Chikungunya

Unique identifier / Notation

BI0203

Synonyms

Chikungunya disease Chikungunya virus CHIKV

Chikungunya is a mosquito-borne viral infection caused by the chikungunya virus. It causes fever and severe arthralgia (joint pain) which is often debilitating. The disease can be endemic and epidemic in countries (WHO, 2025).

Primary reference(s)

WHO, 2025. Chikungunya. World Health Organization (WHO). Accessed 25 May 2025.

Annotations

Additional scientific description

Chikungunya is a mosquito-borne viral disease first described during an outbreak in southern Tanzania in 1952. It is an RNA virus that belongs to the Alphavirus genus of the family Togaviridae. The name 'chikungunya' derives from a word in the Kimakonde language, meaning 'to become contorted', and describes the stooped appearance of sufferers with joint pain (arthralgia) (WHO, 2025).

Chikungunya virus is transmitted between humans through the bites of infected mosquitoes - mainly of the Aedes aegypti and A. albopictus species. Both species can also transmit other mosquito-borne viruses, including dengue and Zika fever viruses. In symptomatic patients, chikungunya disease onset is typically 4-8 days (range 2-12 days) after the bite of an infected mosquito. It is characterized by an abrupt onset of fever, frequently accompanied by severe joint pain. The joint pain is often debilitating and usually lasts for a few days but may be prolonged, lasting for weeks, months or even years. Other common signs and symptoms include joint swelling, muscle pain, headache, nausea, fatigue and rash. Since these symptoms overlap with other infections, including those with dengue and Zika viruses, cases can be misdiagnosed. In the absence of significant joint pain, symptoms in infected individuals are usually mild and the infection may go unrecognized (WHO, 2025).

Laboratory diagnosis is via serological and/or virological testing. Serological testing may confirm the presence of anti-chikungunya antibodies. Immunoglobulin M (IgM) antibody levels are highest three to five weeks after onset of symptoms. Virological testing may isolate the virus itself and should be performed on samples collected during the first week after the onset of symptoms (WHO, 2025).

Metrics and numeric limits

Chikungunya has been identified in over 110 countries in Asia, Africa, Europe and the Americas (WHO, 2025).

The European Centre for Disease Prevention and Control (ECDC) has published case classifications for outbreak management, epidemiological surveillance, and reporting (ECDC, 2018).

Key relevant UN convention / multilateral treaty

International Health Regulations (2005), 3rd ed. (WHO, 2016).

Drivers

The proximity of mosquito vector breeding sites to human habitation is a significant risk factor for chikungunya as well as for other diseases that Aedes mosquito species transmit. At present, the main method to control or prevent the transmission of chikungunya virus is to combat the mosquito vectors. Prevention and control rely heavily on reducing the number of natural and artificial water-filled container habitats that support the breeding of mosquitoes. This requires mobilization of affected and at-risk communities, to empty and clean containers that contain water on a weekly basis to inhibit mosquito breeding and the subsequent production of adults. Sustained community efforts to reduce mosquito breeding can be an effective tool to reduce vector populations (WHO, 2025).

Impacts

Most patients recover fully from the infection; however, occasional cases of eye, heart, and neurological complications have been reported with chikungunya infections. Patients at extremes of the age spectrum are at higher risk for severe disease. Newborns infected during delivery and older people with underlying medical conditions may become severely ill and chikungunya infection can increase the risk of death (WHO, 2025).

Multi-hazard context

Chikungunya vectors are bloodsucking insects, which ingest disease-producing microorganisms during a blood meal from an infected host (human or animal) and later transmit it into a new host, after the pathogen has replicated. Often, once a vector becomes infectious, they are capable of transmitting the pathogen for the rest of its life during each subsequent bite/blood meal (WHO, 2020).

Risk Management

During outbreaks, insecticides may be sprayed to kill flying mosquitoes, applied to surfaces in and around containers where the mosquitoes land, and used to treat water in containers to kill the immature larvae. This may also be performed by health authorities as an emergency measure to control the mosquito population (WHO, 2025).

For protection during outbreaks of chikungunya, clothing which minimises skin exposure to the day-biting vectors is advised. Repellents can be applied to exposed skin or to clothing in strict accordance with product label instructions. Repellents should contain DEET, IR3535 or icaridin. For those who sleep during the daytime, particularly young children, or sick or older people, insecticide-treated mosquito nets afford good protection, because the mosquitoes that transmit chikungunya feed primarily during the day. Basic precautions should be taken by people travelling to risk areas and these include the use of repellents, wearing long sleeves and pants and ensuring rooms are fitted with screens to prevent mosquitoes from entering (WHO, 2025).

There is no specific antiviral drug treatment for chikungunya. Clinical management targets are primarily for relieving the symptoms. There is no commercial vaccine available to protect against chikungunya virus infection. While there are several vaccine strategies being pursued (as of mid-2020), of which some are in various stages of clinical trials, they are still several years away from being licensed and available to the public. Prevention of infection by avoiding mosquito bites is the best protection (WHO, 2025).

Monitoring

WHO supports countries to conduct all-hazards strategic risk assessment in the contexts of health emergencies and disasters, which results in the development of a country risk profile. Empowered with the country risk profile, inclusive of a seasonal risk calendar, countries can anticipate potential emergencies before they occur to trigger early alerts and inform early actions (WHO, 2021).

WHO's Early Warning, Alert and Response System (EWARS) has been designed to improve disease outbreak detection in emergency settings, such as in countries in conflict or following a disaster from natural hazards. It is a simple and cost-effective way to rapidly set up a disease surveillance system. EWARS is deployed during an emergency as an adjunct to the national disease surveillance system. WHO works with Ministries of Health and health sector partners to train local health workers to use the system. After the emergency, EWARS should re-integrate back into the national system (WHO, 2023).

WHO also supports countries to conduct surveillance and control of arboviruses through the implementation of the Global Arbovirus Initiative. Launched in 2022, the Global Arbovirus Initiative is an integrated strategic plan to tackle emerging and re-emerging arboviruses with epidemic and pandemic potential focusing on monitoring risk, pandemic prevention, preparedness, detection and response, and building a coalition of partners (WHO, 2022b).