Duvignaud, A, Fianu, A, Bertolotti, A et al. · Epidemiology and infection · 2018 · DOI
This study followed over 1,000 people on Reunion Island to understand why some patients infected with chikungunya virus develop long-lasting fatigue and joint pain. Researchers found that people who had chikungunya were much more likely to experience chronic fatigue and a condition resembling ME/CFS compared to those who were never infected. About 24% of people with chikungunya developed CFS-like illness, compared to only 7% of those without the virus.
This study demonstrates that viral infections like chikungunya can trigger ME/CFS-like illness in a significant proportion of patients, providing epidemiological evidence for post-infectious disease mechanisms. Understanding the prevalence and burden of post-viral fatigue syndromes helps validate ME/CFS as a real disease outcome and informs clinical care guidelines for patients with persistent symptoms after infection.
This study does not establish the biological mechanisms underlying post-chikungunya fatigue or identify which individuals are genetically or immunologically susceptible to developing CFS-like illness. The study uses CDC-1994/Fukuda criteria adapted for this cohort, so findings may not directly translate to formal ME/CFS diagnoses using alternative case definitions (such as the Canadian Consensus Criteria or ICC). Correlation between CHIKV infection and CFS-like illness does not prove causation, though the temporal relationship and population attributable fraction provide suggestive evidence.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Duvignaud, A, Fianu, A, Bertolotti, A, Jaubert, J, Michault, A, Poubeau, P, et al. (2018). Rheumatism and chronic fatigue, the two facets of post-chikungunya disease: the TELECHIK cohort study on Reunion island.. Epidemiology and infection. https://doi.org/10.1017/S0950268818000031
BibTeX
@article{mecfsatlas-duvignaud-2018-rheumatism-chronic,
author = {Duvignaud, A and Fianu, A and Bertolotti, A and Jaubert, J and Michault, A and Poubeau, P and Fred, A and Méchain, M and Gaüzère, B-A and Favier, F and Malvy, D and Gérardin, P},
title = {Rheumatism and chronic fatigue, the two facets of post-chikungunya disease: the TELECHIK cohort study on Reunion island.},
journal = {Epidemiology and infection},
year = {2018},
doi = {10.1017/S0950268818000031},
note = {PubMed: 29486812},
url = {https://www.mecfsatlas.com/evidence/duvignaud-2018-rheumatism-chronic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/duvignaud-2018-rheumatism-chronic
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