View source for Chikungunya

{{Short description|Infection caused by the chikungunya virus}}
{{Use dmy dates|date=March 2025}}
{{cs1 config |name-list-style=vanc |display-authors=6}}
{{Infobox medical condition (new)
| name = Chikungunya
| image = 2012-01-09 Chikungunya on the right feet at The Philippines.jpeg
| caption = Rash from chikungunya
| field = [[Infectious disease (medical specialty)|Infectious disease]]
| pronounce = {{IPAc-en|ˌ|tʃ|ɪ|k|ən|ˈ|ɡ|ʌ|n|j|ə}}<ref name="Oxford_Dictionary">{{cite web|title=chikungunya|url=http://www.oxfordlearnersdictionaries.com/us/definition/english/chikungunya|website=Oxford Learner's Dictionary|publisher=[[Oxford University Press]]|access-date=4 November 2014|url-status=live|archive-url=https://web.archive.org/web/20141104175820/http://www.oxfordlearnersdictionaries.com/us/definition/english/chikungunya|archive-date=4 November 2014}}</ref> {{Respell|CHIK|ən|GUN|yə}}
| symptoms = [[Fever]], [[joint pain]], [[headache]], [[muscle pain]], [[joint swelling]], and [[rash]].<ref name="CDC_2024_Symptoms"/>
| complications = Long term joint pain<ref name="CDC_2024_Symptoms"/>
| onset = 2 to 14 days after exposure<ref name="WHO_FactSheet_2025"/>
| duration = Usually less than a week<ref name="CDC_2024_Symptoms"/>
| types = 
| causes = Chikungunya virus spread by [[mosquitoes]]<ref name="WHO_FactSheet_2025"/>
| risks = 
| diagnosis = Blood test for viral [[RNA]] or [[antibodies]]<ref name="WHO_FactSheet_2025"/>
| differential = [[Dengue fever]], [[Zika fever]]<ref name="WHO_FactSheet_2025"/>
| prevention = [[Chikungunya vaccine]], [[Mosquito control]], avoidance of bites<ref name="Caglioti-2013"/>
| treatment = [[Supportive care]]<ref name="WHO_FactSheet_2025"/>
| medication = 
| prognosis = [[mortality rate|Risk of death]] ~ 1 in 1,000<ref name="Caglioti-2013"/>
| frequency = > 1 million (2014)<ref name="WHO_FactSheet_2025"/>
| deaths = 
}}

'''<!--Definition and symptoms-->Chikungunya''' is an [[infection]] caused by the [[#Virology|chikungunya virus]].<ref name="WHO_FactSheet_2025">{{Cite web |date=14 April 2025 |title=Chikungunya Fact Sheet (2025)|url=https://www.who.int/news-room/fact-sheets/detail/chikungunya |access-date=20 October 2025 |website=World Health Organization |language=en}}</ref> The most common symptoms are [[fever]] and [[arthralgia|joint pain]],<ref name="CDC_2024_Symptoms">{{Cite web |last=CDC |date=15 May 2024 |title=Symptoms, Diagnosis, & Treatment |url=https://www.cdc.gov/chikungunya/symptoms-diagnosis-treatment/index.html |access-date=2025-10-15 |website=Centers for Disease Control and Prevention |language=en-us}}</ref> typically occurring four to eight days after the bite of an infected mosquito;<ref name="WHO_FactSheet_2025" /> however some people may be infected without showing any symptoms.<ref name="ECDC-factsheet-2024" />  Other symptoms may include [[headache]], [[muscle pain]], [[joint swelling]], and a [[rash]].<ref name="CDC_2024_Symptoms" /> Symptoms usually improve within a week; however, occasionally the joint pain may last for months or years.<ref name="CDC_2024_Symptoms" /><ref>{{Cite journal |last1=van Aalst |first1=Mariëlle |last2=Nelen |first2=Charlotte Marieke |last3=Goorhuis |first3=Abraham |last4=Stijnis |first4=Cornelis |last5=Grobusch |first5=Martin Peter |date=2017-01-01 |title=Long-term sequelae of chikungunya virus disease: A systematic review |url=https://www.sciencedirect.com/science/article/pii/S1477893917300042 |journal=Travel Medicine and Infectious Disease |volume=15 |pages=8–22 |doi=10.1016/j.tmaid.2017.01.004 |pmid=28163198 |issn=1477-8939}}</ref> The very young, old, and those with other health problems are at risk of more severe disease.<ref name="CDC_2024_Symptoms" />

<!-- Cause and diagnosis -->The [[virus]] is spread between people by two species of [[mosquito]] in the ''[[Aedes]]'' genus: ''[[Aedes albopictus]]'' and ''[[Aedes aegypti]]'',<ref name="WHO_FactSheet_2025" /> which mainly bite during the day,<ref>{{Cite journal |last1=Paixão |first1=Enny S. |last2=Teixeira |first2=Maria Gloria |last3=Rodrigues |first3=Laura C. |date=2018 |title=Zika, chikungunya and dengue: the causes and threats of new and re-emerging arboviral diseases |journal=BMJ Global Health |volume=3 |issue=Suppl 1 |article-number=e000530 |doi=10.1136/bmjgh-2017-000530 |issn=2059-7908 |pmc=5759716 |pmid=29435366}}</ref><ref>{{cite web|title=Preventing Chikungunya |url=https://www.cdc.gov/chikungunya/prevention/index.html|website=U.S. [[Centers for Disease Control and Prevention]] (CDC)|access-date=26 September 2016|date=26 February 2016|url-status=live|archive-url=https://web.archive.org/web/20160915205122/http://www.cdc.gov/chikungunya/prevention/index.html|archive-date=15 September 2016}}</ref> particularly around dawn and in the late afternoon.<ref>{{Cite web |last=AFP |date=2025-07-23 |title=Outbreak of Chikungunya Virus Poses Global Risk, Warns WHO |url=https://www.sciencealert.com/outbreak-of-chikungunya-virus-poses-global-risk-warns-who |access-date=2025-07-24 |website=ScienceAlert |language=en-US}}</ref> The [[Natural reservoir|virus may circulate within a number of animals]], including birds and [[rodent]]s.<ref name="WHO_FactSheet_2025" /> Diagnosis is done by testing the blood for either viral [[RNA]] or [[antibodies]] to the virus.<ref name="WHO_FactSheet_2025" /> The symptoms can be mistaken for those of [[dengue fever]] and [[Zika fever]], which are spread by the same mosquitoes.<ref name="WHO_FactSheet_2025" /> It is believed most people become [[immune]] after a single infection.<ref name="CDC_2024_Symptoms" />

<!-- Prevention and treatment -->The best means of prevention are overall [[mosquito control]] and the avoidance of bites in areas where the disease is common.<ref name="Caglioti-2013">{{cite journal |vauthors=Caglioti C, Lalle E, Castilletti C, Carletti F, Capobianchi MR, Bordi L |date=July 2013 |title=Chikungunya virus infection: an overview |journal=The New Microbiologica |volume=36 |issue=3 |pages=211–27 |pmid=23912863}}</ref> This may be partly achieved by decreasing mosquitoes' access to water, as well as the use of [[insect repellent]] and [[mosquito nets]]. [[Chikungunya vaccine]]s have been approved for use in the United States<ref name="FDA Approval-2023">{{cite press release |title=FDA Approval|url=https://www.fda.gov/news-events/press-announcements/fda-approves-first-vaccine-prevent-disease-caused-chikungunya-virus|website=U.S. [[Food and Drug Administration]] (FDA)|access-date=11 November 2023|date=9 November 2023|archive-url=https://web.archive.org/web/20231111030959/https://www.fda.gov/news-events/press-announcements/fda-approves-first-vaccine-prevent-disease-caused-chikungunya-virus|archive-date=11 November 2023}}</ref> and in the European Union.<ref>{{cite web | title=Ixchiq EPAR | website=[[European Medicines Agency]] | date=30 May 2024 | url=https://www.ema.europa.eu/en/medicines/human/EPAR/ixchiq | access-date=1 June 2024 | archive-date=1 June 2024 | archive-url=https://web.archive.org/web/20240601040318/https://www.ema.europa.eu/en/medicines/human/EPAR/ixchiq | url-status=live }}</ref><ref>{{cite press release | title=First vaccine to protect adults from Chikungunya | website=[[European Medicines Agency]] | date=31 May 2024 | url=https://www.ema.europa.eu/en/news/first-vaccine-protect-adults-chikungunya | access-date=1 June 2024}}</ref><ref>{{cite web | title=Vimkunya EPAR | website=[[European Medicines Agency]] | date=30 January 2025 | url=https://www.ema.europa.eu/en/medicines/human/EPAR/vimkunya | access-date=16 February 2025}}></ref> No specific treatment for chikungunya is available; [[Therapy#Supportive therapy|supportive care]] is recommended, with symptomatic treatment of fever and joint swelling.<ref name="Caglioti-2013" />

<!-- Epidemiology and history -->The chikungunya virus is widespread in tropical and subtropical regions where warm climates and abundant populations of its mosquito vectors (''A. aegypti'' and ''A. albopictus'') facilitate its transmission.<ref name="WHO_FactSheet_2025" /> The disease was first identified in 1952 in [[Tanzania]] and named based on the [[Makonde language|Makonde]] words for "to become contorted".<ref name="WHO_FactSheet_2025" /> While the disease is [[Endemic (epidemiology)|endemic]] in Africa and Asia, [[outbreak]]s have been reported in Europe and the Americas since the 2000s.<ref name="WHO_FactSheet_2025" /> In 2014, more than a million suspected cases occurred globally.<ref name="WHO_FactSheet_2025" /> Chikungunya has become a global health concern due to its rapid geographic expansion, recurrent outbreaks, the lack of effective antiviral treatments, and potential to cause severe symptoms and death.<ref>{{Cite journal |last1=Moizéis |first1=Raíza Nara Cunha |last2=Fernandes |first2=Thales Allyrio Araújo de Medeiros |last3=Guedes |first3=Paulo Marcos da Matta |last4=Pereira |first4=Hannaly Wana Bezerra |last5=Lanza |first5=Daniel Carlos Ferreira |last6=Azevedo |first6=Judson Welber Veríssimo de |last7=Galvão |first7=Josélio Maria de Araújo |last8=Fernandes |first8=José Veríssimo |date=19 May 2018 |title=Chikungunya fever: a threat to global public health |journal=Pathogens and Global Health |volume=112 |issue=4 |pages=182–94 |doi=10.1080/20477724.2018.1478777 |issn=2047-7724 |pmc=6147074 |pmid=29806537}}</ref>

==Signs and symptoms==
Chikungunya can be asymptomatic, with estimates of between 17% and 40% of infections showing no symptoms.<ref name="ECDC-factsheet-2024" /> For those experiencing symptoms, they typically begin with a sudden high fever above {{convert|39|°C}} around 3 to 7 days after the bite of an infected mosquito.<ref name="Burt_2017" /><ref name="ECDC-factsheet-2024" /> The fever is often accompanied by severe [[myalgia|muscle]] and [[arthralgia|joint pain]], which affects multiple joints in the arms and legs and is often symmetric – i.e. if one elbow is affected, the other is as well.<ref name="Vairo_2019">{{Cite journal |last1=Vairo |first1=F. |last2=Haider |first2=N. |last3=Kock |first3=R. A. |last4=Ntoumi |first4=F. |last5=Ippolito |first5=G. |last6=Zumla |first6=A. |date=2019-10-25 |title=Chikungunya: Epidemiology, Pathogenesis, Clinical Features, Management, and Prevention (Full text download) |url=https://rvc-repository.worktribe.com/output/1379997 |journal=Infectious Disease Clinics of North America |language=en |volume=33 |issue=4 |pages=1003–1025 |doi=10.1016/j.idc.2019.08.006 |pmid=31668189 |issn=0891-5520}}</ref><ref name="ECDC-factsheet-2024" /> People with chikungunya also frequently experience [[headache]]s, [[back pain]], [[nausea]], and [[fatigue (medical)|fatigue]].<ref name="Vairo_2019" /> Around half of those affected develop a [[rash]], with [[macular rash|reddening]] and sometimes [[maculopapular rash|small bumps]] on the palms, foot soles, torso, and face.<ref name="Vairo_2019" /> 

For some, the rash remains constrained to a small part of the body; for others, the rash can be extensive, covering more than 90% of the skin.<ref name="Burt_2017">{{Cite journal |last1=Burt |first1=Felicity J |last2=Chen |first2=Weiqiang |last3=Miner |first3=Jonathan J |last4=Lenschow |first4=Deborah J |last5=Merits |first5=Andres |last6=Schnettler |first6=Esther |last7=Kohl |first7=Alain |last8=Rudd |first8=Penny A |last9=Taylor |first9=Adam |last10=Herrero |first10=Lara J |last11=Zaid |first11=Ali |last12=Ng |first12=Lisa F P |last13=Mahalingam |first13=Suresh |date=2017-04-01 |title=Chikungunya virus: an update on the biology and pathogenesis of this emerging pathogen |url=https://www.sciencedirect.com/science/article/pii/S1473309916303851 |journal=The Lancet Infectious Diseases |volume=17 |issue=4 |pages=e107–e117 |doi=10.1016/S1473-3099(16)30385-1 |pmid=28159534 |issn=1473-3099}}</ref>  Some people experience gastrointestinal issues, with [[abdominal pain]] and [[vomiting]]. Others experience eye problems, namely [[Photophobia|sensitivity to light]], [[conjunctivitis]], and pain behind the eye.<ref name="Vairo_2019" /> This first set of symptoms – called the "acute phase" of chikungunya – lasts around a week, after which most symptoms resolve on their own.<ref name="Vairo_2019" />

For those with severe symptoms, approximately 30% to 40% continue to have symptoms after the "acute phase" resolves.<ref name="ECDC-factsheet-2024" /><ref name="Vairo_2019" /> The lasting symptoms tend to be joint pains: [[arthritis]], [[tenosynovitis]], and/or [[bursitis]].<ref name="Vairo_2019" /> If the affected person has pre-existing joint issues, these tend to worsen.<ref name="Vairo_2019" /> Overuse of a joint can result in painful swelling, stiffness, [[nerve damage]], and [[neuropathic pain]].<ref name="Vairo_2019" /> Typically the joint pain improves with time; however, the chronic stage can last anywhere from a few months to several years.<ref name="Vairo_2019" />

