Advances in Clinical Diagnosis and Management of Chikungunya Virus Infection

Abstract

In this review, we attempt to give the reader an update on clinical diagnosis, management, and treatment of Chikungunya virus (CHIKV) infection regarding the course of the disease and the role of clinical laboratory. CHIKV infection evolves through three phases: acute, sub-acute, and chronic. Protocol for patient assessment and management should be in agreement with each phase requirements. Despite its benignity, CHIKV infection has shown an increase in severe cases during recent outbreaks. Among the most affected group are neonates, elderly population, and patients with co-morbidities. Furthermore, since CHIKV geographical distribution and clinical spectrum overlaps with other arboviruses, differential diagnosis becomes crucial for physicians to ensure good management and treatment for patients. In this review, we describe and compare the main symptoms, complications, and risk groups for CHIKV, Dengue (DENV), and Zika (ZIKV) infections, regarding key features will guide to an accurate diagnosis. CHIKV is an emergent and reemergent arbovirus that arrived in the Americas in 2014, causing thousands of infections. The acute febrile phase is similar to that of dengue but with a higher proportion of debilitating arthralgia that can persist for months or even years after infection. Severe forms of CHIKV infection can lead to chronic polyarthralgia, neurologic symptoms, or multiorgan failure. Treatment of CHIKV infection is mainly focused on supportive care, which includes the use of analgesic and anti-inflammatory medication, rehydration, and rest.