Chikungunya Virus Workup

Updated: Feb 17, 2022
  • Author: Suganthini Krishnan Natesan, MD, FIDSA; Chief Editor: Michael Stuart Bronze, MD  more...
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Workup

Approach Considerations

Chikungunya infection is confirmed via serological tests, which take about 5 to 7 days into the illness to turn positive. Therefore, early diagnosis is based on a high index of clinical suspicion based on epidemiology and clinical presentation that includes the triad of high fever, rash, and associated rheumatologic manifestations. [97, 98, 99, 100]

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Serologic Testing

Chikungunya virus–specific IgM antibodies usually appear upon cessation of viremia, usually by day 5 to 7 into the illness, and stay positive for 3 to 6 months. Immunoglobulin G (IgG)–neutralizing antibodies appear after 7 to 10 days and may persist for several months. These antibodies are detected with an enzyme-linked immunoassay (ELISA) test that is available through the CDC and several state health departments.

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Viral Culture

Chikungunya virus may be isolated in culture within the first 3 days of illness during the period of active viremia by inoculation of blood into mice or mosquitoes. Culture-based detection is also available through the CDC.

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Molecular Diagnostics

RT-PCR has been standardized using both structural and nonstructural domains of the Chikungunya virus genome and is available through the CDC. A genotyping assay has also been developed that would help in outbreak settings. The molecular assay detects viral RNA during the first 7 to 8 days of the illness. [101]

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