Updated December 16, 2025
NCCID Disease Debriefs provide Canadian public health practitioners and clinicians with up-to-date reviews of essential information on prominent infectious diseases for Canadian public health practice. While not a formal literature review, information is gathered from key sources including the Public Health Agency of Canada (PHAC), the USA Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO) and peer reviewed literature.
This disease debrief was prepared by Kevin Yie. Questions, comments, and suggestions regarding this disease brief are most welcome and can be sent to nccid@manitoba.ca.
What are Disease Debriefs? To find out more about how information is collected, see our page dedicated to the Disease Debriefs.
Questions Addressed in this debrief:
- What are important characteristics of Chikungunya?
- What is happening with the current outbreak of Chikungunya?
- What is the current risk for Canadians for Chikungunya?
- What measures should be taken for a suspected Chikungunya case or contact?
What are important characteristics of Chikungunya?
Characteristics and Causes
Chikungunya virus (CHIKV) is an arbovirus from the Togaviridae family that causes Chikungunya fever. It is a positive-sense, single-stranded RNA virus transmitted by infected female Aedes aegypti or Aedes albopictus mosquitoes. These mosquitos bite during daytime, either indoors (Aedes aegypti)or outdoors (both species). Host species are humans, non-human primates, bats, birds and rodents. The virus has been transmitted to humans in all regions where these mosquito populations are established; it has been identified in over 110 countries in Asia, Africa, Europe and the Americas. Chikungunya fever is characterized by the abrupt onset of a high fever, as well as debilitating bilateral and symmetrical joint pain. Skin rashes and gastro-intestinal symptoms are common with infection. Approximately 30-40% of infected people will experience arthritis or joint pain as long-term sequalae. Complications include neurological, cardiac, and ophthalmological symptoms. Differential diagnoses are Zika virus and Dengue fever, which have similar symptoms and are transmitted by the same mosquitoes.
Chikungunya – World Health Organization
Chikungunya virus: Infectious substances pathogen safety data sheet – Health Canada
Signs and Symptoms
Characteristic symptoms of acute CHIKV infection include the sudden onset of fever over 39°C, accompanied by severe bilateral polyarthralgia (typically in feet, ankles, wrists and hands), after time spent in an area where Aedes aegypti or Aedes albopictus mosquitoes are endemic. The incubation period is typically 4-7 days. Other common symptoms include headache, lymphopenia, diarrhea, vomiting and abdominal pain, as well as skin symptoms, including a flush over the face and trunk followed by maculopapular rash. Chronic CHIKV infection symptoms include fatigue, joint pain, neuritis, rheumatoid arthritis, and ankylosing spondylitis. Differential diagnoses include Zika or dengue virus infection: Zika virus typically causes milder symptoms than Chikungunya, while dengue is more likely to cause neutropenia, thrombocytopenia, and hemorrhage.
For Health Professionals: Chikungunya – Health Canada
Chikungunya virus: Infectious substances pathogen safety data sheet – Health Canada
Clinical Signs and Symptoms of Chikungunya Virus Disease – Centre for Disease Control
Chikungunya – World Health Organization
Severity and Complications
Between 30-40% of cases will lead to long-term sequalae, most commonly arthralgia, rheumatoid arthritis and tenosynovitis, which can persist for months to years. Rare complications include uveitis, retinitis, myocarditis, hepatitis, nephritis, exfoliative dermatitis, bullous skin lesions, vasculitic lesions, mucosal ulceration, hemorrhage, meningoencephalitis, myelitis, Guillain-Barré syndrome, and cranial nerve palsies.
Morbidity is common, but mortality is rare and occurs mostly in older adults and infants. The average fatality rate is 0.4%. For children the mortality rate is 2.8%, and for older adults the mortality rate is 1.6%.
Chikungunya virus: Infectious substances pathogen safety data sheet – Health Canada
Clinical Signs and Symptoms of Chikungunya Virus Disease – Centre for Disease Control
Chikungunya – World Health Organization
Epidemiology
The virus was first detected in Tanzania in 1952. Since then, it has spread to over 110 countries: outbreaks have occurred in Africa, the Americas, Asia, Europe, and islands in the Indian and Pacific Oceans. The expansion of the range of Aedes aegypti and Aedes albopictus mosquitoes because of climate change may further the spread of infection.
