Clinical course of chikungunya infection
CHIK infection may have two consecutive phases. The acute phase consists of two stages— viral (5–7 days) and convalescent (indicated by IgM antiviral antibody). The viral stage is characterized by high fever, rash, myalgia, headache, arthralgia, and conjunctivitis. The majority of patients develop a symmetric arthralgia or less commonly arthritis involving small and large joints. The arthralgias may be severe and debilitating. Laboratory abnormalities include thrombocytopenia and leukopenia, elevated levels of AST and ALT, and elevated muscle enzymes (creatinine kinase and lactate dehydrogenase). During the convalescent stage, many of the symptoms abate, although patients may continue to have arthralgias for up to 6 months. Treatment is supportive.