Almost all symptomatic cases feature joint pain, generally in more than one joint.<ref name="Thiberville-2013">{{Cite journal |last1=Thiberville |first1=Simon-Djamel |last2=Moyen |first2=Nanikaly |last3=Dupuis-Maguiraga |first3=Laurence |last4=Nougairede |first4=Antoine |last5=Gould |first5=Ernest A. |last6=Roques |first6=Pierre |last7=de Lamballerie |first7=Xavier |date=1 September 2013 |title=Chikungunya fever: Epidemiology, clinical syndrome, pathogenesis and therapy |journal=Antiviral Research |volume=99 |issue=3 |pages=345–70 |doi=10.1016/j.antiviral.2013.06.009 |issn=0166-3542 |pmc=7114207 |pmid=23811281}}</ref> Pain most commonly occurs in peripheral joints, such as the wrists, ankles, and joints of the [[phalanges|hands and feet]] as well as some of the larger joints, typically the shoulders, elbows and knees.<ref name="Thiberville-2013" /><ref name="Burt-2012">{{cite journal |vauthors=Burt FJ, Rolph MS, Rulli NE, Mahalingam S, Heise MT |date=February 2012 |title=Chikungunya: a re-emerging virus |journal=Lancet |volume=379 |issue=9816 |pages=662–71 |doi=10.1016/S0140-6736(11)60281-X |pmid=22100854 |s2cid=33440699}}</ref> Joints are more likely to be affected if they have previously been damaged by disorders such as [[osteoarthritis|arthritis]].<ref name="Burt-2012" /> Pain may also occur in the [[myalgia|muscles]] or [[ligaments]]. In more than half of cases, normal activity is limited by significant fatigue and pain.<ref name="Thiberville-2013" /> Infrequently, inflammation of the eyes may occur in the form of [[iridocyclitis]], or [[uveitis]], and [[retinal]] lesions may occur.<ref>{{cite journal | vauthors = Mahendradas P, Ranganna SK, Shetty R, Balu R, Narayana KM, Babu RB, Shetty BK | title = Ocular manifestations associated with chikungunya | journal = Ophthalmology | volume = 115 | issue = 2 | pages = 287–91 | date = February 2008 | pmid = 17631967 | doi = 10.1016/j.ophtha.2007.03.085 }}</ref> Temporary damage to the liver may occur.<ref>{{cite journal | vauthors = Simon F, Javelle E, Oliver M, Leparc-Goffart I, Marimoutou C | title = Chikungunya virus infection | journal = Current Infectious Disease Reports | volume = 13 | issue = 3 | pages = 218–28 | date = June 2011 | pmid = 21465340 | pmc = 3085104 | doi = 10.1007/s11908-011-0180-1 }}</ref>

People with chikungunya occasionally develop long term neurologic disorders, most frequently [[encephalitis|swelling]] or [[encephalopathy|degeneration]] of the brain, [[myelitis|inflammation]] or [[myelopathy|degeneration]] of the [[myelin]] sheaths around neurons, [[Guillain–Barré syndrome]], [[acute disseminated encephalomyelitis]], [[hypotonia]] (in newborns), and issues with visual processing.<ref name="Vairo_2019" />

Newborns, the elderly, and those with [[diabetes]], [[heart disease]], liver and kidney diseases, and [[human immunodeficiency virus]] infection tend to have more severe cases of chikungunya. Fewer than 1 in 1,000 people with symptomatic chikungunya die of the disease; generally these are people with pre-existing health conditions.<ref name="Vairo_2019" /><ref name="ECDC-factsheet-2024" />

===Transmission===
Chikungunya is generally transmitted from mosquitoes to humans. Chikungunya is spread through bites from ''[[Aedes]]'' mosquitoes, specifically ''[[A. aegypti]]'' (Egyptian mosquito) and ''[[A. albopictus]] (Tiger mosquito).''<ref name="WHO_FactSheet_2025" /> Because high amounts of virus are present in the blood during the first few days of infection, the virus can spread from an infected human to a mosquito, where it replicates without harming the mosquito. Subsequently, a bite from the infected mosquito will transmit the virus back to a human.<ref name="WHO_FactSheet_2025" /> The [[incubation period]] ranges from one to twelve days and is most typically three to seven.<ref name="Thiberville-2013" /> 

Rarely, the disease can be transmitted from [[Vertically transmitted infection|mother to child]] during pregnancy or at birth, in women who become infected a few days before [[Childbirth|delivery]].<ref name="ECDC-factsheet-2024" />

==Mechanism==
Chikungunya virus is passed to humans when a bite from an infected mosquito breaks the skin and introduces the virus into the body. The virus initially replicates in cells near the location of the bite; from here it enters the [[lymphatic system]] and the [[Circulatory system|bloodstream]], enabling it to circulate to organs and tissues which become infected. Most frequently it reproduces in the lymphatic system and the [[spleen]], as well as peripheral joints, muscles and tendons where symptoms frequently occur; it appears that the virus is able to penetrate and replicate in many different types of cells.<ref name=":12">{{Cite journal |last1=Silva |first1=Laurie A. |last2=Dermody |first2=Terence S. |date=2017-03-01 |title=Chikungunya virus: epidemiology, replication, disease mechanisms, and prospective intervention strategies |journal=The Journal of Clinical Investigation |language=en |volume=127 |issue=3 |pages=737–749 |doi=10.1172/JCI84417 |pmid=28248203 |pmc=5330729 |issn=0021-9738}}</ref> In severe cases it can infect the brain and liver.<ref name=":0">{{Cite journal |last1=Vu |first1=David M. |last2=Jungkind |first2=Donald |last3=Angelle Desiree LaBeaud |date=2017-06-01 |title=Chikungunya Virus |journal=Clinics in Laboratory Medicine |series=Emerging Pathogens |volume=37 |issue=2 |pages=371–382 |doi=10.1016/j.cll.2017.01.008 |issn=0272-2712 |pmc=5469677 |pmid=28457355}}</ref>'''<ref name=":12" />'''

During the acute phase of infection, large numbers of infectious [[Virion|virus particles]] are [[Viral load|present in the bloodstream]], making it very likely that an uninfected mosquito will pick up the virus if it bites the human host.<ref name=":0" /> '''<ref name=":12" />'''

During the first few days of infection, the host's [[innate immune system]] is activated, producing [[Interferon type I|type I interferons]] and [[Inflammatory cytokine|inflammatory cytokines]] to fight the infection. This generates the fever and localised inflammation which is characteristic of the disease.'''<ref name=":12" />'''<ref name=":3">{{Cite journal |last1=Srivastava |first1=Priyanshu |last2=Kumar |first2=Ankit |last3=Hasan |first3=Abdul |last4=Mehta |first4=Divya |last5=Kumar |first5=Ramesh |last6=Sharma |first6=Chetan |last7=Sunil |first7=Sujatha |date=2020-04-28 |title=Disease Resolution in Chikungunya—What Decides the Outcome? |journal=Frontiers in Immunology |language=English |volume=11 |article-number=695 |doi=10.3389/fimmu.2020.00695 |doi-access=free |issn=1664-3224 |pmc=7198842 |pmid=32411133}}</ref> It takes about a week before the host's [[adaptive immune system]] begins to develop [[Antibody|antibodies]] which eventually clear the virus from the bloodstream.<ref>{{Cite web |last=CDC |date=2025-08-20 |title=Clinical Testing and Diagnosis for Chikungunya Virus Disease |url=https://www.cdc.gov/chikungunya/hcp/diagnosis-testing/index.html |access-date=2025-10-27 |website=Chikungunya Virus |language=en-us}}</ref> However the virus can persist within specific tissues, especially the joints, causing long term inflammation and pain in chronic cases.<ref name=":3" />

The virus has mechanisms which help it to evade the immune response. Within an infected cell, the viral nonstructural protein 2 (nsP2) interferes with the [[JAK-STAT signaling pathway|JAK-STAT]] signalling pathway to hinder it from triggering an antiviral response.<ref>{{Cite journal |last1=Fros |first1=Jelke J. |last2=Liu |first2=Wen Jun |last3=Prow |first3=Natalie A. |last4=Geertsema |first4=Corinne |last5=Ligtenberg |first5=Maarten |last6=Vanlandingham |first6=Dana L. |last7=Schnettler |first7=Esther |last8=Vlak |first8=Just M. |last9=Suhrbier |first9=Andreas |last10=Khromykh |first10=Alexander A. |last11=Pijlman |first11=Gorben P. |date=2010-10-15 |title=Chikungunya Virus Nonstructural Protein 2 Inhibits Type I/II Interferon-Stimulated JAK-STAT Signaling |journal=Journal of Virology |volume=84 |issue=20 |pages=10877–10887 |doi=10.1128/jvi.00949-10 |pmid=20686047 |pmc=2950581 }}</ref> The virus can induce [[apoptosis]] (programmed cell death) in host cells; virus laden [[Bleb (cell biology)|debris from apoptosis]] is engulfed by [[Macrophage|macrophages]] which in turn become infected.<ref>{{Cite journal |last1=Srivastava |first1=Priyanshu |last2=Kumar |first2=Ankit |last3=Hasan |first3=Abdul |last4=Mehta |first4=Divya |last5=Kumar |first5=Ramesh |last6=Sharma |first6=Chetan |last7=Sunil |first7=Sujatha |date=2020-04-28 |title=Disease Resolution in Chikungunya—What Decides the Outcome? |journal=Frontiers in Immunology |language=English |volume=11 |article-number=695 |doi=10.3389/fimmu.2020.00695 |doi-access=free |issn=1664-3224 |pmc=7198842 |pmid=32411133}}</ref> The virus also seems to be able to evade [[T cell|T lymphocytes]] which seek to target and destroy the virus particles.<ref>{{Cite journal |last1=Davenport |first1=Bennett J. |last2=Bullock |first2=Christopher |last3=McCarthy |first3=Mary K. |last4=Hawman |first4=David W. |last5=Murphy |first5=Kenneth M. |last6=Kedl |first6=Ross M. |last7=Diamond |first7=Michael S. |last8=Morrison |first8=Thomas E. |date=2020-04-16 |title=Chikungunya Virus Evades Antiviral CD8+ T Cell Responses To Establish Persistent Infection in Joint-Associated Tissues |journal=Journal of Virology |volume=94 |issue=9 |pages=10.1128/jvi.02036–19 |doi=10.1128/jvi.02036-19 |pmid=32102875 |pmc=7163133 }}</ref>

