Chikungunya-IgM Test

What is Chikungunya?

Chikungunya is a largely debilitating viral disease that is spread by mosquito bites, much like malaria and dengue. This disease is characterized by high fever and severe joint pain. Chikungunya is prevalent mostly in South East Asia and Africa. Since it is a viral disease there is no cure for it. The treatment can help obtain relief from the febrile symptoms. Many clinical symptoms of this disease overlap with those of Zika and dengue, thus it often gets misdiagnosed. Chikungunya IgM test is an accurate diagnostic tool that can be used to correctly diagnose the onset of this viral disease.

What is the Chikungunya IgM test?

This is a blood test that can indicate the presence of chikungunya virus in the body. Accurate diagnosis of the disease is generally accomplished by testing the serum or plasma sample to detect the chikungunya virus, viral nucleic acid, or virus-specific immunoglobulin (Ig) M and neutralizing antibodies.

A viral culture may detect the virus during the first 3 days of illness. During the first 8 days of illness, chikungunya viral RNA can often be identified in serum (blood sample). Chikungunya virus antibodies such as chikungunya IgM and IgG usually develop towards the end of the first week of the onset of the febrile symptoms.

Why has the doctor asked me to undergo the Chikungunya-IgM test?

The name chikungunya has been derived from the Kimakonde language and literally translates to “stooped” or “bent”. This refers to the stooped posture of people suffering from this viral disease as the joint pain associated with chikungunya can often cause them to develop this sort of gait. In addition to this, if you are living in a chikungunya-prone region and have the following symptoms, your doctor will ask you to get your chikungunya-IgM blood test done.

– Sudden onset of high fever
– Muscle pain and headaches
– Nausea and vomiting ‘
– Fatigue
– Skin rashes
– Excessive joint pain
This test is ordered when the symptoms of chikungunya fever have exceeded for more than a week. IgM antibody levels are highest 3 to 5 weeks after the onset of chikungunya and persist in the body for about 2 months.

How is the Chikungunya-IgM test performed?

The blood sample collection is done following the steps of a basic venipuncture procedure.

– The sample is collected from the arm, the area opposite the elbow. The healthcare provider will clean the area with an antiseptic solution.

– A tourniquet or an elastic band is tied around the arm to increase the pressure on the veins and makes it easier to locate the right vein.

– Once the vein has been identified, a syringe will be inserted and blood will be collected in a vial attached to the syringe.

– Usually, around 5ml of blood sample is adequate for testing. Once the sample has been collected, the elastic band is removed and the puncture site is covered with sterile gauze. This is done to prevent bleeding and infection at the site.

– The sample is sent to labs for testing for the chikungunya virus (also known as CHIKV).

What is the price of the Chikungunya IgM test in India?

The price of the chikungunya IgM test is close to Rs 950- Rs 1000. It may vary slightly based on the city and the quality of diagnostic facilities.

Is fasting required for the test?

No fasting or any other special preparation is required prior to the chikungunya-IgM test though you must inform your doctor on any medicine (prescription or OTC) or supplements that you might be on. However, based on the age and diet, in some cases you might be asked to remain on empty stomach before the test.

When will I get my test results?

The test results for chikungunya-IgM are typically available within 4-14 days of the sample collection.

What are the normal reference values for the chikungunya-IgM test?

The chikungunya-IgM test is often paired with the chikungunya-IgG test and the status of both these parameters is taken into account before diagnosing the disease. The following table shows a reference status for both chikungunya- IgM and IgG.

When do the chikungunya antibodies start appearing in the bloodstream?

The IgG and IgM chikungunya antibodies do not appear immediately upon the exposure to the chikungunya virus. It takes some 3-4 days for the IgM and 6-7 days for the IgG antibodies to become detectable in the blood sample. However, the chikungunya- IgM test is generally prescribed after a period of 1 week of the onset of the typical symptoms to avoid misdiagnosis of the disease. Also, upon complete treatment, the IgM antibodies will remain in the blood for 3-4 months (detectable range) whereas the IgG antibodies are present for years.

What precautions must one follow prior to the Chikungunya-IgM test?

– Inform the doctor about your medication/supplement intake. Based on this the doctor will advise you whether you need to stop any of these prior to the test or not.

– The IgM antibodies appear after a set period of time in the blood. Thus, it is advised NOT to undergo the test immediately upon the onset of the symptoms.

– Ask your doctor specifically if you need to fast before the test because this requirement is different for different cases.

– If you have undergone any treatments, therapy, or testing that might have exposed you to certain radioactive substances, inform your doctor about it prior to the test.

How prevalent is Chikungunya in India?

Chikungunya has become one of the most rampant vector-borne diseases in India, with a whopping 300-400% increase in the number of cases in just 3 years. In 2016, more than 60,000 cases of chikungunya were reported.

Should pregnant women undergo the Chikungunya-IgM test?

Recent studies have indicated that in addition to the vector-borne spread of the disease, this disease can also get transferred from an infected mother to the fetus. In such cases, the potential complications include transplacental transmission before birth, congenital malformations, stillbirths, growth restriction, and preterm delivery. Chikungunya infection can lead to severe complications if the patient is pregnant. Thus, if the doctor has reasons to believe that a pregnant might be exposed to the virus, a chikungunya-IgM test will be prescribed.

Is this test done for newborn babies?

In the case of mother-to-child transmission of the chikungunya fever, the newborn baby shows typical symptoms of the disease – fever, rashes, and feeding difficulties. The chikungunya virus can also cause neurological symptoms in neonates such as encephalitis or even multiple organ damage. Thus, this test becomes a necessity in case the mother has been exposed to the chikungunya virus.

How to differentiate between chikungunya and dengue?

The correct diagnosis of dengue and chikungunya can become tough because both the viruses are transmitted by the same mosquitoes and both the diseases present similar clinical features. The two viruses can circulate in the same area in the body (blood) and can cause occasional co-infections in the same patient. However, there are certain typical symptoms associated with chikungunya that can help differentiate between the two infections: