While mosquito bites are often perceived as causing minor local reactions, certain mosquito-borne viruses warrant significant concern. Chikungunya virus is one such pathogen. Infection can lead not only to persistent high fever but also to severe arthralgia that may persist for months, accompanied by the development of a skin rash.

 

1. What is Chikungunya Fever?

Chikungunya fever is an acute febrile illness caused by the Chikungunya virus (CHIKV), which is transmitted to humans primarily through the bite of infected Aedes mosquitoes. Since the virus was first isolated and identified in Tanzania in 1952, outbreaks have been reported in 119 countries, establishing it as a notable global public health challenge. The widespread distribution of vector Aedes mosquitoes in China, coupled with an increasing trend of imported cases in recent years, underscores the ongoing risk.

 

2. How is Chikungunya Fever Transmitted?

The primary mode of transmission for CHIKV is through the bite of infected female mosquitoes, most commonly Aedes aegypti and Aedes albopictus. When a mosquito feeds on a viremic individual, it may become infected and can transmit the virus to a susceptible person after an extrinsic incubation period of approximately 2-10 days.

The "human-mosquito-human" transmission cycle represents the fundamental mechanism for the spread of Chikungunya virus. Infected individuals typically exhibit a high level of viremia during the first week of illness, presenting a significant risk for mosquito-borne transmission. It is important to note that CHIKV is not transmitted through direct interpersonal contact, respiratory droplets, or aerosols (e.g., coughing or sneezing).

 

3. What are the Typical Clinical Manifestations of Chikungunya Fever?

The majority of infected individuals will develop symptoms after an incubation period of 3-7 days (range: 1-12 days) following the bite of an infected mosquito. The onset is often abrupt, characterized by high fever and severe joint pain (arthralgia). The arthralgia predominantly affects the small joints of the wrists, ankles, hands, and feet, though larger joints such as the knees and shoulders may also be involved. The intensity of the joint pain can be debilitating and may impede mobility. Other frequently observed symptoms include a maculopapular rash, headache, generalized myalgia, and nausea.

 

 

4. Treatment Modalities for Chikungunya Fever

There is no specific antiviral therapy for Chikungunya fever; management primarily revolves around symptomatic and supportive care.

General Measures & Joint Care: Patients with significant joint pain are advised to rest in bed. Affected joints should be immobilized, and weight-bearing or strenuous activities (such as mountain climbing or long-distance running) should be avoided to prevent exacerbating joint injury.

Pruritus Relief: For patients experiencing skin itching, oral antihistamines or topical applications such as calamine lotion may be administered.

Antipyresis (Fever Reduction): Physical cooling methods are the primary approach for managing fever. For persistent high fever, acetaminophen is the recommended antipyretic agent. The use of non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin, should generally be avoided. For patients already taking aspirin for underlying medical conditions, the bleeding risk should be carefully assessed to determine whether aspirin should be discontinued or substituted with an alternative medication. Salicylate-based medications (e.g., aspirin) should be avoided in children due to the associated risk of Reye's syndrome.

Analgesia (Pain Management):

(1) Acute Phase Joint Pain: Acetaminophen at the lowest effective dose for short-term use is recommended. However, it is contraindicated in patients with liver disease or elevated transaminase levels.

(2) Persistent Joint Pain Post-Acute Phase: For patients who continue to experience joint pain after the acute phase, topical analgesic patches or physical therapy modalities (such as infrared therapy) may be considered.

 

 

05. Prevention of Chikungunya Fever

Seek Immediate Medical Attention: Prompt diagnosis and management are crucial. Early implementation of mosquito avoidance and isolation measures can help prevent transmission to family members and friends.

Elimination of Mosquito Breeding Sites: Conduct regular environmental cleaning, with a focus on removing any water-holding containers. Comprehensively clean sanitary dead corners and promptly dispose of waste bottles, cans, and other items that can easily collect stagnant water. Maintain water flow in bodies of water to prevent mosquito breeding.

Physical Protection: Install window and door screens, and use mosquito nets while sleeping at night. Wear light-colored, long-sleeved clothing and long pants to minimize skin exposure.

Chemical Protection: Use approved insecticide sprays and electric mosquito repellents indoors. Apply portable repellents, such as mosquito repellent lotions, when outdoors.

As a mosquito-borne "insidious health threat," the danger posed by Chikungunya fever far exceeds common perception. By now, you should be alert to its classic symptoms—if you experience a sudden onset of fever, severe joint pain, rash, or other warning signs, it is imperative to seek immediate medical consultation to seize the critical window for intervention and control disease progression. Concurrently, maintaining routine environmental hygiene and practicing scientific mosquito prevention are essential to erect a robust health barrier for yourself and your family, thereby reducing the risk of infection.

 

References：

Technical Guide for Chikungunya Prevention and Control (2025)