== Diagnosis ==
Diagnosing chikungunya can be difficult because its symptoms, such as sudden fever and joint pain, closely resemble other mosquito-borne illnesses like [[dengue fever]] and [[malaria]].<ref name=":1">{{Citation |last1=Ojeda Rodriguez |first1=Jafet A. |title=Chikungunya Fever |date=2025 |work=StatPearls |url=http://www.ncbi.nlm.nih.gov/books/NBK534224/ |access-date=2025-10-30 |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=30480957 |last2=Haftel |first2=Anthony |last3=Walker |first3=I. I. I.}}</ref> Chikungunya should be suspected if a patient with these symptoms either lives in an area where the virus is endemic, or if f they have recently traveled to such an area.<ref name=":1" /><ref name="CDC_2024_About">{{Cite web |last=CDC |date=15 May 2024 |title=About Chikungunya |url=https://www.cdc.gov/chikungunya/about/index.html |access-date=2025-10-15 |website=Centers for Disease Control and Prevention |language=en-us}}</ref>

During the first week of illness, when virus is present in the bloodstream, it is possible to detect viral RNA in a blood sample using techniques such as [[Reverse transcription polymerase chain reaction|reverse transcription-polymerase chain reaction]] (RT-PCR) or [[viral culture]].<ref name="CDC_2024_About" /> After this time, the body develops antibodies and the virus is eliminated from the bloodstream. Antibodies in blood serum persist for between 3 and 12 months; they can be detected for up to a year after infection using [[ELISA|enzyme-linked immunosorbent assay]] (ELISA) or [[Immunofluorescence|indirect fluorescent antibody]] (IFA).<ref name=":1" /><ref name="Vairo_20192">{{Cite journal |last1=Vairo |first1=F. |last2=Haider |first2=N. |last3=Kock |first3=R. A. |last4=Ntoumi |first4=F. |last5=Ippolito |first5=G. |last6=Zumla |first6=A. |date=2019-10-25 |title=Chikungunya: Epidemiology, Pathogenesis, Clinical Features, Management, and Prevention (Full text download) |url=https://rvc-repository.worktribe.com/output/1379997 |journal=Infectious Disease Clinics of North America |language=en |volume=33 |issue=4 |doi=10.1016/j.idc.2019.08.006 |pmid=31668189 |issn=0891-5520}}</ref> All of these techniques are time consuming and costly, requiring sophisticated laboratory equipment which may not be available in [[Developing country|resource poor settings]].<ref>{{Cite journal |last1=Silva |first1=Lívia do Carmo |last2=Costa |first2=Luiz Henrique Alves |last3=Dos Santos |first3=Isabela Cristina de Oliveira |last4=de Curcio |first4=Juliana Santana |last5=Barbosa |first5=Amanda Munik de Freitas |last6=Anunciação |first6=Carlos Eduardo |last7=Silveira-Lacerda |first7=Elisângela de Paula |date=2024-02-01 |title=Advancing Chikungunya Diagnosis: A Cost-Effective and Rapid Visual employing Loop-mediated isothermal reaction |url=https://www.sciencedirect.com/science/article/pii/S0732889323002201 |journal=Diagnostic Microbiology and Infectious Disease |volume=108 |issue=2 |article-number=116111 |doi=10.1016/j.diagmicrobio.2023.116111 |pmid=38016385 |issn=0732-8893}}</ref>

=== Differential diagnosis ===
The ''Aedes'' mosquitoes which carry chikungunya virus can also carry other viruses such as [[Dengue fever|dengue]], [[Zika fever|zika]], and [[yellow fever]].<ref name=":2">{{Cite journal |last=Abbasi |first=Ebrahim |date=2025-03-01 |title=Global expansion of Aedes mosquitoes and their role in the transboundary spread of emerging arboviral diseases: A comprehensive review |url=https://onehealth.ijidonline.org/article/S2949-9151(25)00006-X/fulltext |journal=IJID One Health |language=English |volume=6 |article-number=100058 |doi=10.1016/j.ijidoh.2025.100058 |issn=2949-9151}}</ref> Other infections which should be considered include [[malaria]], [[leptospirosis]], [[measles]], [[Infectious mononucleosis|mononucleosis]] and [[African tick bite fever]], which are often endemic in the same areas and can have similar symptoms. It is possible for a patient to be infected by [[Coinfection|more than one virus]] simultaneously.<ref name=":1" />

==Prevention==
[[File:Aedes aegypti biting human.jpg|thumb|''A. aegypti'' mosquito biting a person]]
Although an approved [[vaccine]] exists, the most effective means of prevention is to avoid or prevent mosquito bites. The main strategies for this are: controlling mosquito populations by limiting their [[habitat]]; and protection against contact with disease-carrying mosquitoes.<ref name="Caglioti-2013" /> On a large scale, [[mosquito control]] focuses on eliminating standing water where mosquitoes lay eggs and develop as larvae.<ref name="Weaver-2015">{{cite journal |vauthors=Weaver SC, Lecuit M |date=March 2015 |title=Chikungunya virus and the global spread of a mosquito-borne disease |journal=The New England Journal of Medicine |volume=372 |issue=13 |pages=1231–39 |doi=10.1056/NEJMra1406035 |pmid=25806915}}</ref> Individuals should use [[Insect repellent|mosquito repellent]], as well as barriers such as loose clothing that covers the arms and legs, [[mosquito net]]<nowiki/>s and [[Window screen|window and door screen]]<nowiki/>s.<ref>{{Cite web |date=24 January 2023 |title=Mosquito bite avoidance: advice for travellers |url=https://www.gov.uk/government/publications/mosquito-bite-avoidance-for-travellers/mosquito-bite-avoidance-advice-for-travellers--2 |access-date=2025-11-11 |website=UK Health Security Agency |language=en}}</ref>

Once immunity against chikungunya has been acquired, whether as a result of infection or vaccination, it endures long term and may be lifelong.<ref name="ECDC-factsheet-2024" /><ref>{{Cite web |title=What Is Chikungunya? |url=https://my.clevelandclinic.org/health/diseases/25083-chikungunya |archive-url=http://web.archive.org/web/20250914191436/https://my.clevelandclinic.org/health/diseases/25083-chikungunya |archive-date=2025-09-14 |access-date=2025-11-11 |website=Cleveland Clinic |language=en}}</ref>

