How to Recover from Chikungunya Fever

Know when to get medical attention. Your doctor may take a blood sample to test for chikungunya and other mosquito-borne diseases. You should see a doctor if you have the following symptoms: ^[16]

• Fever for more than five days or above 39°C
• Dizziness (may be due to nerve problems or dehydration)
• Cold fingers or toes (raynaud’s phenomenon)
• Bleeding from the mouth or under the skin (this could be dengue fever)
• Rash
• Pain, redness, stiffness or swelling of the joint
• Low urine output (possibly due to dehydration leading to kidney damage)

Know about tests for chikungunya. Your doctor may take a sample of your blood to send to a laboratory. There will be many tests and methods done to diagnose the disease. The enzyme linked immunoassay (ELISA) method is used to find specific antibodies against the virus. Usually these antibodies develop after the first week of infection, peak after three weeks, and last up to 2 months. If the results are negative, your doctor may repeat the blood test to see if these antibodies are elevated. ^{[17] [18]}

• Virus culture test to look for virus growth. This method is usually used within the first 3 days of illness, when the virus is rapidly growing. ^{[19] [20]}
• RT-PCR (reverse transcription-polymerase chain reaction) methods use genes encoding virus-specific proteins to multiply chikungunya-specific genes. If it is chikungunya, the test will show a higher than normal level of the chikungunya gene on the computerized graph. ^{[21] [22]}

Rest. There is currently no proven treatment and no vaccine. Treatments are merely symptom control. The World Health Organization recommends that sick people begin their care at home with rest. This will help alleviate symptoms and shorten recovery time. Resting in an environment that is not humid and not too hot can help relieve symptoms of joint pain. ^[23]

• Apply cold compresses to reduce pain and inflammation. You can use bags of frozen vegetables or meat, or ice packs. Wrap a towel around the outside of the freezer bag and place it on the painful area. Avoid applying frozen packs or ice directly to the skin as this can cause tissue damage.

Take pain relievers. If you have a fever and joint pain, take paracetamol or acetaminophen. Take up to 2 500mg tablets with water up to 4 times a day. Make sure to drink plenty of water throughout the day. Fever can lead to dehydration and electrolyte imbalance, so drink at least 2 liters of water a day with added salt (like the electrolyte sodium).

• If you have previous liver or kidney problems, consult your doctor before taking paracetamol/acetaminophen. Consult your pediatrician or pharmacist about dosage for children.
• Do not take aspirin or non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen, naproxen, etc. Chikungunya fever is similar to other mosquito-borne diseases such as dengue fever, which can cause hemorrhagic fever. Aspirin and NSAIDS can thin the blood and increase bleeding. Physicians should rule out dengue fever first, and then may recommend NSAIDS for joint pain relief if confirmed non-dengue fever.
• If you have severe joint pain that doesn’t improve after taking an NSAIDS, your doctor may prescribe hydroxychloroquine 200 mg orally once a day or chloroquine phosphate 300 mg once a day for up to 4 weeks.

Do exercise. Only light exercises should be done to prevent further pain in the muscles or joints. If possible, you should schedule an appointment with a physical therapist for treatment. This method can help strengthen the muscles around the joints, which can reduce pain and stiffness. Try to exercise in the morning, when the joints are probably most stiff. Try these simple exercises:

• Sit on a recliner. Extend one leg parallel to the floor for 10 seconds before lowering it, soles of your feet close to the floor. Do it with the other leg. Repeat this movement several times a day, doing 2 or 3 times, repeating each leg 10 times.
• Try standing on tiptoes, feet together, heels moving up and down.
• Lie on your side. Raise one leg up for about 1 second, then lower it and place it on the other leg. Do this 10 times. Then turn to the other side and repeat. Do 10 times each leg and several times a day.
• You can also do your own light exercises. Pay attention not to exercise vigorously or use weights.

