Rheumatoid Arthritis and Chikungunya Similarities and Differences

Aedes aegypti is a mosquito which transmits the viruses that cause yellow fever, dengue and chikungunya. It's often known as the yellow fever mosquito.
Aedes aegypti is a mosquito which transmits the viruses that cause yellow fever, dengue and chikungunya. It's often known as the yellow fever mosquito. | Source
A reconstruction of the Chikungunya virus as viewed through an electron microscope
A reconstruction of the Chikungunya virus as viewed through an electron microscope | Source

Rheumatoid arthritis is an autoimmune condition in which the body's immune system mistakenly attacks joints in the body. Chikungunya is an infectious disease caused by a virus entering the body through a mosquito bite. At first glance, the two disorders seem completely different. However, some of their symptoms are so similar that it's sometimes hard for doctors to make a correct diagnosis.

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. Health experts predict that chikungunya will become widespread in North America. Distinguishing a chikungunya infection from rheumatoid arthritis is therefore very important.

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.

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. The number of chikungunya cases caused by a mosquito bite in the US as opposed to a bite in another country is increasing.

When a female mosquito bites someone to suck up blood, she injects an anticoagulant to stop her victim's blood from clotting. 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 then 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 also 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 also 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. | Source
A rash caused by the chikungunya virus
A rash caused by the chikungunya virus | Source

Chikungunya - 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 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 by itself, however, and fatalities are rare. They are most common in elderly people.

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 which 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.

What is Chikungunya and Why is it Spreading?

Distribution of Chikungunya in the United States

The CDC maintains a webpage containing current news about the spread of chikungunya in the United States.

The Spread of Chikungunya

According to the CDC (Centers for Disease Control,and Prevention), from 2006 to 2013 all cases of chikungunya in the United States appeared in travellers to other countries. On July 17th, 2014, the first case of chikungunya acquired from a mosquito bite in the US was reported. By January 13th, 2015, 11 cases of chikungunya in the United States had arisen within the country (specifically in Florida). On the other hand, 420 cases in Florida had been caused by travel to another country.

While 11 cases caused by local mosquitoes may not sound significant, it's actually a worrying statistic. It shows that at least some of the mosquitoes in the state can and do carry the chikungunya virus.

The best way to prevent chikungunya is to use mosquito control techniques. Standing bodies of water where mosquito larvae grow should be drained. Protective clothing should be worn in areas frequented by mosquitoes. Insect repellents are also helpful. Mosquito nets over beds are useful in areas with lots of mosquitoes.

A synovial joint
A synovial joint | Source

Rheumatoid Arthritis Handout

The NIH (National Institutes of Health) maintains a webpage with detailed information about rheumatoid arthritis.

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 eventually 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.

A joint in a healthy person and a joint in a person with rheumatoid arthritis
A joint in a healthy person and a joint in a person with rheumatoid arthritis | Source

Rheumatoid Arthritis - Possible Symptoms

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, 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, as are 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.

A Rheumatologist Discusses Rheumatoid Arthritis

Possible Treatments for Rheumatoid Arthritis

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

A relatively new treatment that is often very effective 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 there are others. One important group of DMARD is the biologics. Biologics are medications produced by genetic engineering. They are proving to be very useful for some cases of rheumatoid arthritis.

Living With Rheumatoid Arthritis

Diagnosing Rheumatoid Arthritis

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.

There are blood tests which can strongly suggest that someone has rheumatoid arthritis, but they aren't conclusive. Many people with RA tend to 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 RA.

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

Shared Symptoms of Chikungunya and Rheumatoid Arthritis

This report from the Washington University School of Medicine discusses the shared symptoms of chikungunya and rheumatoid arthritis.

A Comparison of Rheumatoid Arthritis and Chikungunya

The symptoms of rheumatoid arthritis are either different from those of chikungunya or follow a different pattern of development. 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. However, after the initial symptoms of chikungunya have subsided and only joint pain remains, it can be difficult to tell the two diseases apart.

A blood test is usually 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 blood test is only available at the CDC and at specific research laboratories.

Deformity resulting from advanced rheumatoid arthritis
Deformity resulting from advanced rheumatoid arthritis | Source

Why Does it Matter if Rheumatoid Arthritis and Chikungunya 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 who is trying to prevent permanent joint damage, relieve pain and and lead a relatively normal life, they may be unpleasant and unnecessarily harmful for someone with chikungunya. Suppressing the immune system may make a 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. | Source

Rheumatoid Arthritis and Chikungunya in the Future

Hopefully, the blood test that distinguishes chikungunya from rheumatoid arthritis will become more widespread. I suspect that it will if chikungunya becomes more common in North America, as it's expected to do. It would also be wonderful if an antiviral drug or a vaccine is developed for chikungunya.

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's no 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.

© 2015 Linda Crampton

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Comments 36 comments

Faith Reaper profile image

Faith Reaper 22 months ago from southern USA

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!


pstraubie48 profile image

pstraubie48 22 months ago from sunny Florida

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


DDE profile image

DDE 22 months ago from Dubrovnik, Croatia

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


AliciaC profile image

AliciaC 22 months ago from British Columbia, Canada Author

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!


AliciaC profile image

AliciaC 22 months ago from British Columbia, Canada Author

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!


AliciaC profile image

AliciaC 22 months ago from British Columbia, Canada Author

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


billybuc profile image

billybuc 22 months ago from Olympia, WA

And my education continues and I thank you for it!


VioletteRose profile image

VioletteRose 22 months ago from Chicago

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.


breakfastpop profile image

breakfastpop 22 months ago

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!


AliciaC profile image

AliciaC 22 months ago from British Columbia, Canada Author

Thank you very much, Bill!


AliciaC profile image

AliciaC 22 months ago from British Columbia, Canada Author

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.


AliciaC profile image

AliciaC 22 months ago from British Columbia, Canada Author

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.


ologsinquito profile image

ologsinquito 22 months ago from USA

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


AliciaC profile image

AliciaC 22 months ago from British Columbia, Canada Author

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.


Peggy W profile image

Peggy W 22 months ago from Houston, Texas

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.


AliciaC profile image

AliciaC 22 months ago from British Columbia, Canada Author

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!


tobusiness profile image

tobusiness 22 months ago from Bedfordshire, U.K

Interesting and useful information and as always, beautifully presented.


AliciaC profile image

AliciaC 22 months ago from British Columbia, Canada Author

Thank you very much, Jo.


StephSev108 profile image

StephSev108 22 months ago from Atlanta, GA

Thank you for an interesting and much needed hub.


AliciaC profile image

AliciaC 22 months ago from British Columbia, Canada Author

Thanks, StephSev108. I appreciate your visit.


FlourishAnyway profile image

FlourishAnyway 22 months ago from USA

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.


AliciaC profile image

AliciaC 22 months ago from British Columbia, Canada Author

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


tirelesstraveler profile image

tirelesstraveler 22 months ago from California

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


AliciaC profile image

AliciaC 22 months ago from British Columbia, Canada Author

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!


Thelma Alberts profile image

Thelma Alberts 22 months ago from Germany

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


AliciaC profile image

AliciaC 22 months ago from British Columbia, Canada Author

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


bdegiulio profile image

bdegiulio 21 months ago from Massachusetts

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.


AliciaC profile image

AliciaC 21 months ago from British Columbia, Canada Author

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


Mel Carriere profile image

Mel Carriere 21 months ago from San Diego California

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!


AliciaC profile image

AliciaC 21 months ago from British Columbia, Canada Author

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!


CarolynEmerick profile image

CarolynEmerick 21 months ago

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!


AliciaC profile image

AliciaC 21 months ago from British Columbia, Canada Author

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.


aviannovice profile image

aviannovice 21 months ago from Stillwater, OK

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.


AliciaC profile image

AliciaC 21 months ago from British Columbia, Canada Author

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


RTalloni profile image

RTalloni 19 months ago from the short journey

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.


AliciaC profile image

AliciaC 19 months ago from British Columbia, Canada Author

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

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