What this test measures
Chikungunya IgM is an enzyme-linked immunosorbent assay (ELISA) or chemiluminescence assay that detects IgM-class antibodies against chikungunya virus in serum or plasma. IgM appears around day 5–7 of illness, peaks at 2–3 weeks, and typically persists for 1–3 months.
This is the gold-standard serological diagnosis recommended by NIV Pune and NCDC India for chikungunya — more sensitive and specific than rapid card tests, especially in atypical or severe presentations.
Why it matters
Chikungunya is widely endemic in India with regular monsoon-season outbreaks across Mumbai, Thane, and most major cities. Severe joint pain — sometimes persisting for months — distinguishes chikungunya from dengue clinically, but laboratory confirmation is needed for both surveillance and individual management.
The IgM ELISA is the formal NCDC-recommended diagnostic test in India and is used for outbreak confirmation, hospital admissions, and severe or atypical cases (e.g. neurological involvement, neonatal chikungunya, persistent post-chikungunya arthralgia). RT-PCR is preferred only in the first 5 days of illness.
How to prepare
No fasting required. The test uses serum or plasma. Mention day of illness onset and any prior chikungunya history.
Markers & reference ranges
Reference ranges below are typical adult values. Your lab's reported range may differ slightly based on the assay platform and patient demographics — always read your report against the range printed on it.
| Marker | Normal range | If low | If high |
|---|---|---|---|
| Chikungunya IgM (ELISA) (OD or Index / Reactive-Non-reactive)[1][2] | Non-reactive (Negative) | Non-reactive — no recent chikungunya infection. If illness started < 5 days ago, IgM may still be too early — repeat after day 7. Consider dengue, malaria, leptospirosis. | Reactive — confirmed recent chikungunya infection. Supportive care: paracetamol, hydration, rest. NSAIDs only after dengue is excluded. Persistent joint pain may need physiotherapy and rheumatology input. |
Chikungunya testing — what to use when
| Day of illness | Best test | Why |
|---|---|---|
| Day 1–4 | RT-PCR (at NIV Pune or referral lab) | Virus detectable; antibody not yet developed. |
| Day 5–7 | IgM ELISA + RT-PCR | Transition period; both may work. |
| Day 7–21 | IgM ELISA | Peak IgM; highest sensitivity. |
| After 3 weeks | IgM + IgG | IgM declining, IgG rising. |
| Months later | IgG only | IgM has cleared; IgG persists for years. |
Frequently asked questions
How soon after fever does IgM become positive?
IgM typically becomes detectable by day 5–7 of illness. Testing earlier can give a false negative — RT-PCR is the better test in the first 5 days.
My IgM is positive. How long will joint pain last?
Acute joint pain usually resolves in 1–3 weeks. About 30–50% of patients have persistent arthralgia lasting months. Some develop chronic chikungunya arthritis requiring rheumatology care.
Why is the ELISA preferred over rapid tests?
ELISA has higher sensitivity (>95%) and specificity (>98%). Rapid tests are convenient but can miss low antibody levels — confirm with ELISA in atypical, severe, or pregnant cases.
Can I have dengue and chikungunya together?
Yes — co-infection occurs, especially during simultaneous outbreaks. Both tests are often ordered together. Treatment is supportive for both; avoid NSAIDs until dengue is ruled out.
Is there a vaccine?
A chikungunya vaccine (IXCHIQ) is licensed in the US and Europe but not yet widely available in India. Prevention relies on mosquito control.
How long does IgM stay positive?
Typically 1–3 months. After that, only IgG persists. Repeat IgM testing is not needed once the diagnosis is confirmed.
Should pregnant women be tested?
Yes if they have fever and risk exposure. Maternal chikungunya in late pregnancy can transmit to the newborn (intrapartum), causing severe neonatal infection — early identification matters.
Related Infectious Disease tests
Tests commonly ordered alongside CHIKUNGUNYA-IGM, or that help interpret an unexpected result.
Sources & references
- NIV Pune — Chikungunya · accessed 2026-05-30T00:00:00.000Z
- NCDC India — Chikungunya · accessed 2026-05-30T00:00:00.000Z
- WHO — Chikungunya Fact Sheet · accessed 2026-05-30T00:00:00.000Z
- CDC — Chikungunya Virus · accessed 2026-05-30T00:00:00.000Z
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