Chikungunya Outbreak Toolbox
Update | September 2019
Key references documents
- Guidelines for prevention and control of chikungunya fever (New Delhi: WHO Regional Office for South-East Asia; 2009).
- Preparedness and response for chikungunya virus introduction in the Americas (Washington (DC): Pan American Health Organization; 2011).
- Chikungunya information page (Geneva: World Health Organization).
- Chikungunya fact sheet (Geneva: World Health Organization; 2017).
Case definitionsWHO suggested outbreak case definition1
Acute clinical case:
- clinical criteria: fever > 38.5°C and joint pain2 (usually incapacitating)3 with acute onset; and
- epidemiological criterion: resident or visitor in areas with local transmission of chikungunya on the last 15 days (suspect case for epidemiological surveillance); or
- laboratory criterion: confirmation by laboratory – polymerase chain reaction (PCR), serology or viral culture (confirmed case for epidemiological surveillance).
Atypical case:
- clinical case of laboratory-confirmed chikungunya accompanied by other manifestations: neurological, cardiovascular, dermatological, ophthalmological, hepatic, renal, respiratory or haematological, among others.
Severe acute case:
- clinical case of laboratory-confirmed chikungunya presenting dysfunction of at least one organ or system that threatens life and requires hospitalization.
Suspected chronic case:
- person with previous clinical diagnosis of chikungunya after 12 weeks of the onset of the symptoms presenting with at least one of the following articular manifestation: pain, rigidity or oedema, continuously or recurrently.
Confirmed chronic case:
- every chronic case with a positive chikungunya laboratory test
1 Weekly Epidemiological Record (WER), 14 August 2015, vol. 90, 33 (pp. 409–420).
2 Usually accompanied by exanthema, myalgia, back pain, headache and occasionally, vomiting and diarrhea (in paediatric age group).
3 In children < 3 years of age, joint pain is expressed as inconsolable crying, irritability and rejection to mobilization and/or walking.
WHO surveillance case definition
Technical guidelines for integrated disease surveillance and response in the African Region (Brazzaville: WHO Regional Office for Africa and Atlanta: United States Centers for Disease Control and Prevention; 2010 (p. 263)).
Data collections tools- Case investigation form(s): Not available.
- Line list(s): Not available
- Electronic tools: Not available
Laboratory confirmation- Tool for the diagnosis and care of patients with suspected arboviral diseases (Washington (DC): Pan American Health Organization; 2017 (Chapter 7, page 43)).
- Preparedness and response for chikungunya virus: introduction in the Americas (Washington (DC): Pan American Health Organization; 2011 (Chapter 4, page 22)).
- Guidelines for prevention and control of chikungunya fever (New Delhi: WHO Regional Office for South-East Asia; 2009 (chapter 4, page 13)).
Response tools and resources- Tool for the diagnosis and care of patients with suspected arboviral diseases (Washington (DC): Pan American Health Organization; 2017).
- Guidelines on clinical management of chikungunya fever (New Delhi: WHO Regional Office for South-East Asia; 2008).
Other resources- Managing epidemics: key facts about major deadly diseases (Geneva: World Health Organization; 2018).
- Tool for the diagnosis and care of patients with suspected arboviral diseases ((Washington (DC): Pan American Health Organization; 2017).
- Protecting the health and safety of workers in emergency vector control of Aedes mosquitoes: Interim guidance for vector control and health workers (Geneva: World Health Organization; 2016).