Chikungunya: Fever that Bends the Joints

No relation of chicken or bird flu, chikungunya can dramatically affect your bones and undermine your health

A woman in a hospsital bed

Chikungunya is a viral illness. It is fast spreading across the globe. During the past two years, chikungunya is reported to have affected millions of people.

A virus transmitted by mosquitoes, chikungunya is yet another example of microbes jumping into the civilised world from the jungles as a result of relentless destruction of natural habitat and depleting forest cover.

Chikungunya was first reported from Tanzania, Africa, in 1952.

The illness has nothing to do with chicken, or bird, flu, as some believe. The term is an adaptation of kungunyala, a verb in Makonde, a Tanzanian lingo, meaning “that which bends up.” It describes the bent-up posture caused by severe joint pain, the hallmark of chikungunya.

Chikungunya arrived in India in 1963. Cases of the illness were first reported from Kolkata. Early on, the illness was reported sporadically and considered non-fatal.

Epidemic concerns

In 2005, the illness started spreading in epidemic proportions from Reunion Islands in the Indian Ocean. Thousands of cases, with 100s of deaths, have been reported from southern and central India ever since.

This increased virulence has been attributed to changes that have recently occurred in the structure of the virus [mutation]. These changes have enabled the virus to be transmitted by the mosquito, Aedes albopictus, in addition to Aedes aegypti, its traditional vector. This has also resulted in severe transmission of the illness we are now witness to.


In typical cases, symptoms of chikungunya appear suddenly and dramatically with fever and joint pain. The pain in the joints, with or without swelling, develops over a few hours, as one joint after the other gets affected.

The pain may be so severe in certain cases that the affected individual is unable to even move. S/he is often confined to bed. Headache, low backache, a reddish rash on the limbs and trunk, and redness of the eyes may be the other presenting symptoms.

The fever normally lasts for two days and comes down abruptly. However, joint pain, intense headache, sleeplessness and extreme weakness can last for a variable period, usually for 5-7 days, or, in some cases, even for weeks, or months.

However this may be, the mere presence of joint pains with fever should not be labelled as chikungunya, because a host of other febrile diseases can also present with joint pains and fever. Dengue fever, another viral infection spread by Aedes aegypti mosquito, may, for instance, have similar symptoms in the early stages of infection. However, unlike dengue, chikungunya does not produce haemorrhages [bleeding], or shock. It is also rarely fatal.

Confirmation of chikungunya is possible only by means of blood tests that are expensive. Worse still, they are not readily available. Your doctor would be the best judge to confirm, or rule out the illness, or call for blood tests.

Self-limiting illness

In a majority of cases, chikungunya resolves on its own, in about a week. Generally, no specific treatment is needed. Simple analgesics like paracetamol can be used to ease pain. Potent anti-inflammatory drugs are best avoided. Use of steroids, herbal remedies, or other “magic drugs” may also be best avoided. For those with persistent joint pain, drugs like chloroquine are reported to be beneficial.

Most deaths attributed to chikungunya occur in elderly and debilitated patients who may already be suffering from other illnesses involving major organs.

Preventing chikungunya

Since chikungunya is spread by mosquitoes, the best way its spread can be checked is by tackling mosquito population and/or menace. Given that Aedes mosquitoes are day-time biters, use of bed nets may not protect against chikungunya. It would be advisable to wear long-sleeved shirts and long pants when you are outdoors. This will provide effective “cover” for your body from mosquito bites. Mosquito repellents may also be applied on exposed skin and clothing to keep mosquitoes away.

The best method to prevent all mosquito-borne infections is to destroy the larvae that develop in stagnant water. Aedes mosquitoes breed abundantly in small pools of clean water in flower pots, window shades, buckets, used tyres and the like, that are thrown out in the open, at construction sites, and overhead tanks that are left uncovered. It is mandatory to clear debris, and also clean overhead water sources, at regular intervals.

One can also effectively keep chikungunya away with the participation of the community. Every locality is the responsibility of the people living there rather than the administration. This is, in fact, one of the most practical ways to check and/or prevent mosquito-borne diseases, such as chikungunya.

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Srinivas Bevinje
Dr Srinivas Kakkilaya Bevinje, MD, is a Mangalore-based consultant physician. His areas of interest include metabolic medicine, infectious diseases, and community health.


  1. My mom is 63year old,she was affected by chickungunya 2 months before but till date she is having all joint pain with swelling, any physiotherapy is advisable or not,kindly guide me.

  2. I suffered with chicken guinea fever two months back, but still I have severe joints pain in the leg knee also in the both the hands wrist and I feel most of the time very tired. So I seek your advise to ease from joints pain and what type of food habit i want to adapt, I hope to receive your valuable advice.


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