Symptoms, Diagnosis, & Treatment
Symptoms
- Most people infected with chikungunya virus will develop some symptoms.
- Symptoms usually begin 3–7 days after being bitten by an infected mosquito.
- The most common symptoms are fever and joint pain.
- Other symptoms may include headache, muscle pain, joint swelling, or rash.
- Chikungunya disease does not often result in death, but the symptoms can be severe and disabling.
- Most patients feel better within a week. In some people, the joint pain may persist for months.
- People at risk for more severe disease include newborns infected around the time of birth, older adults (≥65 years), and people with medical conditions such as high blood pressure, diabetes, or heart disease.
- Once a person has been infected, he or she is likely to be protected from future infections.
Diagnosis
- The symptoms of chikungunya are similar to those ofdengue and Zika, diseases spread by the same mosquitoes that transmit chikungunya.
- See your healthcare provider if you develop the symptoms described above and have visited an area where chikungunya is found.
- If you have recently traveled, tell your healthcare provider when and where you traveled.
- Your healthcare provider may order blood tests to look for chikungunya or other similar viruses like dengue and Zika.
Treatment
- There is no vaccine to prevent or medicine to treat chikungunya virus.
- Treat the symptoms:
- Get plenty of rest.
- Drink fluids to prevent dehydration.
- Take medicine such as acetaminophen (Tylenol®) or paracetamol to reduce fever and pain.
- Do not take aspirin and other non-steroidal anti-inflammatory drugs (NSAIDS until dengue can be ruled out to reduce the risk of bleeding).
- If you are taking medicine for another medical condition, talk to your healthcare provider before taking additional medication.
- If you have chikungunya,prevent mosquito bites for the first week of your illness.
- During the first week of infection, chikungunya virus can be found in the blood and passed from an infected person to a mosquito through mosquito bites.
- An infected mosquito can then spread the virus to other people.
What is the current situation?
In December 2013, the World Health Organization (WHO) reported local transmission of chikungunya in Saint Martin. Local transmission means that mosquitoes in the area have been infected with chikungunya and are spreading it to people. This is the first time that local transmission of chikungunya has been reported in the Americas.
Local transmission of chikungunya is now being reported in other countries in the Caribbean. As of March 6, 2015, the following Caribbean countries have reported cases of chikungunya:
- Anguilla
- Antigua
- Aruba
- Bahamas
- Barbados
- British Virgin Islands
- Cayman Islands
- Curaçao
- Dominican Republic
- Grenada
- Guadeloupe
- Haiti
- Jamaica
- Martinique
- Montserrat
- Puerto Rico
- Saint Barthelemy
- Saint Kitts
- Saint Lucia
- Saint Martin (French)
- Saint Vincent and the Grenadines
- Sint Maarten (Dutch)
- Trinidad and Tobago
- Turks and Caicos Islands
- US Virgin Islands
CDC recommends that travelers to the Caribbean protect themselves from mosquito bites. Some travelers may be more likely to get chikungunya, have severe disease, or be at higher risk for other reasons. CDC advises travelers in high-risk groups to discuss their travel plans with their health care provider. These groups include the following:
- People who have arthritis
- People with serious underlying medical conditions (such as high blood pressure, heart disease, or diabetes)
- People older than 65
- Women who are late in their pregnancies, because of the risk to babies born at the time their mother is sick
- Long-term travelers, including missionaries and humanitarian aid workers and people visiting friends and relatives
- People who might have difficulty avoiding mosquito bites, such as those planning to spend a lot of time outdoors or staying in rooms without window screens or air conditioning.
What is chikungunya?
Chikungunya is an illness caused by a virus that spreads through mosquito bites. The most common symptoms of chikungunya are fever and joint pain. Other symptoms may include headache, muscle pain, joint swelling, or rash. Chikungunya disease rarely results in death, but the symptoms can be severe and disabling. Most people who get sick feel better within a week. In some people, the joint pain may last for months or years.
Who is at risk?
Travelers who go to these islands in the Caribbean are at risk of getting chikungunya. In addition, travelers to Africa, Asia, and islands in the Indian Ocean and Western Pacific are also at risk, as the virus is present in many of these areas. The mosquito that carries chikungunya virus can bite during the day and night, both indoors and outdoors, and often lives around buildings in urban areas.
What can travelers do to prevent chikungunya?
There is currently no vaccine or medicine to prevent chikungunya. The only way to prevent chikungunya is to prevent mosquito bites. Preventing bites can be difficult, but it is important as you can get sick after just one bite. Follow these steps to reduce the chances that you will be bitten by mosquitoes during your trip.
Prevent mosquito bites:
- Cover exposed skin by wearing long-sleeved shirts, long pants, and hats.
- Use an appropriate insect repellent as directed.
- Higher percentages of active ingredient provide longer protection. Use products with the following active ingredients:
- DEET(Products containing DEET include Off!, Cutter, Sawyer, and Ultrathon)
- Picaridin(also known as KBR 3023, Bayrepel, and icaridin products containing picaridin include Cutter Advanced, Skin So Soft Bug Guard Plus, and Autan [outside the US])
- Oil of lemon eucalyptus(OLE) or PMD (Products containing OLE include Repel and Off! Botanicals)
- IR3535 (Products containing IR3535 include Skin So Soft Bug Guard Plus Expedition and SkinSmart)
- Always follow product directions and reapply as directed:
- If you are also using sunscreen, apply sunscreen first and insect repellent second.
- Follow package directions when applyingrepellent on children. Avoid applying repellent to their hands, eyes, and mouth.
- Usepermethrin-treated clothing and gear (such as boots, pants, socks, and tents). You can buy pre-treated clothing and gear or treat them yourself:
- Treated clothing remains protective after multiple washings. See the product information to find out how long the protection will last.
- If treating items yourself, follow the product instructions carefully.
- Donot use permethrin directly on skin.
- Stay and sleep in screened or air conditioned rooms.
- Use a bed net if the area where you are sleeping is exposed to the outdoors.
Steve Ramsey, PhD – Public Health – Calgary- Canasa