Rheumatologists should consider the possibility of Chikungunya virus in patients who present with new symmetric polyarthritis, especially if they have just returned from an endemic region such as the Caribbean, according to researchers.

Researchers from Washington University, St. Louis, describe a cohort of 10 Americans who traveled to Haiti within a 20-day period in June 2014 and became infected with Chikungunya virus (CHIKV), an arthritogenic, mosquito-transmitted alphavirus.

The virus spread to the Caribbean in 2013 and the United States in 2014. Its acute phase of infection includes symptoms such as fever, headache, rash, arthralgia, arthritis, and myalgia.

“Eight out of these patients would have met the 2010  ACR/ EULAR criteria for RA if the initial fever, rash, and travel to the Caribbean had not been revealed,” they noted.The virus is likely to become a unique diagnostic challenge for rheumatologists as the arthritis symptoms mimic seronegative arthritis, the researchers note in their paper published in Arthritis and Rheumatology.