OP 4 Re-emergence of chikungunya: A demographic, clinical, and virological profile at Teaching Hospital Jaffna

Apirami K¹, Murugananthan A¹, Sivansuthan S², Sathiadas MG³, Murugananthan K⁴¹Department of Parasitology, Faculty of Medicine, University of Jaffna, ²Teaching Hospital Jaffna, Jaffna, ³Department of Paediatrics, Faculty of Medicine, University of Jaffna, ⁴Department of Microbiology, Faculty of Medicine, University of Jaffna

Abstract

Introduction

Chikungunya virus (CHIKV), responsible for a major outbreak in 2006–2008, has re-emerged after 17 years in 2025. In clinical practice, chikungunya often resembles other arboviral infections such as Dengue fever, making early diagnosis challenging. Understanding its presentation helps in early and accurate patient care.

 Objective

The objective of this study is to analyze the demographic, clinical characteristics, and virological profiles of chikungunya.

 Design,  setting,  and methods

This cross-sectional study was carried out from January to March 2026 among patients admitted to the pediatric and medical wards at Teaching Hospital Jaffna with suspected chikungunya. A total of 385 patients were enrolled consecutively. Data was collected using a pre-tested questionnaire and data extraction sheet. Blood samples were obtained from suspected patients and transported to the Faculty of Medicine, University of Jaffna, where real-time PCR testing was performed to confirm chikungunya and dengue infections in patients presenting within the first five days of fever. Data were analyzed using SPSS version 31.0.

 Results

Out of 385 patients, more than half (54.8%, n=211) were confirmed to have chikungunya, while a smaller proportion (11.7%, n=45) had dengue. A few patients (4.7%, n=18) were found to be co-infected with both viruses. Most patients with chikungunya were adults (82.0%, n=173) with male predominance (66.4%, n=140). Arthralgia (76%), myalgia (67.9%) and headache (76.6%) were significantly associated (p<0.05) with chikungunya, while rash was less frequently (3.8%, n=8) observed and the proportion was higher among pediatric patients (4/38,10.5%) often involving the face.

Moderate inflammatory responses, with a mean CRP of 38.1 mg/L, while mean white cells (5.99×10⁹/L) and platelets (210×10⁹/L) remained within normal ranges. However, 6.2% of patients showed markedly elevated CRP levels (>200mg/L), suggesting severe inflammation. Meningoencephalitis (n=2) was recorded during the current outbreak.

 Conclusion

This study highlights the significant re-emergence of chikungunya in Northern Sri Lanka, with a high rate of confirmed cases. Arthralgia, myalgia, and headache are strongly associated with chikungunya. Although rash is less frequent, proportionally more common in children. The occurrence of neurological complications highlights the need for continued clinical vigilance and timely diagnosis.