===Vaccination===
{{Excerpt|Chikungunya vaccine}}

==Treatment==
No specific treatment for chikungunya is available.<ref name="Caglioti-2013" /> [[Therapy#Supportive therapy|Supportive care]] is recommended, and symptomatic treatment of fever and joint swelling includes the use of  [[paracetamol]] (acetaminophen), rest, and fluids.<ref name="Caglioti-2013" /><ref name="ECDC-factsheet-2024">{{cite web|url=https://www.ecdc.europa.eu/en/chikungunya/facts/factsheet|title=Chikungunya – Fact sheet|date=24 June 2024<!--from page source-->|publisher=[[European Centre for Disease Prevention and Control]] (ECDC)|url-status=live|archive-url=https://web.archive.org/web/20131219030113/http://ecdc.europa.eu/en/healthtopics/chikungunya_fever/basic_facts/pages/factsheet_health_professionals.aspx|archive-date=19 December 2013}}</ref> [[Nonsteroidal anti-inflammatory drug|Non-steroidal anti-inflammatory drugs]] (NSAIDs) such as [[aspirin]] or [[ibuprofen]] should not be used in the acute phase until dengue fever has been ruled out, as these can increase the risk of bleeding in dengue.<ref name="WHO_FactSheet_2025" /><ref name=":1" />

Chronic symptoms, especially joint pain, may persist for months after the infection has passed. The pain and swelling may be treated with NSAIDs or in more severe cases with [[corticosteroid]] drugs or [[Disease-modifying antirheumatic drug|disease-modifying antirheumatic drugs]] such as [[hydroxychloroquine]].<ref name=":1" /><ref>{{Cite journal |last1=Pathak |first1=Himanshu |last2=Mohan |first2=Mithun C |last3=Ravindran |first3=Vinod |date=2019-09-01 |title=Chikungunya arthritis |journal=Clinical Medicine |volume=19 |issue=5 |pages=381–385 |doi=10.7861/clinmed.2019-0035 |issn=1470-2118 |pmc=6771335 |pmid=31530685}}</ref>

==Prognosis==
The [[mortality rate]] of chikungunya is slightly less than 1 in 1000.<ref name="Mavalankar-2008">{{cite journal | vauthors = Mavalankar D, Shastri P, Bandyopadhyay T, Parmar J, Ramani KV | title = Increased mortality rate associated with chikungunya epidemic, Ahmedabad, India | journal = Emerging Infectious Diseases | volume = 14 | issue = 3 | pages = 412–15 | date = March 2008 | pmid = 18325255 | pmc = 2570824 | doi = 10.3201/eid1403.070720 }}</ref> Those over the age of 65, [[neonate|infant]]s, and those with underlying chronic medical problems are most likely to have severe complications.<ref name="Morrison-2014">{{cite journal | vauthors = Morrison TE | title = Reemergence of chikungunya virus | journal = Journal of Virology | volume = 88 | issue = 20 | pages = 11644–47 | date = October 2014 | pmid = 25078691 | pmc = 4178719 | doi = 10.1128/JVI.01432-14 }}</ref> Newborn infants are especially vulnerable as they lack fully developed [[immune system]]s, and may pick up the infection through vertical [[Vertically transmitted infection|transmission]] from their mother.<ref name="Morrison-2014" /> The likelihood of prolonged symptoms or chronic joint pain is increased with increased age and prior rheumatological disease.<ref name="Schilte-2013">{{cite journal | vauthors = Schilte C, Staikowsky F, Staikovsky F, Couderc T, Madec Y, Carpentier F, Kassab S, Albert ML, Lecuit M, Michault A | title = Chikungunya virus-associated long-term arthralgia: a 36-month prospective longitudinal study | journal = PLOS Neglected Tropical Diseases | volume = 7 | issue = 3 | article-number = e2137 | year = 2013 | pmid = 23556021 | pmc = 3605278 | doi = 10.1371/journal.pntd.0002137 | doi-access = free }}{{open access}}</ref><ref name="Gérardin-2013">{{cite journal | vauthors = Gérardin P, Fianu A, Michault A, Mussard C, Boussaïd K, Rollot O, Grivard P, Kassab S, Bouquillard E, Borgherini G, Gaüzère BA, Malvy D, Bréart G, Favier F | title = Predictors of Chikungunya rheumatism: a prognostic survey ancillary to the TELECHIK cohort study | journal = Arthritis Research & Therapy | volume = 15 | issue = 1 | article-number = R9 | date = January 2013 | pmid = 23302155 | pmc = 3672753 | doi = 10.1186/ar4137 | doi-access = free }}</ref>

==Epidemiology==
<!-- DO NOT ADD ANY EXAMPLES OF OUTBREAKS TO THIS SECTION. ADD IT TO THE MAIN ARTICLE "Chikungunya outbreaks" -->
{{Main|Epidemiology of chikungunya}}

[[File:CHIK-World-Map-09-17-2019.jpg|thumb|upright=1.3|Dark green denotes countries with current or previous local transmission of chikungunya virus, per US [[Centers for Disease Control and Prevention]] (CDC) as of September 2019.]]
[[File:Global_Aedes_albopictus_distribution_2015.png|thumb|upright=1.3|''A. albopictus'' distribution as of 2015]]
Historically, chikungunya has been present mostly in the [[developing world]]. The disease causes an estimated 3 million infections each year.<ref>{{cite news|last=Seppa|first=Nathan |date=2 June 2015|title=Chikungunya is on the move|url=https://www.sciencenews.org/article/chikungunya-move|newspaper=[[Science News]]|access-date=13 June 2015|url-status=live|archive-url=https://web.archive.org/web/20150611173200/https://www.sciencenews.org/article/chikungunya-move|archive-date=11 June 2015}}</ref> Epidemics in the Indian Ocean, Pacific Islands, and in the Americas, continue to change the distribution of the disease.<ref name="Sam-2012">{{cite journal | vauthors = Sam IC, Loong SK, Michael JC, Chua CL, Wan Sulaiman WY, Vythilingam I, Chan SY, Chiam CW, Yeong YS, AbuBakar S, Chan YF | title = Genotypic and phenotypic characterization of Chikungunya virus of different genotypes from Malaysia | journal = PLOS ONE| volume = 7 | issue = 11 | article-number = e50476 | year = 2012 | pmid = 23209750 | pmc = 3507689 | doi = 10.1371/journal.pone.0050476 | bibcode = 2012PLoSO...750476S | doi-access = free }}</ref> In Africa, chikungunya is spread by a [[sylvatic cycle]] in which the virus largely cycles between other non-human [[primate]]s, small mammals, and mosquitos between human outbreaks.<ref name="Powers-2007">{{cite journal | vauthors = Powers AM, Logue CH | title = Changing patterns of chikungunya virus: re-emergence of a zoonotic arbovirus | journal = The Journal of General Virology | volume = 88 | issue = Pt 9 | pages = 2363–77 | date = September 2007 | pmid = 17698645 | doi = 10.1099/vir.0.82858-0 | doi-access = free }}</ref> 

During outbreaks, due to the high concentration of virus in the blood of those in the acute phase of infection, the virus can circulate from humans to mosquitoes and back to humans.<ref name="Powers-2007" /> The transmission of the pathogen between humans and mosquitoes that exist in urban environments was established on multiple occasions from strains occurring on the eastern half of Africa in non-human primate hosts.<ref name="Weaver-2015" /> This emergence and spread beyond Africa may have started as early as the 18th century.<ref name="Weaver-2015" /> 

Available data does not indicate whether the introduction of chikungunya into Asia occurred in the 19th century or more recently, but this epidemic Asian strain causes outbreaks in India and continues to circulate in Southeast Asia.<ref name="Weaver-2015" /> In Africa, outbreaks were typically tied to heavy rainfall causing increased mosquito population. In recent outbreaks in urban centers, the virus has spread by circulating between humans and mosquitoes.<ref name="Burt-2012" />

