skip to main content

Chikungunya Differential — SCE Infectious Diseases MCQ

Instant feedback + full explanation. One question, done properly.

ModerateTravel Medicine & VaccinationChikungunya DifferentialSCE Infectious Diseases

A 30-year-old man develops a travel-associated febrile illness. He returned from Nigeria 6 days ago. Malaria films are negative (×3). He has a rash, headache, and myalgia. Dengue NS1 antigen and IgM are negative. He reports that several people in the village he visited also had similar symptoms. He has no haemorrhagic features. What investigation is most appropriate next?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Chikungunya IgM/PCR — chikungunya causes dengue-like febrile illness with prominent arthralgia/rash and is endemic to West Africa; it is NOT detected by dengue testing

In a febrile returned traveller from West Africa with rash, headache, and myalgia with negative malaria and dengue tests, the differential includes: Chikungunya (prominent polyarthralgia + rash), Zika virus (milder), O'nyong-nyong, West Nile virus, and rickettsial infection. Chikungunya is endemic to sub-Saharan Africa and causes outbreaks with high attack rates. Testing is by Chikungunya IgM/IgG serology or PCR (in the first week). There is no specific treatment — management is supportive with NSAIDs for arthralgia. Chikungunya can cause debilitating chronic polyarthralgia for months.

Reference: UKHSA 2023 – Chikungunya; PHE 2022 – Tropical fever algorithm; NaTHNaC