What are the key clinical features to consider when diagnosing Chikungunya virus infection in a patient presenting with fever and joint pain?

When diagnosing Chikungunya virus infection in a patient presenting with fever and joint pain, the key clinical features to consider include an acute onset of high-grade fever accompanied by severe polyarthralgia or polyarthritis, often symmetrical and involving small joints such as wrists, hands, ankles, and feet. This joint involvement can be debilitating and may persist for weeks to months. Additionally, patients frequently present with a maculopapular rash, headache, myalgia, and fatigue. The joint symptoms are a hallmark distinguishing feature from other arboviral infections and may mimic rheumatoid arthritis. Other associated signs can include conjunctivitis and lymphadenopathy. The combination of sudden fever with prominent, often symmetrical joint pain and rash in an endemic or travel-exposed patient strongly supports the diagnosis of Chikungunya virus infection NICE CKS Hrnjaković Cvjetković et al. 2015Vijayan & Sukumaran 2016Kharwadkar & Herath 2024.