Detection of virus-neutralizing antibodies in combination with recent travel history to an endemic area may be meaningful.
Immunosorbent assay- detect the virus specific IgM or IgG antibodies.
Greater than fourfold rise in titer between acute and convalescent sera and cerebo spinal fluid containing virus specific IgG or IgM or both are the diagnostic features.
Real time polymerase chain reaction (RT-PCR)- is valuable in the early confirmation of arbovirus infections, particularly chikungunya. However, the value of RT PCR is limited to diagnosis in the viraemic phase, with later infection requiring serology.
Direct immonofluorescense assay -to detect chikungunya IgM has a high sensitivity and specificity and is used in the latter stages.However, the use of these tests in the tropics may be limited by financial constraints.
A normal erythrocyte sedimentation rate- and a negative rheumatoid factor are useful to differentiate chikungunya arthritis from rheumatoid arthritis. Extensive, symmetrical joint involvement, particularly of the metacarpophalangeal and proximal joints, the presence of rheumatoid nodules or anti-cyclic citrullinated peptide (anti-CCP) antibodies favours rheumatoid arthritis over chikungunya with chronic arthropathy. The presence of lower limb asymmetrical joint involvement with axial skeletal affliction favours the diagnosis of spondyloarthropathy over chikungunya.