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Rheumatoid Arthritis and Chikungunya Facts and Similarities

Linda Crampton is an experienced teacher with a first-class honors degree in biology. She writes about the scientific basis of disease.

Aedes aegypti is a mosquito that transmits the viruses that cause yellow fever, dengue, and chikungunya. It's often known as the yellow fever mosquito.

Aedes aegypti is a mosquito that transmits the viruses that cause yellow fever, dengue, and chikungunya. It's often known as the yellow fever mosquito.

An Infection and an Autoimmune Disease

Chikungunya is an infectious disease caused by a virus entering the body through a mosquito bite. Rheumatoid arthritis is an autoimmune condition in which the body's immune system mistakenly attacks joints in the body. At first glance, the two disorders seem completely different. Some of their symptoms may be so similar that at times it may be hard for a doctor to make a correct diagnosis without a very specific type of blood test, however.

Chikungunya infections are present in Asia, Europe, and Africa and on islands in the Indian and Pacific Oceans. Recently, they have also appeared in North, Central, and South America and in the Caribbean. Some health experts suspect that chikungunya will spread through these areas. Distinguishing a chikungunya infection from rheumatoid arthritis could therefore be very important.

A reconstruction of the Chikungunya virus as viewed through an electron microscope

A reconstruction of the Chikungunya virus as viewed through an electron microscope

According to WHO (the World Health Organization), the name "chikungunya" is derived from a word in the Kimakonde language of the Makonde people in Tanzania. The name means "to become contorted". This phrase refers to the stooped posture that some people assume due to the severe joint pain produced by the viral infection.

The Cause of Chikungunya

The chikungunya virus is transmitted through a bite by two species of mosquitoes—Aedes albopictus and Aedes aegypti. These are normally inhabitants of tropical and subtropical areas, but both have been introduced to the United States. Researchers say that the virus isn't transmitted from person to person. There may be one exception, however. According to the CDC, "Chikungunya virus is transmitted rarely from mother to newborn around the time of birth."

At the moment, most North Americans that have chikungunya have just returned from a trip to a tropical country inhabited by the mosquitoes. Unfortunately, the insects are spreading to new areas. This is especially true for Aedes albopictus, which can survive in temperate climates as well as tropical ones. A few people have developed chikungunya after a mosquito bite in the US as opposed to a bite in another country.

When a female mosquito bites someone to suck up blood, she injects an anticoagulant to stop her victim's blood from clotting. (Only female mosquitoes bite.) The virus enters the victim's blood in the mosquito's saliva. Later, when an uninfected mosquito bites the victim to withdraw blood, she may also withdraw the virus. If the virus survives in the new mosquito, the insect is capable of infecting someone else. Chikungunya symptoms may develop in as little as two to as long as twelve days after a mosquito bite.

Aedes albopictus transmits the chikungunya virus and is capable of surviving outside tropical regions. This female is feeding on blood. The insect is often known as the Asian tiger mosquito.

Aedes albopictus transmits the chikungunya virus and is capable of surviving outside tropical regions. This female is feeding on blood. The insect is often known as the Asian tiger mosquito.

Possible Symptoms and Treatment

Some people never develop symptoms from a chikungunya virus infection, but most do. The most common effects are fever and severe joint pain, which is often disabling. Other possible symptoms include swollen joints, muscle pain, a rash, a headache, and nausea.

At the present time, there is no specific medication available to treat chikungunya. Antibiotics aren't helpful because they don't destroy viruses. The body is nearly always able to defeat the chikungunya virus, however (though a doctor should be visited) and fatalities are rare. The disease is sometimes more serious in newborn babies, elderly people, and people with certain preexisting illnesses.

Even though chikungunya is rarely dangerous, it's very unpleasant and often painful. It can also produce lingering effects that may last for a long time. One of the symptoms that may linger—even for years—is the joint pain.

Anyone with unexplained symptoms should visit a doctor. In the case of chikungunya, the doctor may prescribe pain killers, rest, and fluids. He or she may also offer other suggestions to help the patient.

