That Which Bends Up: A Case Report and Literature Review of Chikungunya Virus

Shana M. Peper, Benjamin J. Monson, Trevor Van Schooneveld, Christopher J. Smith

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


We present a case of chikungunya virus (CHIKV) in a 39-year-old female who developed an acute febrile illness marked by polyarthralgia and rash after returning from Saint Lucia. This epidemic-prone pathogen is increasingly likely to be encountered by primary care and hospital physicians in the coming months. The virus was first locally transmitted in the Caribbean in December 2013 and has since spread to 44 countries and 47 US states, affecting a suspected 1.2 million people. A mosquito-borne virus, CHIKV causes a severe and symmetric polyarthralgia that can relapse for months to years, creating debilitating illness and profound socioeconomic consequences. Current treatment is limited to supportive measures, which are dependent on nonsteroidal anti-inflammatory drugs. Research into immunomodulatory agents, antiviral therapies, and vaccines is ongoing. Prevention remains key in slowing the spread of disease. Patient education should focus on personal protective measures, such as insect repellant and remaining indoors, while public health departments should implement strategies to control vector breeding grounds. Given the possibility of relapsing and debilitating disease, general internists should consider CHIKV in the differential diagnosis of a returning traveler with acute onset of fever, polyarthralgia, and rash.

Original languageEnglish (US)
Pages (from-to)576-581
Number of pages6
JournalJournal of general internal medicine
Issue number5
StatePublished - May 1 2016


  • Caribbean
  • chikungunya
  • febrile rash
  • mosquito-transmitted virus
  • symmetric polyarthralgia

ASJC Scopus subject areas

  • Internal Medicine


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