Chikungunya symptoms include high fever, severe joint and muscle pain, swelling, and red spots on the skin that appear a few days after being bitten by an infected Aedes aegypti mosquito. These symptoms usually develop suddenly and can cause significant discomfort, especially in the joints.
In most cases, the acute phase of Chikungunya lasts around 14 days, but symptoms like joint pain, hair loss, and numbness may persist for months in chronic cases. Some people may also experience sleep problems, fatigue, and blurred vision that can interfere with daily activities.
There is no specific treatment for Chikungunya, and recovery depends on the body’s ability to eliminate the virus. Management focuses on relieving pain and inflammation with medications like acetaminophen, resting, staying hydrated, and using cold compresses, while prevention relies on avoiding mosquito bites.
Acute symptoms
The main symptoms of Chikungunya are:
- Sudden onset of fever greater than 39ºC (102.2°F) and chills;
- Severe joint and muscle pain;
- Localized swelling in the areas of joint pain;
- Small red spots on the skin that appear on the trunk and spread to the rest of the body, including the hands and soles of the feet;
- Back pain or sore throat;
- Full body itching or itching of the hands and feet accompanied by skin peeling in these areas;
- Persistent headache;
- Generalized lymphadenopathy (swollen lymph nodes);
- Pain behind the eyes;
- Excessive tiredness;
- Abdominal pain, diarrhea, nausea, and vomiting;
- Redness of the eyes and increased sensitivity to light.
Red spots on the body, vomiting, bleeding, and mouth sores are more common in women, while men and older adults tend to experience joint pain and swelling as well as fever that can last for several days.
These symptoms are characteristic of the acute phase of Chikungunya and appear about 3 to 7 days after being bitten by an Aedes aegypti mosquito.
Chronic symptoms
The most common symptoms of chronic Chikungunya disease are:
- Joint pain;
- Hair loss;
- Numbness in certain areas of the body;
- Cold hands and fingertips that are white or purple in color (also called Reynaud's phenomenon);
- Sleep disturbances;
- Difficulties with memory and concentration;
- Cloudy or blurred vision;
- Depression.
The chronic phase of Chikungunya is characterized by persistent symptoms lasting more than 3 months, primarily joint pain, which can last up to 6 years.
Medication is necessary to treat these and other symptoms, in addition to physical therapy to relieve pain and improve mobility.
Severe symptoms
In rare cases, Chikungunya can present without fever or joint pain. The following symptoms are signs of severe disease that may require admission to the hospital for treatment:
- Nervous system: seizures, Guillain-Barré syndrome (characterized by loss of muscle strength), loss of mobility in the arms or legs, and tingling;
- Eyes: inflammation of the iris or retina, which can become serious and compromise vision;
- Heart: heart failure, arrhythmias, and pericarditis;
- Skin: darkening of the skin and the appearance of blisters or ulcers similar to canker sores;
- Kidneys: kidney inflammation or acute kidney injury;
- Other complications: bleeding, pneumonia, respiratory insufficiency, hepatitis, pancreatitis, adrenal insufficiency, and an increase or decrease in diuretic hormone.
These symptoms are rare but can be caused by the virus itself, an exaggerated immune response, or the use of certain medications.
Duration of symptoms
In the vast majority of cases, symptoms of acute Chikungunya resolve within 14 days or sooner with rest and medications to relieve discomfort.
However, there are reports of people experiencing symptoms for more than 3 months, which is characteristic of chronic Chikungunya.
Symptoms in babies
The main symptoms of Chikungunya in babies include:
- High fever;
- Joint pain;
- Muscle pain;
- Swelling of the hands and feet;
- Weakness.
Skin symptoms can be more serious in babies, including a cutaneous rash and blisters that can burst and increase the risk for dehydration and secondary infections.
Babies may also exhibit other signs like irritability, frequent or persistent crying, and refusal to nurse or take a bottle. Mothers with the disease can continue to breastfeed, since the virus does not pass through human milk.
The Chikungunya fever in newborns can be severe and may affect the central nervous system, leading to serious complications like seizures, meningoencephalitis, cerebral edema, and intracranial hemorrhage. Hemorrhages and cardiac involvement, such as ventricular dysfunction and pericarditis, can also occur.
In children under 2, a pediatrician may decide to admit the child to the hospital for treatment.
Confirming a diagnosis
The diagnosis of Chikungunya is made by a general practitioner or infectious disease specialist based on an evaluation of symptoms and the results of blood tests.
To confirm the diagnosis, a provider may order a molecular test to verify the presence of the virus in the bloodstream or antibody tests to check for the presence of antibodies produced by the body against the infection.
Treatment options
Treatment generally lasts for about 15 days and consists of analgesics like acetaminophen to relieve symptoms like fever, fatigue, and headaches.
In the case of severe pain, a provider may prescribe the use of stronger medications for pain and inflammation. It is important to avoid taking any medications without a prescription from your doctor or other healthcare provider, as this can cause serious complications like drug-induced hepatitis.
In addition to medications, applying cold compresses to the joints can help relieve swelling and discomfort. It is also important to rest and drink plenty of water to allow the body to recover faster.