Atypical and severe manifestations • Although most chikungunya virus infections result in fever and arthralgia, other clinical manifestations can occur. • Atypical or severe clinical manifestations can be due to the direct effects of the virus, immunologic response to the virus, drug toxicity, or diseases unrelated to chikungunya virus infection. • Some atypical or severe manifestations are more common in certain groups. For example, vesiculobullous lesions, febrile seizures, and meningoencephalitis have been reported in infants and young children. • Since many atypical and severe clinical manifestations will be unrelated to chikungunya virus infection, healthcare providers should consider and evaluate for other etiologies.

Stephen B. Thacker CDC Library collection