Incidence of the Disease in the United States

Chikungunya was first identified in 1952. According to the CDC (Centers for Disease Control and Prevention), from 2006 to 2013 all cases of chikungunya in the United States appeared in people who had travelled to other countries and become infected there. This conclusion was based on the illnesses that were diagnosed and reported. The following information was reported more recently.

  • 2014: 2,811 cases were reported, 12 of which were acquired from a mosquito bite within the United States (in Florida)
  • 2015: 896 cases were reported, 1 of which was acquired from a mosquito bite within the United States (in Texas)
  • 2016: 248 cases were reported, none locally transmitted
  • 2017: 156 cases were reported, none locally transmitted
  • 2018: 90 cases were reported, none locally transmitted
  • 2019: 192 cases were reported, none locally transmitted
  • 2020: 33 cases were reported, non locally transmitted

It should be noted that in all of the years mentioned above except for 2020, U.S. territories experienced locally-transmitted cases. While the number of cases caused by mosquitoes within the United States may not sound significant, it shows that at least some of the mosquitoes in the country were quite recently capable of carrying the chikungunya virus.

The recent trend in the disease incidence in the United States is encouraging. The situation needs to be watched carefully in case the disease flares up again. Outbreaks of chikungunya periodically appear in various parts of the world. The CDC website has a map showing the recent location of the disease under the “Geographic Distribution” link.

Preventing Mosquito-Borne Diseases

The CDC says that the best way to prevent chikungunya or other mosquito-borne diseases is to use insect control and avoidance techniques.

  • Doors and windows should have screens.
  • Mosquito nets should be placed over beds in places where lots of insects are found.
  • Protective clothing should be worn in areas frequented by mosquitoes.
  • Insect repellents should be used on the body and clothing.
  • Standing bodies of water where mosquito larvae grow should be drained. (Even a small puddle is an attractive place for a female to lay eggs.)

How Does Rheumatoid Arthritis Develop?

In rheumatoid arthritis, or RA, the immune system attacks a thin membrane called the synovium. The synovium is also known as the synovial membrane. This membrane lines the capsule around many of our joints, which are known as synovial joints.

The immune system's attack involves inflammation. The inflammation causes the synovium to thicken. Eventually, the inflammation from the synovium spreads to the cartilage and bone in the joint and causes these structures to break down. The damage may stop the ligaments, tendons, and muscles around the joint from doing their jobs and may lead to deformity in the affected area.

The trigger for the immune system's attack is unknown. There seems to be a genetic component to the disorder. The possession of a certain gene or genes is thought to make a person more susceptible to an environmental trigger that leads to joint damage. The trigger might be a viral or bacterial infection or a hormonal change. Neither of these theories have been proven, though.

Possible Symptoms of the Disease

Someone with rheumatoid arthritis will probably find that their joints feel warm, tender, and swollen. The joints may also look red. The person may experience stiffness, especially after getting out of bed in the morning. They may experience fatigue, low energy, and an occasional fever as well.

The joints in the hands and wrists are most commonly affected, usually on both sides of the body. Other joints may also be affected by the disorder, however.

RA may involve symptoms in other parts of the body in addition to joints. A decrease in red blood cells, or anemia, is a possible symptom. The patient may also experience a dry mouth and dry eyes. Rarely, the blood vessels or the membrane around the lungs or heart may become inflamed.

There is considerable variability in the seriousness of rheumatoid arthritis. Some people experience flare-ups (periods when their symptoms are worse) alternating with remissions (periods when their symptoms are much weaker or absent). For other people, the symptoms are constant. The symptoms remain mild for some people, but for many people they are progressive. New medications can weaken this progression, however.

Possible Treatments for the Disease

Anyone with rheumatoid arthritis or joint pain must be under the care of their doctor, who will prescribe treatment. Many potential treatments are available. Some are more effective for certain patients than others.

A relatively new treatment that seems to often be very effective for some people is the use of DMARDS (disease-modifying antirheumatic drugs). These are medications that suppress the patient's overactive immune system, interfering with the inflammation that is damaging the joints. Methotrexate is a commonly prescribed DMARD, but others exist.

