Chikungunya in the Caribbean: symptoms, duration and how to recover

Chikungunya is often the forgotten disease among the three mosquito-borne illnesses of the Caribbean — overshadowed by dengue and Zika, which receive more media coverage. Yet chikungunya is frequently described by those who have contracted it as the most painful of the three. Its name, from a Bantu language of Tanzania, means "that which bends up" — a vivid image for the intense joint pain that characterises the disease.

Present in the Caribbean since the major 2013-2014 epidemic that affected more than one million people in the region, chikungunya still circulates endemically in Martinique, Guadeloupe and French Guiana. Here is everything you need to know to identify it, get through it and recover.

What is chikungunya?

Chikungunya is a viral disease caused by the CHIKV virus, transmitted by the bite of Aedes aegypti and Aedes albopictus mosquitoes — the same species that transmit dengue and Zika. There is no vaccine available to the general public and no specific antiviral treatment; management is purely symptomatic.

Chikungunya is not fatal in the vast majority of cases, but it can be very debilitating, particularly in elderly people and immunocompromised individuals.

Symptoms: how to recognise chikungunya

Symptoms generally appear 2 to 7 days after the infective bite. The disease is distinguished from dengue by the intensity of joint pain:

The distinctive sign of chikungunya is polyarthralgia: pain affecting several joints simultaneously (wrists, ankles, knees, fingers), often symmetrical and particularly intense in the morning.

The chronic phase: chikungunya's distinctive feature

Unlike dengue and Zika, chikungunya can leave joint sequelae that persist for several months or even years after the acute phase. This is known as chronic chikungunya:

• Approximately 30 to 40% of patients develop persistent joint pain beyond 3 months
• This pain can mimic rheumatoid arthritis
• It is more frequent and more severe in people over 45
• Rheumatological follow-up may be necessary in severe cases

Treatment and recovery

There is no antiviral treatment for chikungunya. Management is based on:

Acute phase (7-10 days):

• Paracetamol for fever and pain — absolutely to be preferred
• Ibuprofen and aspirin to be avoided in the acute phase (haemorrhagic risk, especially if dengue co-infection is possible)
• Complete rest, abundant hydration (2-3 litres of water per day)
• Elevate painful limbs to reduce swelling

Recovery phase:

• Gradual resumption of physical activity
• Non-steroidal anti-inflammatory drugs (NSAIDs) on medical advice for persistent joint pain
• Physiotherapy for cases of prolonged joint stiffness
• Patience: post-chikungunya fatigue can last several weeks

When to see a doctor?

Seek medical advice promptly if:

• Fever exceeds 39°C and does not respond to paracetamol
• You show signs of dehydration (no urination, dry mouth, dizziness)
• You are pregnant, immunocompromised or over 65
• Joint pain persists beyond 3 weeks

In Martinique: CHU Fort-de-France — 05 96 55 20 00

In Guadeloupe: CHU Pointe-à-Pitre — 05 90 89 10 10

In French Guiana: CHU Cayenne — 05 94 39 50 50

Protecting yourself from chikungunya

Prevention relies on protection against Aedes mosquito bites, which bite during the day (morning and late afternoon):

• Skin repellents: DEET 30-50%, icaridin, IR3535
• Covering clothing impregnated with permethrin
• Mosquito nets on windows and doors
• Elimination of breeding sites around the home (saucers, gutters, used tyres)

A reassuring word for travellers

The vast majority of people who contract chikungunya recover completely within a few weeks. Caribbean residents know this disease well and know how to get through it. With good mosquito protection and an appropriate first aid kit, the risk of contracting chikungunya during a tourist stay remains limited — and the Caribbean is well worth the trip.