II. Definition

  1. Mosquito-borne alphavirus named for "To walk bent over" in Tanzanian

III. Pathophysiology

  1. Mosquito borne alphavirus
  2. Regions
    1. Originally described in East Africa in 1950s
    2. Caribbean
    3. Central America
  3. Vectors
    1. Mosquito vectors
      1. Aedes aegypti
      2. Asian tiger Mosquito

IV. Symptoms

  1. Symptoms follow 2-4 days (up to 12 days) of asymptomatic incubation period
  2. Fever with abrupt onset
    1. Fever may be absent
    2. Undulating fever may occur (similar to Dengue Fever)
  3. Pharyngitis
  4. Back pain
  5. Headache
  6. Polyarthralgias, especially small joints (e.g. ankles, wrists, toes, fingers)
    1. May be severe, similar to Dengue Fever

V. Signs

  1. Rash (present in 50% of patients)
    1. Pruritic rash
    2. Starts with Flushing and then maculopapular rash involving trunk and extremities
    3. Desquamation of palms and soles
    4. Bullous facial edema
  2. Other uncommon presentations
    1. Meningoencephalitis (children)
    2. Ocular changes

VI. Labs

  1. Complete Blood Count
    1. Lymphocytosis (or often normal WBC Count)
    2. Thrombocytopenia
  2. Chikungunya IgM
    1. May be falsely negative in first 2 weeks

VII. Differential Diagnosis

VIII. Management

  1. Supportive care
  2. Avoid Aspirin and NSAIDs (until Dengue is excluded)

XII. References

  1. Martin (2010) Park Nicollet Primary Care Update CME, Minneapolis, MN
  2. Huntington (2016) Am Fam Physician 94(7): 551-7 [PubMed]

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Ontology: Chikungunya Fever (C0008055)

Definition (MSH) An acute infection caused by a mosquito-borne alphavirus CHIKUNGUNYA VIRUS characterized by RASH; FEVER; JOINT PAINS; CONJUNCTIVITIS; MENINGOENCEPHALITIS; LYMPHOPENIA; and THROMBOCYTOPENIA.
Concepts Disease or Syndrome (T047)
MSH D065632
ICD10 A92.0
SnomedCT 186598001, 26257001, 111864006
English Chikungunya virus disease, Chikungunya virus infection, Chikungunya hemorrhagic fever (diagnosis), infection due to Chikungunya virus (diagnosis), infection due to Chikungunya virus, Chikungunya (hemorrhagic) fever, chikungunya, chikungunya fever, Chikungunya hemorrhagic fever (disorder), Chikungunya, Chikungunya Virus Infection, Infections, Chikungunya Virus, Fever, Chikungunya, Virus Infections, Chikungunya, Chikungunya Fever, Fevers, Chikungunya, Virus Infection, Chikungunya, Chikungunya Fevers, Chikungunya Virus Infections, Infection, Chikungunya Virus, Chikungunya fever, Chikungunya hemorrhagic fever, Chikungunya haemorrhagic fever, Chikungunya fever (disorder), chikungunya viral disease, fever; Chikungunya, hemorrhagic fever; Chikungunya, Chikungunya; fever, Chikungunya; hemorrhagic fever, Mosquito-borne viral fever, Chikungunya
Dutch Chikungunya-virusinfectie, Chikungunya; hemorragische koorts, Chikungunya; koorts, hemorragische koorts; Chikungunya, koorts; Chikungunya, Chikungunya-virusziekte
French Infection à virus Chikungunya
German Chikungunya Virus-Infektion, Chikungunya-Viruskrankheit
Italian Infezione da virus Chikungunya
Portuguese Infecção pelo vírus Chikungunya
Spanish Infección por virus Chikungunya, fiebre hemorrágica de Chikungunya (concepto no activo), fiebre de Chikungunya (trastorno), fiebre de Chikungunya, fiebre hemorrágica de Chikungunya
Japanese チクングニヤウイルスカンセン, チクングニヤウイルス感染
Czech Infekce viru čikungunja
Korean 치쿤구니야 바이러스병
Hungarian Chikungunya vírus fertőzés