Global rates of chikungunya infection are variable, depending on outbreaks. When chikungunya was first identified in 1952, it had a low-level circulation in West Africa, with infection rates linked to rainfall. Beginning in the 1960s, periodic outbreaks were documented in Asia and Africa. Since 2005, following several decades of relative inactivity, chikungunya has re-emerged and caused large outbreaks in Africa, Asia, and the Americas. In India, for instance, chikungunya re-appeared following 32 years of absence of viral activity.<ref name="Lahariya-2006">{{cite journal | vauthors = Lahariya C, Pradhan SK | title = Emergence of chikungunya virus in Indian subcontinent after 32 years: A review | journal = Journal of Vector Borne Diseases | volume = 43 | issue = 4 | pages = 151–60 | date = December 2006 | pmid = 17175699 | url = http://www.mrcindia.org/journal/issues/434151.pdf | archive-url = https://web.archive.org/web/20131019092834/http://www.mrcindia.org/journal/issues/434151.pdf | archive-date = 19 October 2013 }}</ref> 

Outbreaks have occurred in Europe, the Caribbean, and South America, areas in which chikungunya was not previously transmitted. Local transmission has also occurred in the United States and Australia, countries in which the virus was previously unknown.<ref name="Burt-2012" /> In 2005, an outbreak on the island of [[Réunion]] was the largest then documented, with an estimated 266,000 cases on an island with a population of approximately 770,000.<ref name="Roth-2014">{{cite journal | vauthors = Roth A, Hoy D, Horwood PF, Ropa B, Hancock T, Guillaumot L, Rickart K, Frison P, Pavlin B, Souares Y | title = Preparedness for threat of chikungunya in the pacific | journal = Emerging Infectious Diseases | volume = 20 | issue = 8 | date = August 2014 | pmid = 25062306 | pmc = 4111160 | doi = 10.3201/eid2008.130696 }}</ref> In a 2006 outbreak, India reported 1.25 million suspected cases.<ref name="Muniaraj-2014">{{cite journal | vauthors = Muniaraj M | title = Fading chikungunya fever from India: beginning of the end of another episode? | journal = The Indian Journal of Medical Research | volume = 139 | issue = 3 | pages = 468–70 | date = March 2014 | pmid = 24820844 | pmc = 4069744 }}</ref> 

Chikungunya was introduced to the Americas in 2013, first detected on the French island of [[Collectivity of Saint Martin|Saint Martin]],<ref>{{cite news |last1=Charles |first1=Jacqueline |title=Mosquito-borne virus knocking on Fla.'s door |url=https://www.newspapers.com/image/651097045 |access-date=22 February 2023 |work=Newspapers.com |publisher=The Miami Herald |date=1 June 2014 |page=A17 }}</ref> and for the next two years in the Americas, 1,118,763 suspected cases and 24,682 confirmed cases were reported by the [[PAHO]].<ref>{{cite web |url=http://www.paho.org/hq/index.php?option=com_docman&task=doc_download&Itemid=&gid=30198&lang=en |title=Number of cumulative cases 2013–2014 |author=<!--Staff writer(s); no by-line.--> |date=15 May 2015 |website=www.paho.org |publisher=Pan-American Health Organization (PAHO) |access-date=19 July 2015 |url-status=live |archive-url=https://web.archive.org/web/20150721172909/http://www.paho.org/hq/index.php?option=com_docman&task=doc_download&Itemid=&gid=30198&lang=en |archive-date=21 July 2015 }}</ref> In 2023, Brazil experienced a significant outbreak, with over 180,000 cases reported, prompting intensified public health interventions and renewed research efforts on viral mutations and transmission patterns<ref>{{Cite journal |last1=de Jesus |first1=Augusto César Parreiras |last2=Fonseca |first2=Paula Luize Camargos |last3=Alves |first3=Hugo José |last4=Bonfim |first4=Diego Menezes |last5=Dutra |first5=João Victor Rodrigues |last6=Moreira |first6=Filipe Romero Rebello |last7=de Brito Mendonça |first7=Cristiane Pinheiro Toscano |last8=Rios |first8=Jéssica Silqueira Hickson |last9=do Prado Silva |first9=Joice |last10=Malta |first10=Frederico Scott Varella |last11=Braga-Paz |first11=Isabela |last12=de Araújo |first12=João Locke Ferreira |last13=de Oliveira |first13=Jaqueline Silva |last14=de Souza |first14=Carolina Senra Alves |last15=da Silva |first15=Sandra Elisa Barbosa |date=20 November 2024 |title=Retrospective epidemiologic and genomic surveillance of arboviruses in 2023 in Brazil reveals high co-circulation of chikungunya and dengue viruses |journal=BMC Medicine |volume=22 |issue=1 |page=546 |doi=10.1186/s12916-024-03737-w |doi-access=free |issn=1741-7015 |pmc=11577721 |pmid=39567979}}</ref>

An analysis of the genetic code of chikungunya virus suggests that the increased severity of the 2005–present outbreak may be due to a change in the genetic sequence which altered the E1 segment of the virus' [[viral coat]] protein, a variant called E1-A226V. This mutation potentially allows the virus to multiply more easily in mosquito cells.<ref name="Schuffenecker-2006">{{cite journal | vauthors = Schuffenecker I, Iteman I, Michault A, Murri S, Frangeul L, Vaney MC, Lavenir R, Pardigon N, Reynes JM, Pettinelli F, Biscornet L, Diancourt L, Michel S, Duquerroy S, Guigon G, Frenkiel MP, Bréhin AC, Cubito N, Desprès P, Kunst F, Rey FA, Zeller H, Brisse S | title = Genome microevolution of chikungunya viruses causing the Indian Ocean outbreak | journal = PLOS Medicine | volume = 3 | issue = 7 | article-number = e263 | date = July 2006 | pmid = 16700631 | pmc = 1463904 | doi = 10.1371/journal.pmed.0030263 | doi-access = free }}</ref> The change allows the virus to use ''[[Aedes albopictus]]'' as a [[Vector (epidemiology)|vector]] in addition to the more strictly [[tropical]] main vector, ''[[Aedes aegypti]]''.<ref>{{cite journal | vauthors = Tsetsarkin KA, Vanlandingham DL, McGee CE, Higgs S | title = A single mutation in chikungunya virus affects vector specificity and epidemic potential | journal = PLOS Pathogens | volume = 3 | issue = 12 | article-number = e201 | date = December 2007 | pmid = 18069894 | pmc = 2134949 | doi = 10.1371/journal.ppat.0030201 | doi-access = free }} {{open access}}</ref> Enhanced transmission of chikungunya virus by ''A. albopictus'' could mean an increased risk for outbreaks in other areas where the mosquito is present.<ref>{{cite journal | vauthors = Liumbruno GM, Calteri D, Petropulacos K, Mattivi A, Po C, Macini P, Tomasini I, Zucchelli P, Silvestri AR, Sambri V, Pupella S, Catalano L, Piccinini V, Calizzani G, Grazzini G | title = The Chikungunya epidemic in Italy and its repercussion on the blood system | journal = Blood Transfusion = Trasfusione del Sangue | volume = 6 | issue = 4 | pages = 199–210 | date = October 2008 | pmid = 19112735 | pmc = 2626913 | doi = 10.2450/2008.0016-08 }}</ref> ''A. albopictus'' is an invasive species which since the 1960's has spread through Europe, the Americas, the Caribbean, Africa, and the Middle East.<ref>{{Cite web |title=Global Invasive Species Database |url=https://www.iucngisd.org/gisd/100_worst.php |access-date=2025-10-19 |website=The International Union for Conservation of Nature Species Survival Commission}}</ref>

After the detection of [[zika virus]] in Brazil in April 2015, the first ever in the Western Hemisphere,<ref>{{cite web |url=http://g1.globo.com/bahia/noticia/2015/04/identificado-virus-causador-de-doenca-misteriosa-em-salvador-e-rms.html |title=Identificado vírus causador de doença misteriosa em Salvador e RMS |access-date=9 May 2015 |url-status=live |archive-url=https://web.archive.org/web/20150518101940/http://g1.globo.com/bahia/noticia/2015/04/identificado-virus-causador-de-doenca-misteriosa-em-salvador-e-rms.html |archive-date=18 May 2015 |date=29 April 2015 }}</ref><ref>{{cite web |url=http://www.cenariomt.com.br/noticia/442333/sao-paulo-ja-pode-ter-casos-de-zika-virus.html |title=São Paulo já pode ter casos de Zika Vírus - Cenário da Notícia em Lucas do Rio Verde e Região |access-date=9 May 2015 |archive-url=https://web.archive.org/web/20150505223949/http://www.cenariomt.com.br/noticia/442333/sao-paulo-ja-pode-ter-casos-de-zika-virus.html |archive-date=5 May 2015 }}</ref> it is now{{When|date=October 2025}} thought some chikungunya and dengue cases could in fact be zika virus cases or [[coinfection]]s.{{cn|date=March 2025}}

