Sign and symptoms of chikungunya fever

Chikungunya fever typically begins abruptly 3-7 days after the bite of an infected female Aedes mosquito with the following key signs and symptoms:

1. High-grade fever:  Temperature often >39°C or 102°F 
2. Severe joint pain and swelling: usually bilateral and symmetric, affecting wrists, fingers, ankles, and knees; the pain can be debilitating and may last weeks to years.
3. Headache: 
4. Muscle Pain (myalgia) 
5. Rash: Usually maculopapular on the torso and limbs.
6. Nausea and Vomiting 
7. Fatigue and malaise 
8. Conjunctivitis
9. Lymphadenopathy  (swelling of lymph nodes) 

Rare but serious complications can include uveitis, retinitis, myocarditis, hepatitis, nephritis, and neurological complications like meningoencephalitis, Guillain-Barré syndrome, and cranial nerve palsies. 

Severe disease and complications are more common in neonates (infected around birth), elderly people, and those with underlying medical conditions.

Most patients recover in days to weeks, but joint pain can persist for months or years, causing chronic arthritis-like symptoms. Deaths are rare. 

Distinguish Chikungunya symptoms from Dengue and Zika virus

Chikungunya, dengue, and Zika virus  have overlapping symptoms  but also distinct features to help differentiate them clinically 

Sr. no.	Feature	Chikungunya	Dengue	Zika
1	Fever	Sudden high fever, often >102°F	High fever, sudden onset	Usually mild or low-grade fever
2	Joint pain	Severe, debilitating, symmetrical polyarthralgia common	Mild or absent	Mild to moderate arthralgia
3	Rash	Maculopapular rash on face, hands, feet, and limbs, less itchy	Rash on limbs and face, often itchy	Maculopapular rash, often itchy, and conjunctivitis are common
4	Headache	Present	Severe, often with retro-orbit pain	Mild to moderate
5	Muscle pain (myalgia)	Common	Common	Common
6	Conjunctivitis	Occasionally	Rare	Common
7	Bleeding Tendency	Rare	Common ,risk of hemorrhagic manifestation	Rare
8	Severe Complication	Chronic arthritis ,rare complication neurological	Dengue hemorrhagic fever and shock syndrome possible	Neurological complications; congenital infections in fetus (microcephaly)
9	Duration of symptoms	Fever lasts 2-7 days; joint pain can persist for months	Fever usually 2-7 days; recovery is longer in severe cases	Usually lasts less than a week

Treatment on Chikungunya Fever 

Chikungunya fever has no specific antiviral treatment or vaccine, focusing instead on symptom relief. Supportive care emphasizes rest, hydration, and pain management to ease fever, joint pain, and rash. Paracetamol is the preferred medication for fever as well as pain reduction.

Acute Phase Management

Patients receive fluids, electrolytes, and analgesics during the initial 3-7 days of high fever and severe arthralgia. Avoid aspirin and NSAIDs like ibuprofen to prevent bleeding risks from potential co-infection with dengue fever especially. Hospitalization is rare but needed for dehydration or severe symptoms. 

Chronic Symptom Management

Persistent joint pain lasting weeks to years affects up to 50% of cases and may require NSAIDs once dengue is ruled out. Physiotherapy and natural remedies like homeopathy offer adjunct relief in some settings.