What Is Chikungunya?

Chikungunya is a mosquito-borne viral disease caused by the chikungunya virus (CHIKV), an RNA virus in the genus Alphavirus of the family Togaviridae. [1]
The name “chikungunya” comes from a word meaning “that which bends up,” reflecting the severe joint pain experienced by many patients.[2]

"Chikungunya Virus" by Dr. Victor Padilla-Sanchez, PhD is licensed under CC BY-SA 4.0.

Cause and Transmission

Chikungunya virus is primarily transmitted to humans through bites of infected Aedes mosquitoes, especially Aedes aegypti and Aedes albopictus.[1]
After a 3-7 day incubation period, the virus replicates in blood and other tissues, leading to systemic symptoms.[3]

Symptoms of Chikungunya

The acute phase typically begins abruptly with high fever (often >39 °C) and severe, symmetric polyarthralgia affecting wrists, ankles, and small joints.[2]
Additional symptoms often include headache, myalgia, conjunctivitis, nausea, vomiting, and maculopapular rash.[3]
In roughly 50% of cases, the rash appears 2-5 days after fever onset as flat or slightly raised red lesions, primarily on the trunk and limbs.[3]

Course and Phases

Chikungunya infection progresses through three phases:

Acute (first 3 weeks): fever, intense joint pain, rash.[2]
Post-acute (4-12 weeks): persistent arthralgia and fatigue.[4]
Chronic (>12 weeks): ongoing joint pain and stiffness in up to 40% of patients.[4]

What Is Chickenpox?

Chickenpox, or varicella, is an acute, highly contagious disease caused by primary infection with the varicella-zoster virus (VZV), a member of the herpesvirus family.[5]
After initial infection, VZV remains dormant in nerve ganglia and may reactivate as shingles later in life.[5]

Cause and Transmission

Varicella-zoster virus spreads from person to person via respiratory droplets or direct contact with vesicular fluid from chickenpox lesions.[5]
An infected individual is contagious 1-2 days before rash onset until all vesicles have crusted over.[5]

Symptoms of Chickenpox

Chickenpox usually begins with low-grade fever, malaise, and loss of appetite, followed 1-2 days later by a pruritic, maculopapulovesicular rash.[5]
The rash appears in successive “crops,” so lesions in different stages- papules, vesicles, pustules, and crusts are seen simultaneously.[5]
The rash often affects the trunk, face, and scalp, then spreads to extremities; itching can be intense and distressing.[5]

Course and Phases

Chickenpox illness typically lasts 4-7 days, with most lesions crusting by day 7.[5]
Complications such as bacterial skin infections, pneumonia, encephalitis, and hospitalization occur in <1% of healthy children but are more common in neonates, immunocompromised persons, and adults.[6][5]

Chikungunya vs Chickenpox: Key Differences

Understanding the chikungunya and chickenpox difference helps differentiate these illnesses, as both can present with fever and rash.[7]

Symptoms Comparison

Fever: Sudden, high (>39 °C) in chikungunya; moderate in chickenpox.[3][5]
Joint Pain: Intense polyarthralgia/polyarthritis is hallmark of chikungunya; rare in chickenpox.[2][5]
Rash: Maculopapular in chikungunya; fluid-filled vesicles evolving to crusts in chickenpox.[3][5]

Rash Characteristics

Chikungunya rash tends to be flat or slightly raised and non-itchy or mildly pruritic.[3]
Chickenpox rash is highly pruritic, evolves through distinct stages, and occurs in crops, creating lesions in multiple stages concurrently.[5]

Treatment and Prevention

There is no specific antiviral treatment for chikungunya; management focuses on symptomatic relief with analgesics, antipyretics, and hydration.[2]
For chickenpox, antiviral therapy (e.g., acyclovir) is reserved for high-risk patients; symptomatic relief includes calamine lotion and antihistamines for itching.[5]
Vaccines are available:

Chikungunya vaccine approved in some regions for travelers and high-risk adults.[1]
Varicella vaccine is recommended in two doses for children and susceptible adults to prevent chickenpox.[5]

When to Seek Medical Attention

Medical evaluation is warranted if experiencing severe or persistent symptoms.

Warning Signs

For chikungunya: unrelenting fever, debilitating joint pain, confusion, or signs of dehydration.[3]
For chickenpox: difficulty breathing, neurological symptoms (e.g., severe headache, confusion), uncontrolled itching leading to secondary infection, or rash in newborns and immunocompromised persons.[6][5]

FAQs

What are the main chikungunya symptoms vs chickenpox symptoms?
Chikungunya features high fever and severe joint pain, while chickenpox causes moderate fever and an intensely itchy blistering rash.[3][5]
Can both chikungunya and chickenpox be prevented by vaccination?
Yes, varicella vaccines prevent chickenpox effectively, and chikungunya vaccines are available in select areas; mosquito avoidance also reduces chikungunya risk.[1][5]
How long is one contagious with chickenpox compared to chikungunya?
Chickenpox is contagious from 1-2 days before rash until lesions crust over, whereas chikungunya is not spread person-to-person but via mosquitoes; viremic patients may pose risk to mosquitoes for ~5 days.[3][5]
Can chikungunya cause long-term joint problems?
Yes, up to 40% of patients may experience persistent arthralgia for months to years post-infection.[4]
Should I get tested to differentiate between chikungunya and chickenpox?
Laboratory tests RT-PCR or serology can confirm chikungunya, while PCR or IgM antibodies detect varicella; testing is ordered by a doctor if diagnosis is unclear.[3][5]

Disclaimer: This content is for educational purposes only and does not replace professional medical advice. Please consult a qualified healthcare provider for personalized guidance.

References

Ayoade, F. (2022). Varicella-Zoster Virus (Chickenpox). In StatPearls. NCBI Bookshelf.[8]
Bakker, K. M., et al. (2021). Exploring the Seasonal Drivers of Varicella Zoster Virus. American Journal of Epidemiology, 190(9), 1814–1823.[9]
da Cunha, R. V. (2017). Chikungunya Virus: Clinical Aspects and Treatment – A Review. PMC.[2]
de Lima Cavalcanti, T. Y. V. (2022). A Review on Chikungunya Virus Epidemiology. PLoS Neglected Tropical Diseases.[10]
Ng, W. H., et al. (2024). Chronic Chikungunya Disease (CCD): Clinical Insights. QJM – An International Journal of Medicine, 117(7), 489–497.[4]
Santiago, R. A., et al. (2025). Clinical Manifestations Associated with the Chronic Phase of Chikungunya. PLOS Neglected Tropical Diseases.[11]
World Health Organization. (2025). Chikungunya Fact Sheet.[1]
Centers for Disease Control and Prevention. (2025). Clinical Signs and Symptoms of Chikungunya Virus Disease.[3]
Centers for Disease Control and Prevention. (2025). About Chickenpox.[5]

1. who.int/news-room/fact-sheets/detail/chikungunya

2. pmc.ncbi.nlm.nih.gov/articles

3. cdc.gov/chikungunya/hcp/clinical-signs

4. academic.oup.com/qjmed

5. cdc.gov/chickenpox

6. health.alaska.gov/varicellafactsheet

7. touchwoodpharmacy.com/whats-the-difference

8. ncbi.nlm.nih.gov/books/

9. academic.oup.com/aje/article/

10. pmc.ncbi.nlm.nih.gov/articles/

11. journals.plos.org/plosntds/article

12. art.torvergata.it/retrieve.pdf