Since the start of 2025, and as of 25 February, more than 30,000 chikungunya virus cases and 14 related deaths have been reported across 14 countries and territories in the Americas, Africa, Asia, and Europe.<ref>{{Cite web |date=3 March 2025 |title=Chikungunya worldwide overview |url=https://www.ecdc.europa.eu/en/chikungunya-monthly |access-date=5 March 2025 |website=[[European Centre for Disease Prevention and Control]] }}</ref>

==History==

The disease was first described by Marion Robinson<ref name="Robinson-1955">{{cite journal | vauthors = Robinson MC | title = An epidemic of virus disease in Southern Province, Tanganyika Territory, in 1952–53. I. Clinical features | journal = Transactions of the Royal Society of Tropical Medicine and Hygiene | volume = 49 | issue = 1 | pages = 28–32 | date = January 1955 | pmid = 14373834 | doi = 10.1016/0035-9203(55)90080-8 }}</ref> and W.H.R. Lumsden<ref name="Lumsden-1955">{{cite journal | vauthors = Lumsden WH | title = An epidemic of virus disease in Southern Province, Tanganyika Territory, in 1952–53. II. General description and epidemiology | journal = Transactions of the Royal Society of Tropical Medicine and Hygiene | volume = 49 | issue = 1 | pages = 33–57 | date = January 1955 | pmid = 14373835 | doi = 10.1016/0035-9203(55)90081-X }}</ref> in a pair of 1955 papers, following an outbreak in 1952 on the [[Geography of Mozambique|Makonde Plateau]], along the border between [[Mozambique]] and [[Tanganyika (territory)|Tanganyika]] (the mainland part of modern-day [[Tanzania]]). Since then outbreaks have occurred occasionally in Africa, South Asia, and Southeast Asia; recent outbreaks have spread the disease over a wider range.{{citation needed|date=May 2021}}

The first recorded outbreak may have been in 1779.<ref name="Carey-1971">{{cite journal | vauthors = Carey DE | title = Chikungunya and dengue: a case of mistaken identity? | journal = Journal of the History of Medicine and Allied Sciences | volume = 26 | issue = 3 | pages = 243–62 | date = July 1971 | pmid = 4938938 | doi = 10.1093/jhmas/XXVI.3.243 }}</ref>

According to the original paper by Lumsden, the term 'chikungunya' is derived from the [[ Makonde language |Makonde]] root verb ''kungunyala'', meaning to dry up or become contorted. In concurrent research, Robinson{{citation needed|date=August 2023}} [[Gloss (transliteration)|glossed]] the Makonde term more specifically as "that which bends up". It is understood to refer to the contorted [[Human position|posture]] of people affected with severe joint pain and [[arthritis|arthritic]] symptoms associated with this disease.<ref>{{cite journal | title = Chikungunya fever diagnosed among international travelers – United States, 2005–2006 | journal = MMWR. Morbidity and Mortality Weekly Report | volume = 55 | issue = 38 | pages = 1040–2 | date = September 2006 | pmid = 17008866 | url = https://www.cdc.gov/mmwr/PDF/wk/mm5538.pdf | archive-url = https://web.archive.org/web/20170528212257/https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5538a2.htm | url-status = live | archive-date = 28 May 2017 | author1 = Centers for Disease Control Prevention (CDC) }}</ref> Subsequent authors overlooked the references to the Makonde language and assumed the term to have been derived from [[Swahili language|Swahili]], the ''[[lingua franca]]'' of the region and part of a different branch of [[Bantu language]]s. The erroneous attribution to Swahili has been repeated in numerous print sources.<ref>{{cite web|url=https://kamusi.org/content/chikungunya-not-swahili-word-it-makonde-language | author=Benjamin M | title=Chikungunya is NOT a Swahili word, it is from the Makonde language! | year=2008}}</ref>

In July 2025, a severe outbreak occurred in [[China]]'s [[Guangdong]] province. Seven thousand people tested positive for the disease, although symptoms were said to be minor for 95% of those people.<ref>{{Cite web |date=2025-08-05 |title=Chikungunya virus: China reports 7,000 cases |url=https://www.bbc.com/news/articles/cvg0edj332yo |access-date=2025-08-05 |website=www.bbc.com |language=en-GB}}</ref>

==Research==
Chikungunya is one of more than a dozen agents researched as a potential [[biological weapon]].<ref name="James_Martin_2002">"[http://cns.miis.edu/cbw/possess.htm Chemical and Biological Weapons: Possession and Programs Past and Present] {{webarchive|url=https://web.archive.org/web/20140623181122/http://cns.miis.edu/cbw/possess.htm |date=23 June 2014 }}", James Martin Center for Nonproliferation Studies, [[Middlebury College]], 9 April 2002, accessed 18 June 2014.</ref><ref>{{Cite web|url=https://www.thenewsminute.com/article/how-chikungunya-got-its-name-and-was-potential-biological-weapon-50332|title=How Chikungunya got its name, and was a potential biological weapon|date=23 September 2016}}</ref>

This disease is part of the group of [[neglected tropical diseases]].<ref>{{cite web|title=Neglected tropical diseases|url=https://www.who.int/neglected_diseases/diseases/en/|website=WHO|access-date=26 September 2016|url-status=live|archive-url=https://web.archive.org/web/20140222035302/http://www.who.int/neglected_diseases/diseases/en/|archive-date=22 February 2014}}</ref>

==Chikungunya virus==
{{Split|date=October 2025|Chikungunya virus|discuss=Talk:Chikungunya#Split proposal|section=section}}

===Virology===
{{Virusbox
| name = Chikungunya virus
| image = Chikungunya Virus.png
| image_caption = Chikungunya virus structure at atomic resolution. Bar = 100 Å<ref>{{Citation |last=Padilla-Sanchez |first=Victor |title=Chikungunya Virus |date=2025-08-10 |url=https://zenodo.org/records/16790088 |access-date=2025-08-10 |doi=10.5281/zenodo.16790088}}</ref>
| image_upright = 2.0
| image_alt = The Chikungunya virus structure at atomic resolution has been constructed utilising UCSF Chimera software
| parent = Alphavirus
| species = Alphavirus chikungunya
| synonyms = 
| synonyms_ref = 
| subdivision_ranks = 
| subdivision = 
}}

