), an RNA virus belonging to the alphavirus genus of the family Togaviridae.
How Chikungunya Spreads
Chikungunya virus is primarily transmitted to humans through the bite of infected female mosquitoes, most commonly Aedes aegypti and Aedes albopictus. These mosquitoes acquire the virus by feeding on an infected person. The virus then replicates within the mosquito, making it capable of transmitting the virus during subsequent bites.
Aedes aegypti and Aedes albopictus mosquitoes bite primarily during daylight hours, with peak activity in the early morning and late afternoon. While mosquito bites are the main mode of transmission, human-to-human transmission is not typical through direct contact. However, rare cases of transmission from mother to child during birth, particularly when the mother is viremic around the time of delivery, have been documented.
Recognizing Chikungunya Symptoms
Symptoms usually appear 3 to 7 days after being bitten by an infected mosquito, though this can range from 2 to 12 days. The most common symptoms are a sudden onset of high fever, often reaching 102-104°F (39-40°C), and severe joint pain, known as arthralgia. This joint pain can affect wrists, ankles, fingers, toes, and knees, and can be so intense that it significantly limits mobility.
Other common symptoms include muscle pain, headache, nausea, fatigue, and a rash. The rash appears as red spots on the face, trunk, and limbs, sometimes with itching. While acute symptoms generally resolve within 7 to 10 days, the severe joint pain can persist for weeks, months, or even years in some individuals, becoming a chronic condition. Severe complications are uncommon, but can occur in newborns, older adults, or those with underlying medical conditions like high blood pressure, diabetes, or heart disease. Death from chikungunya is rare.
Treatment and Prevention of Chikungunya
Currently, there is no specific antiviral treatment or vaccine widely available for chikungunya. Clinical management focuses on supportive care to relieve symptoms. Rest, adequate fluid intake, and over-the-counter pain relievers are recommended. Acetaminophen (paracetamol) is often suggested to reduce fever and pain.
It is important to avoid aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen until dengue can be ruled out, especially in areas where both viruses circulate. These medications can increase the risk of bleeding in dengue patients. For persistent joint pain, nonsteroidal anti-inflammatory drugs, topical corticosteroids, and physical therapy may be considered.
Preventing mosquito bites is the most effective way to avoid chikungunya infection. This includes:
Using EPA-registered insect repellents on exposed skin.
Wearing long-sleeved shirts and pants to reduce skin exposure.
Using mosquito nets while sleeping and ensuring windows and doors have screens.
Eliminating standing water around homes, which serves as mosquito breeding sites.
Where Chikungunya is Found
Chikungunya is widespread in tropical and subtropical regions, where warm climates and abundant populations of its mosquito vectors, Aedes aegypti and Aedes albopictus, facilitate its transmission. The virus was first identified in Tanzania in 1952 and has historically been endemic in parts of Africa, Asia, and the Indian subcontinent.
Since 2004, outbreaks have become more frequent and geographically widespread, partly due to viral adaptations. The disease has since spread to Europe and the Americas, with large outbreaks reported in the Caribbean and parts of the United States. As of early 2025, chikungunya cases continue to be reported in various countries across the Americas, Africa, Asia, and Europe.