What is Chikungunya?

In simplest terms, Chikungunya is a virus characterized by flu-like symptoms including fever and joint pain.. Primarily a disease of the tropics, this mosquito-borne ailment with the funny name gained some notoriety back in December of 2014 after actress Lindsay Lohan developed a case of it while vacationing in Bora Bora.

Chikungunya is transmitted by mosquitoes - primarily, by Aedes albopictus. Also known as the Asian Tiger Mosquito, A. Albopictus is a nasty and aggressive species that bites during the day. These insects pick up the virus by drinking the blood of an infected person or animal and subsequently spread disease by biting other victims.

Native to tropical Asia, Africa and the South Pacific, the first case of Chikungunya documented in the Western hemisphere occurred in the French West Indies in 2013 ^[1]. Since then, it has spread throughout South and Central America and the Caribbean, and cases have occurred in North America and Europe as well. Most cases in non-tropical regions have been attributed to local mosquitoes biting someone who picked up the disease while visiting an area where it is endemic.

Chikungunya epidemics in North America are rare but not unheard of. The last one occurred in 1827-1828. It began in the Caribbean and spread via infected returning travellers to South Carolina, Georgia and Louisiana.

What are the symptoms?

Symptoms of Chikungunya begin 3-7 days after a mosquito bite and can include joint pain, suden onset of fever, headaches, and muscle pain. Around 50% of those with the disease develop a rash. Most victims recover spontaneously within a week, but fever and joint pain may persist and relapse for some time. Joint pain can be severe.

The symptoms are very similar to Dengue fever. If you think you have Chikungunya, you should see a doctor to distinguish between the two. This can be done by blood tests. Dengue fever can cause bleeding, so NSAIDs and aspirin are contraindicated until it is ruled out.

How serious is it?

Chikungunya was once thought to be self-limiting and non-fatal, however a recent outbreak on Reunion Island exhibited a fatality rate of 1 in 1000 ^[2]. At the same time, epidemics in other locations have shown no measurable effect upon mortality. There are several strains of Chikungunya, which may explain why some outbreaks are more severe than others.

What if you're pregnant?

The virus can be transmitted from mother to child during pregnancy, but a study during the Reunion outbreak failed to show an effect on pregnancy outcomes ^[3].

How do you treat Chikungunya?

There are currently no vaccines or medications that specifically target Chikungunya. In general, treat your symptoms like you would a case of the flu - drink plenty of fluids, rest, and take acetaminophen to reduce fever and pain. As mentioned earlier, its important to avoid nsaids (like Ibuprofen) and aspirin until Dengue fever has been ruled out.

Also avoid mosquito bites to prevent further spread of the disease. The virus remains in your blood for about a week and can be transmitted via mosquito bites during this time.

How do you prevent it?

If you are travelling to a country where Chikungunya is endemic, the US Centers for Disease Control recommends using repellents containing Deet, Picaridin, IR3535 or Oil of Lemon Eucalyptus, as these ingredients have been shown to effectively repel the mosquitoes which carry Chikungunya. If feasible, wear clothing with long sleeves and long pants, and use mosquito netting. You can also treat your clothing with Permethrin, which kills mosquitoes

Sources:

[1] - http://wwwnc.cdc.gov/eid/article/20/8/14-0650_article
[2] - http://wwwnc.cdc.gov/eid/article/14/3/07-0720_article
[3] - http://wwwnc.cdc.gov/eid/article/16/3/pdfs/09-1403.pdf

Further reading: http://www.cdc.gov/chikungunya/pdfs/factsheet_chikungunya-what-you-need-to-know.pdf