What Is Chikungunya?
A mosquito-borne viral disease causing fever and severe, often debilitating joint pain that can persist for months or years.
Pathogen: Chikungunya virus (CHIKV, Alphavirus genus, Togaviridae family)
Type: Virus
Transmission
Bite of infected Aedes aegypti and Aedes albopictus mosquitoes. Same vectors as dengue and Zika. Human-to-mosquito-to-human cycle during outbreaks. Rare vertical transmission from mother to newborn.
Vector: Aedes aegypti and Aedes albopictus mosquitoes (daytime biters, most active early morning and late afternoon)
Symptoms
Sudden onset of high fever and severe bilateral joint pain (especially in hands, wrists, ankles, and feet). The joint pain can be intensely debilitating. Also: headache, muscle pain, joint swelling, and rash. The name 'chikungunya' means 'to become contorted' in Kimakonde, describing the stooped posture caused by joint pain.
Incubation period: 2 – 12 days
Usually 3-7 days. Most infected people develop symptoms (unlike dengue, where many are asymptomatic).
Timeline: Acute phase lasts 7-10 days. Fever typically resolves within a week. Joint pain may persist for weeks, months, or in some cases years. Chronic arthralgia affects 30-60% of patients.
Case fatality rate: Less than 0.1% overall. Higher in neonates and elderly with comorbidities. Deaths are rare but can occur from organ failure in vulnerable populations.
Diagnosis & Treatment
Diagnosis: Chikungunya PCR (first 5 days of illness). IgM serology (from day 5). IgG serology (from day 7-10). Must be differentiated from dengue, which has similar early presentation but different management implications.
Treatment: No specific antiviral treatment. Supportive care: rest, fluids, paracetamol for fever and pain. Avoid aspirin and NSAIDs until dengue is ruled out (co-circulation is common). For chronic joint pain: NSAIDs, physiotherapy, and in some cases disease-modifying antirheumatic drugs.
Prevention
- DEET-based insect repellent during the day (20-50% concentration)
- Wear long sleeves and light-coloured clothing
- Use air-conditioned or screened accommodation
- Remove standing water near accommodation
- Permethrin-treated clothing for high-risk areas
- Ixchiq vaccine may be available through travel clinics (approved by TGA)
Post-Exposure
If you develop sudden fever and severe joint pain within 2 weeks of travel to an endemic area, see a doctor. Mention your travel history. Avoid aspirin and ibuprofen until dengue is excluded. Joint pain may persist for months — this is common and does not mean ongoing infection.
Long-Term Effects
Chronic inflammatory arthralgia persists for 3 months or more in 30-60% of patients, and in some cases for years. The chronic joint pain can significantly impair quality of life and work capacity. Risk factors for chronicity include older age, pre-existing joint disease, and severe acute illness.
📋 Chikungunya is a nationally notifiable disease in Australia. Cases are acquired overseas. There is no local transmission in mainland Australia.
Frequently Asked Questions
Is there a vaccine for chikungunya?
Yes. The Ixchiq vaccine (live attenuated) was approved by the US FDA in late 2023 and has since been registered by the TGA in Australia. It is a single-dose vaccine for adults 18 and older. Availability at Australian travel clinics may vary — discuss with your travel doctor whether it is recommended and available for your trip.
How long does chikungunya joint pain last?
The acute joint pain typically lasts 1-2 weeks. However, 30-60% of people experience persistent joint pain (chronic arthralgia) lasting months, and in some cases years. The joint pain can be debilitating and affect daily activities and work. Older adults and those with pre-existing joint conditions are at higher risk of chronic symptoms.
Can you get chikungunya in Thailand?
Yes. Thailand has had multiple chikungunya outbreaks, and the virus circulates year-round. All regions of Thailand, including popular tourist destinations like Bangkok, Chiang Mai, Phuket, and the islands, are at risk. The same mosquitoes that carry dengue also carry chikungunya, so daytime bite prevention is essential.
What is the difference between chikungunya and dengue?
Both cause fever and are spread by the same mosquitoes. Dengue features more prominent high fever, headache, and pain behind the eyes, and can cause severe haemorrhagic complications. Chikungunya is dominated by severe joint pain, which can persist for months. Dengue can be life-threatening; chikungunya is rarely fatal but can be debilitating. Blood tests are needed to distinguish them definitively.
Can you get chikungunya and dengue at the same time?
Yes. Co-infection with chikungunya and dengue is possible because they are transmitted by the same mosquitoes and co-circulate in many regions. A single mosquito bite can even transmit both viruses simultaneously. Co-infection can make diagnosis and management more complex.
Is chikungunya dangerous during pregnancy?
Chikungunya during pregnancy does not cause birth defects (unlike Zika). However, if a mother is infected around the time of delivery, the virus can be transmitted to the newborn, causing neonatal chikungunya, which can be severe. Pregnant women should take rigorous mosquito bite precautions when travelling to endemic areas.
What does 'chikungunya' mean?
The name comes from the Kimakonde language of southern Tanzania and Mozambique, meaning 'to become contorted' or 'that which bends up'. It describes the stooped posture of patients suffering from the severe joint pain that characterises the disease.
Can you get chikungunya twice?
Infection with chikungunya is believed to confer lifelong immunity. Unlike dengue, there is only one serotype of chikungunya virus, so a second infection is extremely unlikely. The persistent joint pain that some people experience after infection is not due to ongoing viral activity but rather a post-infectious inflammatory response.
Sources & References
Last updated: April 2026