Healthcare Provider Information for Mosquito & Vector-Borne Diseases

Prompt reporting is the key to preventing local outbreaks of mosquito-borne diseases.  Healthcare providers should use the following clinical guidelines if they suspect a patient has a mosquito-borne illness.
  1. Chikungunya
  2. Dengue
  3. St. Louis Encephalitis & West Nile Viruses 
  4. Zika


If you suspect chikungunya virus infection, please call and report to Maricopa County Department of Public Health (MCDPH) at 602-506-6767 Monday-Friday, 8 a.m. - 5 p.m. within 5 working days. Depending upon the patient's travel history, other arboviral infections might be included in the differential, including dengue and Zika. Dengue and Zika often circulate in the same areas as chikungunya and are clinically indistinguishable. Please test for all three.

To date, all cases in Maricopa County have been travel-associated. Countries that have had locally-acquired transmission include Africa, Asia, Mexico, Central and South America, and the Caribbean. For a more complete list, see list of affected areas.

Considerations for Suspect Chikungunya Infections:

  1. Screening Criteria:
    1. Anyone with appropriate travel history (see list of affected areas) PLUS
    2. Acute onset of fever and joint pain; possibly headache, muscle pain, joint swelling or rash
  2. Diagnostics:
    When collecting specimens for testing at either a commercial or public health laboratory, count the number of days since onset of symptoms or last known exposure to determine which tests are appropriate. Blood may be collected in serum separator tubes for the following tests:
    • 0-3 days - PCR only
    • 4-6 days - both PCR and IgM Serology
    • ≥7 days - IgM Serology only

      Note: When in doubt, order both tests and remember to test for dengue and Zika, if warranted
    Please check with your laboratory provider for testing availability and specimen shipping recommendations. If your laboratory provider is unable to test for chikungunya and the patient meets screening criteria, testing at a public health laboratory (ASPHL) can be arranged through MCDPH by calling 602-506-6767 Monday-Friday, 8 a.m. to 5 p.m.

  3. Prevention:
    It is extremely important that patients with possible chikungunya exposure avoid mosquito bites during the first 7 days of illness to avoid transmission to mosquitoes locally. If Zika virus is in the differential, extend this to the first three weeks post-travel or onset date. Please educate patients and families about mosquito prevention.

    The following may be used to deliver appropriate educational material to patient:

  4. Treatment:
    No specific antiviral therapy is available for chikungunya virus disease. Treatment is supportive and may include rest, fluids, and use of NSAIDs to relieve acute pain and fever. Persistent joint pain may benefit from use of NSAIDs, corticosteroids, or physiotherapy. NOTE: rule out dengue before prescribing NSAIDS.

    Please refer to the following for more detailed information: