Chikungunya fever is a tropical viral disease transmitted by mosquitoes and is most common in India, Southeast Asia and Africa. The term chikungunya translates to “the bent” and is due to the severe joint pain that is a typical symptom of the disease. Despite the sometimes high fever, the disease is usually harmless and heals on its own without therapy. A vaccination against the Chikungunya virus does not yet exist – the best prevention is therefore mosquito protection in the risk areas.
Chikungunya virus: prevalence in southern regions.
Chikungunya virus is found in the saliva of the yellow fever mosquito and the Asian tiger mosquito and is transmitted to humans through the bite of the mosquito. Because these mosquito species are common in warm regions, chikungunya fever occurs predominantly in southern countries around the world – including the following high-risk areas:
- Southeast Asia: Philippines, Malaysia, Thailand, Cambodia, Indonesia.
- India and Sri Lanka
- Arabian Peninsula
- Indian Ocean islands: Reunion, Madagascar, Mauritius, Seychelles
- Africa: Senegal, Gambia, Guinea, Tanzania
However, outbreaks of the disease are occasionally observed in southern Europe. Thus, the Asian tiger mosquito is also found in Italy since the early 1990s, which has spread the virus there every now and then. Meanwhile, the mosquito is found in almost all of southern Europe and cases are not excluded in Germany either.
Chikungunya epidemic in South America
In December 2013, there was a chikungunya epidemic in the Caribbean, where more than 800,000 people were infected within a year. As a result, the virus was also spread to the United States and South American countries – Cuba, Costa Rica, and Colombia were among those affected.
Symptoms include fever and joint pain
After infection with the Chikungunya virus through the mosquito bite, symptoms appear after about five to ten days. There are then episodes of fever up to 40°C with chills, headache and aching limbs. Characteristic of Chikungunya fever, however, is severe joint pain, especially in the arms and legs. The affected joints are swollen and sensitive to touch. In addition, conjunctivitis and a skin rash may occur.
Chikungunya: severe course rare
Usually, the symptoms of chikungunya fever disappear on their own after about seven to ten days. In rare cases, however, joint pain can last for months or even years. Then, not infrequently, the diagnosis of rheumatoid joint inflammation (arthritis) is incorrectly made. Also rare is a so-called hemorrhagic course: In this case, the virus itself or the inflammatory reaction triggered in the body causes damage to blood vessels and disrupts blood clotting. Bleeding is then possible, which in exceptional cases – for example in children or the elderly – can be fatal. After overcoming an infection, there is lifelong immunity to the virus.
Differentiation from malaria and dengue fever.
Diagnosing chikungunya fever can be quite difficult in some circumstances, because similar symptoms can occur with other travel illnesses such as malaria or dengue fever. It is particularly important to distinguish it from malaria because, unlike the chikungunya virus, there are effective drugs against the causative agents of malaria. However, the distinction from dengue fever is also significant, because severe hemorrhagic or even fatal courses may occur more frequently with this disease.
Diagnostics: virus detection in the blood
In the diagnosis, therefore, a thorough collection of medical history is necessary – in particular, the mention of stays in risk areas is important for the doctor to assess the probability of infection with the Chikungunya virus. If Chikungunya fever is suspected, the diagnosis can be made by a blood test. This detects the virus itself or antibodies to the virus in the blood.
Chikungunya: symptomatic therapy only
To date, there are no drugs against the chikungunya virus. Therefore, therapy is limited to alleviating symptoms:
- Fever reduction with agents such as paracetamol or acetylsalicylic acid.
- Anti-inflammatory painkillers such as ibuprofen or diclofenac
- Adequate intake of fluids and minerals to compensate for their loss due to fever.
Vaccination not yet possible
A vaccination against Chikungunya fever does not yet exist – however, a vaccine is currently under development. Therefore, the only way to prevent infection with the chikungunya virus is to consistently protect yourself from mosquito bites. So if you are in a risk area, make sure to wear long clothing and use mosquito repellents. In addition, you should avoid stagnant water and other places where there are particularly many mosquitoes, if possible.
