Chikungunya virus infection

Chikungunya virus infection has a global distribution, thanks to a genetic change enabling the virus to be transmitted by Aedes albopictus (a more widespread Aedes vector), as well as Aedes aegypti.

Most patients fully recover, but some develop chronic joint disease characterized by polyarthritis and systemic manifestations that may last for months or years and may resemble rheumatoid arthritis or a seronegative spondyloarthropathy.

Diagnosis is based on clinical manifestations and epidemiologic clues. It is important to distinguish it from dengue fever and Zika virus infection, which are transmitted by the same vector. Confirmation is via serologic detection of antibodies. Real-time reverse transcription polymerase chain reaction (RT-PCR) can be used to determine whether a patient is infected with chikungunya, Zika, or dengue virus in one test.

There is no specific treatment, and management is mainly supportive in the acute phase. Patients with chronic symptoms may require disease-modifying antirheumatic drug (DMARD) therapy under the supervision of a rheumatologist.

Avoidance of mosquito bites is the best method of prevention; however, a vaccine is available and recommended for certain groups of people.

Chikungunya virus (also known as CHIKV) is an alphavirus transmitted by the Aedes species of mosquitoes.[1]Tsetsarkin KA, Chen R, Leal G, et al. Chikungunya virus emergence is constrained in Asia by lineage-specific adaptive landscapes. Proc Natl Acad Sci U S A. 2011 May 10;108(19):7872-7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3093459 http://www.ncbi.nlm.nih.gov/pubmed/21518887?tool=bestpractice.com Chikungunya means "that which bends up" in the Makonde language (spoken in a border area between Mozambique and Tanzania where the first outbreak was described), which refers to the arthritis that the infection can cause. Fever and joint aches are the most common manifestations of infection, which may resemble other viral illnesses, including dengue fever. The disease is usually self-limited, but some cases may evolve into a chronic condition with debilitating arthritis.