Use cream or oil to relieve itching. You may have dry, scaly skin (xerosis) or an itchy rash (morbilliform rash). This condition does not require treatment, but you can manage the itching sensation and restore your skin’s natural state and moisture. Apply mineral oil, moisturizer, or calamine lotion. ^[24] If the itching is caused by a rash, you can take an antihistamine, such as diphenhydramine, according to the directions on the package. This medicine can cause inflammatory cells to reduce the secretion of proteins that cause itching.

• Be careful when taking antihistamines, as they can cause drowsiness. Do not drive or operate machinery after taking the medicine.
• Soaking in a warm bath with colloidal oatmeal can help soothe the skin.
• Persistent dark spots on the skin can be treated with hydroquinone products. These products can help fade dark spots. ^[25]
• There are many lotions and creams to treat skin irritations, so it’s probably a good idea to consult your doctor to find out which one to use.

Try herbal remedies. The herb and plant combination is thought to help relieve the symptoms of chikungunya. While it’s easily available at most drugstores, you should always consult with your doctor before trying herbal remedies or supplements. These herbal remedies include: ^[26]

• Eupatorium perfpiatum 200C: This is the leading homeopathic remedy in the treatment of chikungunya fever, is a plant extract that you should take when symptoms appear. It can reduce symptoms and joint pain. Take 6 drops for a month while having symptoms.
• Chamomile: This is a flower extract used to treat the symptoms of chikungunya by improving the effectiveness of the immune system. Take 40 drops per day, divided into three doses.

Note cardiac complications. Pay particular attention to potentially fatal irregular heart rhythms (arrhythmias). ^[27] To check, place your index and middle fingers on your wrist below the thumb area. If you feel the pulse, it’s a radial artery. Count how many beats in a minute. 60 -100 beats per minute is considered normal. You should also note whether the pulse is continuous; if there are extra beats or irregular pauses it could signal an irregular heartbeat. You may also notice fast or more pounding beats as a palpitations. See your doctor right away if you notice signs of an irregular heartbeat. Your doctor may give you an electrocardiogram with electrodes attached to your chest to check your heart rhythm.

• The chikungunya virus can invade the heart muscle and cause inflammation of the heart muscle (myocarditis), which causes the heart to beat irregularly.

Note neurological complications. Watch for fever, fatigue, and confusion as signs of encephalitis. Distraction and disorientation are also a manifestation of this complication. If in addition to the symptoms of encephalitis you also notice severe headache, neck stiffness/pain, sensitivity to light, fever, seizures, double vision, nausea and vomiting, you may have encephalitis – meningitis. This is a combination of meningitis and encephalitis (inflammation of the tissue in the spinal cord that connects to the brain). ^[28]

• If nerve damage starts in your legs or arms, you may have Guillain Barre syndrome. Note the decrease in sensation, response, and movement on both sides of the body. Also be aware of stinging, burning, numbing, or pins-and-needles sensations on both sides of the body. This phenomenon can progress to the upper body and potentially cause breathing difficulties from the nerves that supply the muscles of the respiratory system. ^[29]
• If you have trouble breathing or any of the above symptoms, call 911 immediately. ^[30]

Watch out for eye complications. Watch for eye pain, tearing, and redness. These can be all symptoms of inflammation of the inner lining of the eye caused by conjunctivitis, sclera, and uveitis. You may also notice blurred vision and sensitivity to light with uveitis. See your doctor right away if you have any of the above symptoms.

• If you have difficulty seeing objects straight ahead (center of vision) or the colors of objects appear duller than usual, you may have optic neuritis. ^[31]

Observe the skin for signs of hepatitis. Look in the mirror for jaundice and yellowing in the whites of the eyes (jaundice). Those could be signs of hepatitis. Inflammation of the liver causes the liver’s product (bilirubin) to spread, leading to jaundice and itching. Get medical attention right away.

• If left untreated, hepatitis can lead to liver failure.

Consider dehydration signaling kidney failure. Chikungunya fever can lead to dehydration because the kidneys may not receive enough blood to function properly. This can lead to kidney failure, so urine output should be monitored. If you notice a drastic decrease in urine output, concentrated urine and dark color, you should seek medical attention immediately.

• Your doctor will do more tests and precise measurements to check your kidney function and may give you intravenous fluids if you are dehydrated.