chikungunya

  • Historically, chikungunya virus was limited to Southeast Asia and Africa but has recently emerged in the Americas, with outbreaks in Central and South America and the Caribbean. No vaccine is available.
  • Symptoms resemble dengue fever, including abrupt onset of fever (≥39.0 °C [102.2 °F]) and severe bilateral and symmetrical polyarthralgia, often involving the hands and feet.
  • A maculopapular rash on the limbs and trunk is common.
  • Rarely, central nervous system, ophthalmologic, hepatic, and kidney manifestations are present.
  • Abnormal laboratory findings include lymphopenia, thrombocytopenia, and elevated aminotransferase levels. Definitive diagnosis relies on serologic assays or detection of viral RNA by reverse transcriptase PCR testing.
  • Disease is generally self-limited, resolving in 7 to 10 days. However, some patients may experience relapsing and chronic rheumatologic symptoms for months or even years. Symptomatic treatment includes NSAIDs and aspirin avoidance (risk of bleeding complications and potential risk of Reye syndrome in children).