What are the current guidelines for managing pain and other symptoms in patients diagnosed with Chikungunya virus infection?

Management of pain and other symptoms in patients with Chikungunya virus infection primarily focuses on symptomatic relief, as there is no specific antiviral treatment available. Initial management includes the use of analgesics and antipyretics to control fever and joint pain, which are the hallmark symptoms of the infection.

Paracetamol is recommended as the first-line analgesic and antipyretic due to its safety profile and effectiveness in reducing fever and mild to moderate pain ¹. Nonsteroidal anti-inflammatory drugs (NSAIDs) may be considered for more severe joint pain but should be used cautiously, especially in patients with contraindications such as gastrointestinal, renal, or cardiovascular risks ¹. Aspirin is generally avoided in acute viral infections due to the risk of bleeding and Reye’s syndrome ¹.

For persistent or severe arthralgia and arthritis, which can mimic rheumatoid arthritis, short courses of corticosteroids may be considered under specialist guidance, particularly if symptoms are debilitating and unresponsive to NSAIDs (Brito et al., 2016). However, corticosteroids should be used cautiously and are not routinely recommended in the acute phase due to potential immunosuppression (Brito et al., 2016).

Supportive care includes adequate hydration, rest, and physical therapy to maintain joint mobility and function ¹. Chronic joint symptoms may require referral to rheumatology for further management, including consideration of disease-modifying antirheumatic drugs (DMARDs) if symptoms persist beyond the acute phase (Brito et al., 2016).

Other symptoms such as rash and conjunctivitis are generally self-limiting and managed symptomatically. Patients should be advised on vector control measures to prevent further mosquito bites and transmission ¹.