In 2025 to date, 458,840 CHIKV cases and 146 associated deaths have been reported globally. In the last two months (September and October 2025), there were nine outbreaks of Chikungunya, concentrated in the Americas (Brazil, Cuba, Paraguay, El Salvador, Barbados and Bolivia) and Asia (China, Singapore, Pakistan). Since the beginning of 2025 there have been a total of 2,197 reported cases in Africa, and both France (776) and Italy (384) have reported cases in mainland Europe.
Chikungunya virus disease worldwide overview – European Centre for Disease Prevention and Control
Seasonal surveillance of chikungunya virus disease in the EU/EEA, weekly report – European Centre for Disease Prevention and Control
Surveillance of Chikungunya – Health Canada
Chikungunya: Causes and How It Spreads – Centre for Disease Control
Areas at Risk for Chikungunya – Centre for Disease Control
Chikungunya – World Health Organization
Reservoir and Transmission
The virus is most commonly transmitted by a vector – female Aedes aegypti or Aedes albopictus mosquitoes. Humans, non-human primates, birds, bats and rodents are reservoirs for CHIKV; humans are typically the primary host in epidemics. When a non-infected mosquito feeds on an infected animal, the virus is ingested and replicates in the mosquito until it enters the salivary glands, at which point it can be transmitted to a new host. The virus can be transmitted by contact with blood, including in medical settings and intrapartum, and transmission in utero has been documented in rare cases. The virus does not appear to be transmitted through breastfeeding; breastfeeding is encouraged for mothers who are infected with CHIKV and/or who live in areas where Chikungunya disease is outbreaking. Aerosol transmission has been reported in a laboratory setting.
Transmission of Chikungunya Virus – Centre for Disease Control
Chikungunya virus: Infectious substances pathogen safety data sheet – Health Canada
Chikungunya – World Health Organization
Incubation period
The incubation period ofCHIKV is typically 3-7 days, with a range of 1-12 days.
Chikungunya virus: Infectious substances pathogen safety data sheet – Health Canada
Clinical Signs and Symptoms of Chikungunya Virus Disease – Centre for Disease Control
Diagnosis
Chikungunya disease should be considered in patients who present with acute onset of fever and polyarthralgia, who have recently lived in or travelled to areas with known transmission. Chikungunya disease can be diagnosed by nucleic acid testing of blood, serum, or plasma in the first week of the infection using reverse-transcription polymerase chain reaction. After the acute phase, immunofluorescent assays and enzyme-linked immunosorbent assays (ELISAs) can be used for the detection of anti-CHIKV antibodies in blood serum. Chikungunya antibodies typically develop one week after infection; to definitively rule out the diagnosis, both acute and convalescent phase samples should be tested since antibodies may not be present during acute phase infection. The plaque reduction neutralization test (PRNT) can also be used after the acute stage of illness to measure neutralizing antibody levels. Viral culture is possible, but time-consuming, and requires biosafety hazard level 3 precautions.
Chikungunya virus: Infectious substances pathogen safety data sheet – Health Canada
Clinical Testing and Diagnosis for Chikungunya Virus Disease – Centre for Disease Control
Chikungunya – World Health Organization
Prevention and Control
Travelers at increased risk of severe disease, particularly older adults and pregnant individuals, should avoid travel to areas with ongoing outbreaks when possible. Vaccination should be considered if travel is unavoidable.
The disease can be prevented by preventing mosquito bites, and steps should be taken to avoid bites. These include wearing loose-fitting clothing treated with permethrin, using insect repellant, and ensuring that lodgings have well-fitted mosquito screens on windows and doors. Peak biting periods are just after sunrise and before sunset.
