There has been in excess of 1.1 million locally acquired cases of the mosquito borne virus, chikungunya reported in the Western hemisphere since first detected in the Caribbean in Dec. 2013.

Image/CDC
Image/CDC

A hallmark symptom of chikungunya is localized, intense joint pain and swelling that may last for months or years and may become a cause of chronic pain and disability. It may present like rheumatoid arthritis.

Researchers at Washington University School of Medicine in St. Louis also found that blood tests of patients with the Chikungunya virus and those with rheumatoid arthritis can produce similar results. This may lead some patients with the virus to be misdiagnosed.

The findings, reported in the January issue of Arthritis and Rheumatology, underscore the need for doctors to obtain detailed travel and medical histories from patients being evaluated for rheumatoid arthritis. Such details could help distinguish between the two conditions.

“For now, good travel histories of patients are among the best diagnostic tools for physicians,” said senior author Wayne Yokoyama, MD, the Sam and Audrey Loew Levin Professor of Medicine. “Recent travel to the Caribbean, Central and South America, Africa, India or other areas where the virus is prevalent should raise suspicions of Chikungunya infection. In addition, the disease typically starts with high fever and abrupt onset of severe pain in the joints, which are not usually seen with rheumatoid arthritis.”

The global spread of the Chikungunya virus suggests that the disease is likely to be a diagnostic challenge in the years ahead. Physicians treat rheumatoid arthritis with drugs that suppress the immune system, but it’s not yet known whether that approach will help or harm patients with Chikungunya virus.

As of January 13, 2015, a total of 2,344 chikungunya virus disease cases, primarily travel-associated,  have been reported to the CDC ArboNET from U.S. states for 2014. Eleven locally-transmitted cases have been reported from Florida.

Read the rest of the Washington University news release HERE