Signs and symptoms
It can take one to twelve days for a person to get sick after they get the chikungunya virus. (This period of time is called the virus's incubation period.) Usually, people get sick in three to seven days. Most people who get the virus (72% to 97%) get symptoms.
Chikungunya has an acute phase, which lasts a short time, and a chronic phase, which can last weeks, months, or years.
The acute phase usually begins with a sudden high fever that can last up to ten days. The fever is usually above 39 °C (102 °F), and can sometimes get as high as 40 °C (104 °F). About half of people with chikungunya get a
rash, usually about two to five days after symptoms start. Some people also have gastrointestinal symptoms, like abdominal pain, nausea, vomiting, or diarrhea. In rare cases, people may get conjunctivitis or other problems with their eyes.
The body starts to fight the virus after about a week by sending out immunoglobulin M (IgM), which attacks the virus. After this, most of the symptoms usually start to get better. However, people often keep having some symptoms for about another week, like headache, insomnia (trouble sleeping), and exhaustion. After these symptoms end, the acute phase of chikungunya is usually over.
In chikungunya's chronic phase, almost everyone with the virus (87% - 98%) gets very bad joint pain or stiffness. This usually lasts for weeks or months. However, it can last for years. The joint pain can be so bad that a person cannot move the joints that hurt. The pain almost always happens in more than one joint. Usually, people have pain in the joints in their arms and legs, on both sides. These may include the joints in the wrists, ankles, hands, feet, shoulders, elbows, and knees. The virus can also cause pain in the muscles or ligaments.
Sometimes, it can be difficult to tell the difference between chikungunya and dengue fever. Both infections cause some of the same symptoms, like fever and very bad pain. However, chikungunya usually does not cause bleeding. If a person diagnosed with chikungunya has bleeding problems, they may:
- Have dengue fever instead of chikungunya
- Have both chikungunya and dengue fever (both are spread by mosquitoes, and are common in some of the same places)
- Have both chikungunya and liver problems