What are the symptoms of chikungunya?
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Symptoms of Chikungunya
Chikungunya is a viral disease transmitted by Aedes mosquitoes, primarily Aedes aegypti and Aedes albopictus. The disease is characterized by a sudden onset of symptoms that can significantly impact the quality of life of affected individuals. Below, we explore the various symptoms associated with chikungunya, categorized into common, oral, ocular, neurological, and atypical manifestations.
Common Symptoms of Chikungunya
Fever and Polyarthralgia
The most prevalent symptoms of chikungunya are high fever and polyarthralgia (joint pain). These symptoms typically appear after an incubation period of 1 to 12 days and are reported in nearly all cases2 6. The joint pain can be severe and debilitating, often affecting multiple joints simultaneously.
Myalgia and Headache
Myalgia (muscle pain) and headache are also common symptoms, contributing to the overall discomfort experienced by patients7 9. These symptoms, along with fever and joint pain, form the core clinical presentation of chikungunya.
Skin Rash and Conjunctivitis
A widespread skin rash and conjunctivitis (red eyes) are frequently observed in chikungunya patients. The rash can vary in appearance and is often accompanied by itching2 6. Conjunctivitis, while less severe, adds to the array of symptoms that can affect daily activities.
Oral Manifestations
Ulcers and Oral Thrush
Chikungunya can cause several oral symptoms, including ulcers and oral thrush, which lead to masticatory discomfort1. These symptoms are typically seen in the acute phase of the disease and tend to resolve within 3 to 10 days.
Gingival Bleeding and TMJ Arthralgia
Other oral manifestations include gingival bleeding and temporomandibular joint (TMJ) arthralgia, which can cause significant pain and discomfort1. Changes in taste and opportunistic infections in the oral cavity have also been reported.
Ocular Manifestations
Ocular Pain and Inflammation
Ocular symptoms such as pain and inflammation are common in chikungunya patients. These symptoms can lead to reduced visual acuity and significantly impact the quality of life4.
Conjunctivitis and Optic Neuritis
Conjunctivitis and optic neuritis are among the most frequently reported ocular manifestations. These conditions can cause severe discomfort and, in some cases, long-term visual impairment4.
Neurological Manifestations
Headaches and Meningeal Involvement
Headaches are the most common neurological symptom associated with chikungunya. More severe neurological manifestations include meningeal involvement, which can lead to encephalitis, convulsions, and polyneuropathies such as Guillain-Barré syndrome5.
Severe Neurological Complications
In extreme cases, chikungunya can cause severe neurological complications, including myelitis and cranial nerve palsies. These conditions are more likely to occur in patients with comorbidities or those experiencing multiple viral infections5.
Atypical Symptoms
Joint Pain Before Fever
Atypical symptoms of chikungunya include joint pain that precedes the onset of fever, a unique manifestation reported predominantly in female patients3. This symptom can complicate the diagnosis and management of the disease.
Red Eye and Dermatological Manifestations
Other atypical symptoms include red eye and various dermatological manifestations, such as skin lesions and rashes. These symptoms are reported in a significant proportion of patients and can vary widely in presentation3.
Conclusion
Chikungunya presents with a wide range of symptoms, from common manifestations like fever and joint pain to more specific oral, ocular, neurological, and atypical symptoms. Understanding these diverse symptoms is crucial for effective diagnosis and management of the disease. While most symptoms resolve within a few days to weeks, some patients may experience long-term complications that require ongoing medical attention.
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Most relevant research papers on this topic
Oral manifestations in chikungunya patients: A systematic review
Chikungunya fever is associated with oral manifestations that cause discomfort when chewing, such as ulcerations, with complete remission within 3-10 days, mainly affecting women and older individuals.
Systematic Review
Rigorous JournalChikungunya: Epidemiology, Pathogenesis, Clinical Features, Management, and Prevention.
Chikungunya is a zoonotic disease caused by the Chikungunya virus (CHIKV), transmitted by Aedes spp mosquitoes, with symptoms similar to other febrile infections and serious complications.
Highly CitedManifestations of Atypical Symptoms of Chikungunya during the Dhaka Outbreak (2017) in Bangladesh.
Atypical symptoms of Chikungunya include joint pain before fever, red eye, oral ulcer, and dermatological manifestations, with joint pain being the most common and occurring predominantly in females.
Observational StudyOcular Manifestations of Chikungunya Infection: A Systematic Review
Ocular symptoms of CHIKV infection include ocular pain, inflammation, reduced visual acuity, conjunctivitis, and optic neuritis, with conjunctivitis and optic neuritis being the most common manifestations.
Systematic ReviewChikungunya Neurological Manifestations: A Systematic Literature Review
Headaches are the most common neurological symptom in adult CHIKV patients, followed by meningeal involvement, which can lead to more severe complications.
Systematic ReviewOutbreak of chikungunya on Reunion Island: early clinical and laboratory features in 157 adult patients.
Chikungunya virus can cause explosive outbreaks of disease, with polyarthralgia and fever as its main clinical features, and should be considered in the differential diagnosis of febrile polyarthralgia with an abrupt onset.
Rigorous JournalHighly CitedChikungunya virus and the global spread of a mosquito-borne disease.
Chikungunya virus infection is a rapidly-onset, febrile disease with intense asthenia, arthralgia, myalgia, headache, and rash, spreading throughout the Caribbean and into much of Central America, with further spread in the Americas likely.
Rigorous JournalHighly CitedLong-term sequelae of chikungunya virus disease: A systematic review.
Chikungunya leads to long-term sequelae, impacting quality of life in a significant proportion of patients, and requires consideration in public and individual health management.
Systematic ReviewHighly CitedDisease Resolution in Chikungunya—What Decides the Outcome?
Immune responses during the post-acute phase of chikungunya disease infection determine disease progression and resolution, with some patients progressing to chronic arthritic phases.
Chikungunya: a re-emerging virus
Chikungunya virus has re-emerged in Africa, southern and southeastern Asia, and the Indian Ocean Islands, causing severe morbidity and mortality, with potential for new endemic regions due to the spread of Aedes albopictus.
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