Prevention of Chikungunya – Health Canada
Treatment and Prevention of Chikungunya Virus Disease – Centre for Disease Control
Vaccination
IXCHIQ is a live-attenuated vaccine approved for use in Canada as a single dose immunization for non-pregnant individuals 18 years or older.
In August 2025, the American FDA suspended the U.S. license for IXCHIQ, due to concerns about serious adverse events in older persons, including hospitalizations for cardiac and neurologic events. At present, Health Canada recommends not using the vaccine in people aged 65 and over. The Committee to Advise on Tropical Medicine and Travel (CATMAT) recommends that persons aged 65 years and older avoid travel to areas experiencing sustained transmission.
For Health Professionals: Chikungunya – Health Canada
Chikungunya virus: Infectious substances pathogen safety data sheet – Health Canada
Chikungunya Vaccine Information for Healthcare Providers – Centre for Disease Control
Treatment
There is no specific treatment for Chikungunya disease; treatment involves reducing the severity of symptoms using non-steroidal anti-inflammatory drugs and antipyretics. Acetylsalicylic acid should not be used until a diagnosis of dengue is ruled out, to reduce the risk of hemorrhage. Fluid levels should be monitored and maintained. In cases of severe chronic arthralgia, treatment with methotrexate, hydroxychloroquine, or sulphasalazine can be considered.
For Health Professionals: Chikungunya – Health Canada
Treatment of Chikungunya – Health Canada
Treatment and Prevention of Chikungunya Virus Disease – Centre for Disease Control
Chikungunya virus: Infectious substances pathogen safety data sheet – Health Canada
What is happening with the current outbreak of Chikungunya?
Prior to 2025, sustained autochthonous transmission of CHIKV was documented in 119 countries. In 2025, the virus began outbreaking in several areas of the world, predominantly in the Americas, Europe, and Asia. In 2025 to date, 458,840 cases and 146 associated deaths have been reported globally. As of September 2025, in the WHO health region of the Americas there were 228,591 suspected cases (100,329 confirmed) and 21,299 confirmed cases in the Western Pacific health region. In the European health region there were 56,456 confirmed cases (concentrated in the overseas French territories of Reunion and Mayotte). In mainland Europe there were 1,165 confirmed cases. In Africa there have been 2,197 confirmed cases.
Chikungunya virus disease – Global situation – World Health Organization
Chikungunya virus disease worldwide overview – European Centre for Disease Prevention and Control
Seasonal surveillance of chikungunya virus disease in the EU/EEA, weekly report – European Centre for Disease Prevention and Control
Surveillance of Chikungunya – Health Canada
Canada
No cases have been reported in Canada in the current outbreaks.
Surveillance of Chikungunya – Health Canada
Chikungunya virus disease – Global situation – World Health Organization
What is the current risk for Canadians for Chikungunya?
The risk to Canadians is low. However, travelers to many parts of the world can be exposed to CHIKV, and risks are higher in areas where there is current sustained transmission. A current overview of global outbreaks and map of geographical distribution of Chikungunya cases is published by the World Health Organization and can be found online here. Canadians traveling to areas where Chikungunya disease is outbreaking should consider changing travel plans or vaccination if they are at high risk; travelers should also take precautions to avoid mosquito bites.
For Health Professionals: Chikungunya – Health Canada
Chikungunya virus disease – Global situation – World Health Organization
What measures should be taken for a suspected Chikungunya case or contact?
Case and Contact Management
If Chikungunya disease is suspected on the basis of fever, polyarthralgia and relevant travel history, samples should be tested using RT-PCR. Clinical treatment should follow guidelines for management of dengue, given the increased risk of hemorrhage and shock, until it is eliminated as a diagnosis. Chikungunya treatment involves reducing the severity of symptoms using non-steroidal anti-inflammatory drugs and antipyretics. Corticosteroids and physical therapy can be used to manage persistent joint pain.
Chikungunya is not a nationally notifiable disease in Canada.
For Health Professionals: Chikungunya – Health Canada
Chikungunya: Official Clinical Management in Dengue-Endemic Areas – Centre for Disease Control
Treatment and Prevention of Chikungunya Virus Disease – Centre for Disease Control