One important group of DMARDs is the biologics, which are mentioned in both of the arthritis videos above. Biologics are medications produced by genetic engineering. They are proving to be very useful for some cases of rheumatoid arthritis.

Diagnosing the Disease

One reason that RA may be misdiagnosed—at least in the early stage—is that there is no test that proves that someone has rheumatoid arthritis. Inflammation and painful joints can be part of other diseases. Joint X-rays may look normal or only slightly abnormal in the early stage of RA.

Some blood tests can strongly suggest that someone has rheumatoid arthritis, but they aren't conclusive. Many people with the disease have distinctive factors in their blood. Not everyone with RA has these factors in their blood, however, and some people have the factors without having rheumatoid arthritis.

Generally, a doctor makes a diagnosis of RA based on a combination of a patient's symptoms, an examination, and multiple lab tests.

Deformity resulting from advanced rheumatoid arthritis

Deformity resulting from advanced rheumatoid arthritis

A Comparison of Rheumatoid Arthritis and Chikungunya

The symptoms of rheumatoid arthritis follow a different pattern of development from those of chikungunya. Chikungunya begins with a fever while rheumatoid arthritis generally doesn't, for example. Symptoms of joint pain caused by the chikungunya virus generally appear suddenly and are severe, while those of rheumatoid arthritis appear more slowly and gradually worsen. After the initial symptoms of chikungunya have subsided and only joint pain and perhaps swelling in the joints remain, however, it may be difficult to tell the two diseases apart.

A blood test is often unhelpful in distinguishing the two diseases. Both disorders involve an elevated blood level of a specific type of T-cell, for example. In order to positively identify chikungunya, a blood test has to show antibodies to the virus in the patient's blood. Unfortunately, at the moment this type of blood test is only available at the CDC and at specific research laboratories.

Why Does It Matter if the Two Diseases Are Confused?

Early and effective treatment of rheumatoid arthritis is very important because it can delay and reduce joint damage. If someone with rheumatoid arthritis believes that their joint pain is a result of a chikungunya infection, they may take pain killers to feel more comfortable but take no medications to help protect their joints. Joint damage could therefore continue unabated.

On the other hand, if someone with a chikungunya infection is diagnosed with rheumatoid arthritis, they may be prescribed immune system suppression drugs that they don't need. All drugs have side effects. While these side effects may be a small price to pay for someone with RA who is trying to prevent permanent joint damage, relieve pain, and lead a relatively normal life, they may be unpleasant and unnecessarily harmful for someone with chikungunya. Suppressing the immune system may also make the patient more susceptible to infections.

Hopefully, we will move forward in our understanding of rheumatoid arthritis and chikungunya in the near future.

Hopefully, we will move forward in our understanding of rheumatoid arthritis and chikungunya in the near future.

Rheumatoid Arthritis and Chikungunya in the Future

I hope that the blood test that distinguishes chikungunya from rheumatoid arthritis becomes more widespread. I suspect that it will if chikungunya becomes more common. It would also be wonderful if an antiviral drug or a vaccine is developed for the infection.

Studying the way in which the chikungunya virus causes joint pain may help researchers learn more about the pain caused by rheumatoid arthritis. RA can be a major health problem, yet it's still not completely understood. Although there appears to be no current evidence that the chikungunya virus causes the same effects inside joints as rheumatoid arthritis, there may be some similarities. Studying the viral infection may be important not only to help people who are infected by the virus but also to help people with other diseases that affect joints, including rheumatoid arthritis.


  • The CDC (Centers for Disease Control and Prevention) maintains a web page containing current news about the spread of chikungunya in the United States.
  • WHO (the World Health Organization) has a web page about chikungunya that refers to the 2019 outbreak in Congo. It also contains links to pages containing other information about the disease
  • The NIH (National Institutes of Health) maintains a web page with detailed information about rheumatoid arthritis.
  • WebMD discusses biologics for rheumatoid arthritis.
  • This report from the Washington University School of Medicine in St. Louis discusses the shared symptoms of chikungunya and rheumatoid arthritis.

