CLINICAL

MANIFESTATIONS OF
CHIKUNGUNYA VIRUS
Acute Disease 3-7 days

Subacute 2-3 months

Chronic >3 months

Atypical rare
 ACUTE DISEASE
Presentation:
 Abrupt onset of chills
 Sudden onset high fever (40 ºC)
 Nausea and vomiting
 Headache
 myalgia
 Severe joint pain (polyarthralgia)- usually symmetric and bilateral in upper and lower
extremities
 Maculopapular rash characterised by raised spotted lesions - occurs 2-5 days following
the fever; involves the trunk and extremities
In infants a diffuse erythema that blanches is present
These symptoms usually resolve within 7-10 days
Clinical Manifestations- Subacute
Disease
Presents 2-3 months following onset of illness with:
 Distal polyarthritis
 Exacerbation of pain in previously injured joints and bones
 Hypertrophic tenosynovitis in wrists and ankles
Clinical Manifestations – Chronic Disease

Symptoms occurring for more than 3 months and may last for years. They are
inclusive of:
 Inflammatory arthralgias in the same joints that were affected during the
acute stages
 Destructive arthropathy/ arthritis resembling rheumatoid or psoriatic arthritis
The chronic phase is more common among the following at risk groups:
 very young
 Elderly
 Immunocompromised
Clinical Manifestations- Atypical Disease

These manifestations are a result of :

 Direct effects of the virus
 Immunologic response to the virus
 Drug toxicity