¹ For latest guidance, see CDC’s Chikungunya virus site.

² Modes of transmission
• Primarily transmitted to humans through the bites of infected mosquitos, predominantly Aedes aegypti and Aedes albopictus. Humans are the primary host of chikungunya virus during epidemic periods.
• Blood-borne transmission is possible; cases have been documented among laboratory personnel handling infected blood and a health care worker drawing blood from an infected pt.
• Rare in utero transmission documented mostly during the 2nd trimester.
• Intrapartum transmission also documented when mother was viremic around the time of delivery.

The risk of a person transmitting the virus to a biting mosquito or through blood is highest when pt viremic during 1st wk of illness.

³ Because benefits of breastfeeding outweigh risks, mothers encouraged to breastfeed even if they are infected w/ chikungunya virus or live in an area where chikungunya virus is circulating.

⁴ Differential Dx - Dengue and chikungunya viruses transmitted by same mosquitos, have similar clinical features, can circulate in same area & cause occasional co-infxns in same pt.

⁵ Rheumatologic sx - Some pts might undergo relapse of rheumatologic sx (eg, polyarthralgia, polyarthritis, tenosynovitis) months following acute illness. Studies show that joint pain can persist months/yrs. Mortality rare and occurs mostly in older adults.

⁶ Rare complications incl:
• uveitis
• retinitis
• myocarditis
• hepatitis
• nephritis
• bullous skin lesions
• hemorrhage
• meningoencephalitis
• myelitis
• Guillain-Barre syndrome
• cranial nerve palsies