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2015 Linda Crampton


Linda Crampton (author) from British Columbia, Canada on May 11, 2015:

Thank you for the comment, RTalloni. The study of human health can certainly be difficult. There are so many factors to consider!

RTalloni on May 11, 2015:

This is an interesting and important read. What science has yet to learn about diseases, testing, and treatments sometimes makes me very suspicious of the declarations made about some of the difficult health needs people face. Thanks for a look at chikungunya and what we need to know about it.

Linda Crampton (author) from British Columbia, Canada on February 24, 2015:

Thanks for the comment, Deb. The ways in which climate affects disease are interesting.

Deb Hirt from Stillwater, OK on February 24, 2015:

Northern climates definitely have their benefits, and I never realized that until now. I am just flabbergasted with some of the diseases out there that have only the climate between health and illness.

Linda Crampton (author) from British Columbia, Canada on February 18, 2015:

I hope you get an accurate diagnosis very soon, Carolyn, and that you're given some effective help. Best wishes for the future. Thank you for the comment.

Carolyn Emerick on February 18, 2015:

Thank you for this! I was diagnosed with early onset RA last year, but didn't like the dr so I switched, then the new one keeps flip flopping on my diagnosis. I will have to do some more research, but this is excellent!

Linda Crampton (author) from British Columbia, Canada on February 16, 2015:

Hi, Mel. Thanks for the comment. I'm sorry that you have to deal with psoriatic arthritis, but I'm glad that you finally got the correct diagnosis. I think people are going to hear a lot more about chikungunya in the future!

Mel Carriere from Snowbound and down in Northern Colorado on February 16, 2015:

There are actually more cases of Chikungunya than Ebola, but I have not heard any public outcry. This topic interested me because I have psoriatic arthritis, which is a type of rheumatoid arthritis. It never showed up on blood tests, which could be why it took a while before a skilled rheumologist found it. Great hub!

Linda Crampton (author) from British Columbia, Canada on February 15, 2015:

Hi, Bill. I hope you enjoyed your trip to Florida. Thank you for the comment. I appreciate your visit.

Bill De Giulio from Massachusetts on February 15, 2015:

Hi Linda. Very interesting. I had never heard of the Chikungunya Disease before. We just returned from Florida and was not aware that the Mosquitoes there could be carrying this disease. Great info for future reference. Once again I learned something new today.

Linda Crampton (author) from British Columbia, Canada on February 11, 2015:

Happy Hump Day to you too, Thelma! Thank you very much for the comment.

Thelma Alberts from Germany on February 11, 2015:

Thank you very much for writing this very useful and informative hub. I have learned a lot. Happy Hump Day!

Linda Crampton (author) from British Columbia, Canada on February 09, 2015:

Thanks for reading the hub, tirelesstraveler. I hope it doesn't happen, but we may be hearing a lot more about chikungunya in the near future!

Judy Specht from California on February 09, 2015:

Chikungunya is certainly a new disease to me. Thanks for the information.

Linda Crampton (author) from British Columbia, Canada on February 09, 2015:

That's so true, Flourish - diseases don't respect borders. It's a scary time. Thanks for the comment.

FlourishAnyway from USA on February 09, 2015:

Reading through the symptoms and knowing someone with RA, I sure hope not to get either one of these. The world is certainly smaller than ever before, and our diseases sure don't respect borders.

Linda Crampton (author) from British Columbia, Canada on February 09, 2015:

Thanks, StephSev108. I appreciate your visit.

Stephanie Marie Severson from Atlanta, GA on February 09, 2015:

Thank you for an interesting and much needed hub.

Linda Crampton (author) from British Columbia, Canada on February 09, 2015:

Thank you very much, Jo.

Jo Alexis-Hagues from Lincolnshire, U.K on February 09, 2015:

Interesting and useful information and as always, beautifully presented.

Linda Crampton (author) from British Columbia, Canada on February 09, 2015:

Thank you very much for the vote and all the shares, Peggy. The mosquito eradication program in your area sounds very useful. It's definitely scary that the mosquitoes are moving into new areas!

