Chikungunya (pronunciation: chik-en-gun-ye) virus is transmitted to people by mosquitoes. The most common symptoms of chikungunya virus infection are fever and joint pain. Other symptoms may include headache, muscle pain, joint swelling, or rash. Outbreaks have occurred in countries in Africa, Asia, Europe, and the Indian and Pacific Oceans. In late 2013, chikungunya virus was found for the first time in the Americas on islands in the Caribbean. There is a risk that the virus will be imported to new areas by infected travelers. There is no vaccine to prevent or medicine to treat chikungunya virus infection. Travelers can protect themselves by preventing mosquito bites. When traveling to countries with chikungunya virus, use insect repellent, wear long sleeves and pants, and stay in places with air conditioning or that use window and door screens.
- No vaccine exists to prevent chikungunya virus infection or disease.
- Prevent chikungunya virus infection by avoiding mosquito bites (see below).
- The mosquitoes that spread the chikungunya virus bite mostly during the daytime.
Protect Yourself from Mosquito Bites
- Use air conditioning or window/door screens to keep mosquitoes outside. If you are not able to protect yourself from mosquitoes inside your home or hotel, sleep under a mosquito bed net.
- Help reduce the number of mosquitoes outside your home or hotel room by emptying standing water from containers such as flowerpots or buckets.
- When weather permits, wear long-sleeved shirts and long pants.
- Use insect repellents
- Repellents containing DEET, picaridin, IR3535, and oil of lemon eucalyptus and para-menthane-diol products provide long lasting protection.
- If you use both sunscreen and insect repellent, apply the sunscreen first and then the repellent.
- Do not spray repellent on the skin under your clothing.
- Treat clothing with permethrin or purchase permethrin-treated clothing.
- Always follow the label instructions when using insect repellent or sunscreen.
If you have chikungunya, follow these instructions:
- During the first week of infection, chikungunya virus can be found in the blood and passed from an infected person to another mosquito through mosquito bites. An infected mosquito can then transmit the virus to other people.
- To prevent further spread of the virus, it is important for people to avoid mosquito bites during the first week of illness.
Through mosquito bites
- Chikungunya virus is transmitted to people through mosquito bites. Mosquitoes become infected when they feed on a person already infected with the virus. Infected mosquitoes can then spread the virus to other people through bites.
- Chikungunya virus is most often spread to people by Aedes aegypti and Aedes albopictus mosquitoes. These are the same mosquitoes that transmit dengue virus. They bite mostly during the daytime.
Rarely, from mother to child
- Chikungunya virus is transmitted rarely from mother to newborn around the time of birth.
Rarely, through infected blood
- In theory, the virus could be spread through a blood transfusion. To date, there are no known reports of this happening.
Symptoms, Diagnosis, & Treatment
- 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.
- The symptoms of chikungunya are similar to those of dengue, another disease spread by mosquitoes.
- See your doctor if you develop the symptoms described above.
- If you have recently traveled, tell your doctor.
- Your doctor may order blood tests to look for chikungunya or other similar diseases.
- There is no medicine to treat chikungunya virus infection or disease.
- Decrease the symptoms:
- Get plenty of rest
- Drink fluids to prevent dehydration
- Take medicines, such as ibuprofen, naproxen, acetaminophen, or paracetamol, to relieve fever and pain.
Information For Health Care Providers
Chikungunya virus infection should be considered in patients with acute onset of fever and polyarthralgia, especially travelers who recently returned from areas with known virus transmission.
Laboratory diagnosis is generally accomplished by testing serum or plasma to detect virus, viral nucleic acid, or virus-specific immunoglobulin (Ig) M and neutralizing antibodies. Viral culture may detect virus in the first 3 days of illness; however, chikungunya virus should be handled under biosafety level (BSL) 3 conditions. During the first 8 days of illness, chikungunya viral RNA can often be identified in serum. Chikungunya virus antibodies normally develop toward the end of the first week of illness. Therefore, to definitively rule out the diagnosis, convalescent-phase samples should be obtained from patients whose acute-phase samples test negative.
What type of tube should I collect blood in?
The best type of tube is serum separator (typically tiger/speckled-top). The blood should be allowed to coagulate and tubes should be spun to separate the serum from the clot prior to shipping.
If a red-top is used (no additive), the blood must be allowed to coagulate, the tube centrifuged, and the serum drawn off into a clean tube prior to shipping. Heparin (green top) and EDTA (purple top) are unsuitable for CHIK testing.
Where and how should I send the samples to CDC?
Please refer to the instructions for sending diagnostic specimens to CDC, which also includes detailed instructions for completing the on-line CDC specimen submission form 50.34 [PDF – 2.5 MB].
Please note: because chikungunya virus testing is not listed in the drop-down menu for the Test Order Name field of form 50.34 (located on 1st page, top left), you will need to select “ARBOVIRUS SEROLOGY” and then type “CHIK testing” in the Brief Clinical Summary field located at the top of the second page of the form
When will results be available?
Test results are normally available 4 to 14 days after specimen receipt. Reporting times for test results may be longer during summer months when arbovirus activity increases. Receipt of a hard copy of the results will take at least 2 weeks after testing is completed. Initial serological testing will be performed using IgM-capture ELISA and IgG ELISA. If the initial results are positive, further confirmatory testing will be performed and it may delay the reporting of final results. ALL RESULTS WILL BE SENT TO THE APPROPRIATE STATE HEALTH DEPARTMENT. Notify your state health department of any direct submissions to CDC.
Resources for Healthcare Providers
- Fact Sheet: General Information for Healthcare Providers [PDF 2 pages]
- Presentation: Chikungunya Virus – An Emerging Threat to the Americas [PDF – 32 pages]
- CDC Yellow Book Chapter: Chikungunya
- Differentiating Chikungunya From Dengue: A Clinical Challenge Medscape Commentary, Dr. Tyler Sharp, CDC
- Fact Sheet: Clinical Management in Dengue-Endemic Areas [PDF 2 pages]
- Fact Sheet: Atypical and Severe Disease Manifestations [PDF 2 pages]
- CDC Health Advisory (December 13, 2013): Notice to Public Health Officials and Clinicians: Recognizing, Managing, and Reporting Chikungunya Virus Infections in Travelers Returning from the Caribbean
More info at CDC