Chikungunya virus is a member of the genus ''[[Alphavirus]]'', and family ''[[Togaviridae]]''. Chikungunya virus features an icosahedral capsid surrounded by a lipid envelope, with a diameter ranging from 60 to 70 nm.<ref>{{Cite journal |last1=Rougeron |first1=Virginie |last2=Sam |first2=I-Ching |last3=Caron |first3=Mélanie |last4=Nkoghe |first4=Dieudonné |last5=Leroy |first5=Eric |last6=Roques |first6=Pierre |date=1 March 2015 |title=Chikungunya, a paradigm of neglected tropical disease that emerged to be a new health global risk |url=https://linkinghub.elsevier.com/retrieve/pii/S1386653214003710 |journal=Journal of Clinical Virology |volume=64 |pages=144–52 |doi=10.1016/j.jcv.2014.08.032 |issn=1386-6532 |pmid=25453326 |url-access=subscription}}</ref> It was first isolated in 1953 in [[Tanzania]] and is an [[RNA virus]] with a [[RNA virus#Replication|positive-sense single-stranded]] genome of about 11.6kb.<ref name="Weaver-2012">{{cite journal |vauthors=Weaver SC, Osorio JE, Livengood JA, Chen R, Stinchcomb DT |date=September 2012 |title=Chikungunya virus and prospects for a vaccine |journal=Expert Review of Vaccines |volume=11 |issue=9 |pages=1087–101 |doi=10.1586/erv.12.84 |pmc=3562718 |pmid=23151166}}</ref> It is a member of the [[Semliki Forest virus complex]] and is closely related to [[Ross River virus]], [[O'nyong'nyong virus]], and [[Semliki Forest virus]].<ref>{{cite journal |vauthors=Powers AM, Brault AC, Shirako Y, Strauss EG, Kang W, Strauss JH, Weaver SC |date=November 2001 |title=Evolutionary relationships and systematics of the alphaviruses |journal=Journal of Virology |volume=75 |issue=21 |pages=10118–31 |doi=10.1128/JVI.75.21.10118-10131.2001 |pmc=114586 |pmid=11581380}}</ref> Because it is transmitted by [[arthropod]]s, namely mosquitoes, it can also be referred to as an [[arbovirus]] ('''ar'''thropod-'''bo'''rne virus). In the United States, it is classified as a [[Virus Pathogen Database and Analysis Resource|category B priority pathogen]],<ref>{{cite web |title=NIAID Category A, B, and C Priority Pathogens |url=https://www.niaid.nih.gov/research/niaid-biodefense-pathogens |url-status=live |archive-url=https://web.archive.org/web/20140105051524/http://www.niaid.nih.gov/topics/BiodefenseRelated/Biodefense/Pages/CatA.aspx |archive-date=5 January 2014 |access-date=23 July 2020}}</ref> and work requires [[Biosafety level 3|biosafety level III]] precautions.<ref>{{cite web |title=Biosafety in Microbiological and Biomedical Laboratories (BMBL) Fifth Edition |url=https://www.cdc.gov/biosafety/publications/bmbl5/BMBL5_sect_VIII_f.pdf |url-status=live |archive-url=https://web.archive.org/web/20141014111841/http://www.cdc.gov/biosafety/publications/bmbl5/BMBL5_sect_VIII_f.pdf |archive-date=14 October 2014 |access-date=1 January 2014}}</ref>

Three genotypes of this virus have been described, each with a distinct [[genotype]] and [[antigenic]] character: West African, East/Central/South African, and Asian genotypes.<ref name="Powers-2000">{{cite journal |vauthors=Powers AM, Brault AC, Tesh RB, Weaver SC |date=February 2000 |title=Re-emergence of Chikungunya and O'nyong-nyong viruses: evidence for distinct geographical lineages and distant evolutionary relationships |journal=The Journal of General Virology |volume=81 |issue=Pt 2 |pages=471–79 |doi=10.1099/0022-1317-81-2-471 |doi-broken-date=11 July 2025 |pmid=10644846 |doi-access=free}}</ref> The Asian lineage originated in 1952 and has subsequently split into two lineages – India (Indian Ocean Lineage) and South East Asian clades. This virus was first reported in the Americas in 2014. Phylogenetic investigations have shown two strains in Brazil – the Asian and East/Central/South African types – and that the Asian strain arrived in the Caribbean (most likely from Oceania) in about March 2013.<ref name="Sahadeo-2017">{{cite journal |vauthors=Sahadeo NS, Allicock OM, De Salazar PM, Auguste AJ, Widen S, Olowokure B, Gutierrez C, Valadere AM, Polson-Edwards K, Weaver SC, Carrington CV |year=2017 |title=Understanding the evolution and spread of chikungunya virus in the Americas using complete genome sequences |journal=Virus Evol |volume=3 |issue=1 |doi=10.1093/ve/vex010 |pmc=5413804 |pmid=28480053 |doi-access=free |article-number=vex010}}</ref> The rate of molecular evolution was estimated to have a mean rate of 5 × 10<sup>−4</sup> substitutions per site per year (95% higher probability density 2.9–7.9 × 10<sup>−4</sup>).<ref name="Sahadeo-2017" />

The chikungunya virus genome encodes both structural and non-structural proteins as typical of alphavirus genomic organization.<ref name="Wang-2024">{{Cite journal |last1=Wang |first1=Mengke |last2=Wang |first2=Lidong |last3=Leng |first3=Ping |last4=Guo |first4=Jinlin |last5=Zhou |first5=Hao |date=1 March 2024 |title=Drugs targeting structural and nonstructural proteins of the chikungunya virus: A review |url=https://linkinghub.elsevier.com/retrieve/pii/S0141813024007529 |journal=International Journal of Biological Macromolecules |volume=262 |issue=Pt 2 |doi=10.1016/j.ijbiomac.2024.129949 |issn=0141-8130 |pmid=38311132 |url-access=subscription |article-number=129949}}</ref> The structural proteins, including the capsid, E3, E2, 6K and E1, are responsible for encapsulating the viral genome and assembling new viral particles. These proteins are critical for viral entry into host cells. Meanwhile, the non-structural proteins, nsP1, nsP2, nsP3, and nsP4, play essential roles in viral replication, translation, and immune evasion.<ref name="Wang-2024" />

==== Viral replication ====
[[File:Chikungunya virus particles-PHIL-17369.jpg|thumb|[[Transmission electron micrograph]] of chikungunya virus particles]]
The virus consists of four nonstructural proteins and three structural proteins.<ref name="Weaver-2015" /> The structural proteins are the [[capsid]] and two [[Viral envelope|envelope]] glycoproteins: E1 and E2, which form [[heterodimeric]] spikes on the viron surface. E2 binds to cellular receptors in order to enter the host cell through [[receptor-mediated endocytosis]]. E1 contains a [[fusion peptide]] which, when exposed to the acidity of the [[endosome]] in [[eukaryotic cell]]s, dissociates from E2 and initiates [[Lipid bilayer fusion|membrane fusion]] that allows the release of nucleocapsids into the host cytoplasm, promoting infection.<ref>{{cite journal |vauthors=Voss JE, Vaney MC, Duquerroy S, Vonrhein C, Girard-Blanc C, Crublet E, Thompson A, Bricogne G, Rey FA |date=December 2010 |title=Glycoprotein organization of Chikungunya virus particles revealed by X-ray crystallography |journal=Nature |volume=468 |issue=7324 |pages=709–12 |bibcode=2010Natur.468..709V |doi=10.1038/nature09555 |pmid=21124458 |s2cid=4412764}}</ref> The mature virion contains 240 [[heterodimeric]] spikes of E2/E1, which after release, bud on the surface of the infected cell, where they are released by [[exocytosis]] to infect other cells.<ref name="Weaver-2012" />

==See also==
{{Portal|Viruses}}
* [[Coalition for Epidemic Preparedness Innovations]]
* [[Epidemiology of chikungunya]]
* [[Wolbachia]]

== References ==
{{Reflist}}
*

== External links ==
* {{cite web|url=https://www.ecdc.europa.eu/en/chikungunya-virus-disease|title= Chikungunya virus disease |date= 11 June 2017 |publisher=[[European Centre for Disease Prevention and Control]] }}

{{Medical resources
|  DiseasesDB      = 32213
|  ICD11           = {{ICD11|1D40}}
|  ICD10           = {{ICD10|A|92|0|a|90}}
|  ICD9            = {{ICD9|065.4}}, {{ICD9|066.3}}
|  OMIM            =
|  eMedicineSubj   =article
|  eMedicineTopic  =2225687
|  MeshID          = D018354
| Orphanet=324625
}}
{{Zoonotic viral diseases}}
{{Vaccines}}
{{Taxonbar|from=Q15794049}}
{{Portal bar | Medicine}}
{{Authority control}}

[[Category:Chikungunya| ]]
[[Category:Biological agents]]
[[Category:Health disasters in India]]
[[Category:Tropical diseases]]
[[Category:Zoonotic viral diseases]]