Peggy Woods from Houston, Texas on February 09, 2015:

Hi Alicia,

Very informative and detailed hub! We have plenty of mosquitoes here in Houston. I am glad that our subdivision dues pays for once a week mosquito eradication spraying during many months of the year but that does not mean other precautions need not also be addressed. Rather scary that the diseases are moving further north because of the warming temperatures. Up votes, pinning, tweeting, G+ and sharing.

Linda Crampton (author) from British Columbia, Canada on February 09, 2015:

Hi, ologsinquito. The virus has been in the news a lot recently. It does cause a horrible infection. It's good that fatalities are rare, although it's sad that anyone has to die from the disease.

ologsinquito from USA on February 09, 2015:

I just heard about this terrible virus a few months ago. It sounds dreadful.

Linda Crampton (author) from British Columbia, Canada on February 09, 2015:

Best wishes, breakfastpop. I hope you continue to avoid the mosquitoes! I would definitely take the precautions that you do if I was in an area where mosquito-borne disease was common.

Linda Crampton (author) from British Columbia, Canada on February 09, 2015:

Thank you very much for sharing your experience, VioletteRose. I'm so glad that you recovered fully and didn't have any problems after the chikungunya infection! Your story is very scary.

Linda Crampton (author) from British Columbia, Canada on February 09, 2015:

Thank you very much, Bill!

breakfastpop on February 09, 2015:

I travel to the Caribbean quite a bit, and I now live in fear of this new form of danger from a bite. I have always worn boots, pants and long sleeves when walking about, and I have been doing so for 25 years! Dengue fever is also a threat and I don't want to take any chances, because mosquitoes love me!

VioletteRose from Atlanta on February 09, 2015:

Great hub. I had Chikungunya 8 years back. I was very healthy until one day afternoon, then I had difficulty with walking due to the problems in joints. In fact I was watching a film in the theatre, and I just realized the problem after the film was over!

We went to the hospital and I was admitted there for three days, but just taking fluids, pain killers and taking rest. You are right that there is no medicine. The best medicine is getting enough rest, and it will naturally cure by itself. I was back to being healthy in about a month. In my case I didn't have any long term health problems from Chikungunya. However, those who didn't get enough rest had problems later in life. Age is also a factor it seems.

Bill Holland from Olympia, WA on February 09, 2015:

And my education continues and I thank you for it!

Linda Crampton (author) from British Columbia, Canada on February 09, 2015:

Hi, Devika. Thank you very much for the comment and the votes! I appreciate your visit, as always.

Linda Crampton (author) from British Columbia, Canada on February 09, 2015:

Hi, Patricia. I would love to visit Florida to see its wildlife, but I would prefer to avoid the mosquitoes! I'm sorry to hear the sad story about your aunt. It's good to hear that she didn't let RA interfere with her life, despite the pain. Thanks for the angels!

Linda Crampton (author) from British Columbia, Canada on February 09, 2015:

I'm very sorry about the pain in your toes, Faith. I hope you find relief soon. At the moment we are more likely to get chikungunya if we travel to another country, but this may not be the situation for long. As always, I appreciate your kind votes and shares!

Devika Primić from Dubrovnik, Croatia on February 09, 2015:

A well-shared hub! A great discovery and so interestingly researched.Voted up, interesting, and useful.

Patricia Scott from North Central Florida on February 09, 2015:

I live in Florida so this was of great interest to me. We are ever vigilant here as there are other worrisome illnesses caused by mosquitoes here too as you must know.

My one precious Aunt had RA and she was in pain most of her 95 years. It was heartbreaking but she never let it stop her from and active and full life.

Angels are on the way to you today ps

Faith Reaper from southern USA on February 09, 2015:

Interesting insight you have provided here as to the difference between the two. I have not heard of Chikungunya. We have plenty of mosquitoes here in the deep south, but not tropical. Hopefully, we are not susceptible to Chikunguna unless we travel to another country?

I have been having terrible (well, I call them cramps) pain in my toes where the bones become distorted looking, so I hope that is not a sign of arthritis! It is very painful.

Up +++ tweeting, pinning and sharing

Good to know the symptoms of each!