Sindbis Fever

By | June 10, 2022

Sindbis fever is caused by the Sindbis virus, which is primarily transmitted by mosquitoes in some African countries.

What is Sindbis fever?

Sindbis fever is a viral disease that causes flu-like symptoms. It eventually leads to joint inflammation and often to skin rashes, and in isolated cases causes encephalitis (inflammation of the brain). For bs definitions, please visit

In many cases, however, Sindbis fever is unremarkable. Outside of Africa, the virus has also been detected in Europe (especially in Scandinavia), Asia and Australia in both humans and mosquitoes. In Germany, a case of illness was confirmed for the first time in 2009.

Sindbis fever is also known as “epidemic polyarthritis” because of the joint inflammation that occurs. The Sindbis virus exists in six different forms, which are, however, quite similar. Subtypes of Sindbis fever are called Ockelbo, Karelian and Pogosta fever. Ockelbo fever was first detected in Sweden in 1982 and also occurs in Finland and western Russia.


The Sindbis fever is caused by the virus of the same name, which mainly lives in host birds. The pathogens are transmitted by nocturnal mosquitoes of the species-rich genus Culex, of which 16 species are native to Central Europe and which also includes the widespread “common mosquito” (Culex pipiens). In contrast, infection between humans is not possible.

Birds are the main hosts of Sindbis virus. The virus seems to have been brought to Europe not only by infected travelers, but above all by migratory birds.

Discovered in 1952 in the northern Egyptian village of Sindbis, the Sindbis virus belongs to a group of alphaviruses, which are between 60 and 70 nanometers in size called arboviruses.

Symptoms, Ailments & Signs

Sindbis fever is initially manifested by fever. Three to eleven days after infection, an increasing feeling of discomfort occurs, which is often accompanied by headache and joint pain and severe tiredness. In general, Sindbis fever is associated with severe fatigue. Affected people are mentally and physically less efficient and need regular rest breaks.

Many patients also complain of eye pain, due to conjunctivitis, which subsequently makes the eyes more sensitive to light. The joint pain is only mild at the beginning, but gets worse as the disease progresses. They mainly appear on the wrists, fingers and ankles.

As the viral disease progresses, a rash appears. The skin lesions first appear on the thighs and then spread to the soles of the feet and palms. Rarely, the pharynx and oral mucosa are also affected by the rash. The actual fever runs in spurts.

The symptoms seem to go away after a week, only to reappear three to five days later. If not treated or treated improperly, Sindbis fever can develop into a chronic disease in which joint problems and skin changes persist.

Diagnosis & History

The incubation period (the period between infection and the appearance of the first symptoms of the disease) is between three and eleven days for Sindbis fever.

Headache occurs first with Sindbis fever. Later, joint problems occur, which primarily affect the finger, wrist and ankle joints. The patients feel exhausted and tired.

Finally, reddening of the skin and blisters develop on the skin. In the first days of the disease, these skin changes appear on the torso and thighs and later in the disease on the palms of the hands and soles of the feet.

The development of fever occurs in two phases (biphasic): after the first phase of fever, the temperature drops before the temperature rises again.

Nausea and vomiting occur in some cases of Sindbis disease. Redness of the throat, inflammation of the conjunctiva (conjunctivitis) and sensitivity to light (photophobia) occur more frequently. However, chronic courses of the disease have also been observed, leading to years of joint pain. Antigens formed against the Sindbis virus can be detected with a blood test.


In the course of the disease, joint problems can occur in the finger, wrist and ankle joints. In patients with arthritis or rheumatic complaints, this can cause flare-ups of pain, stiffness and other serious complications. If the course is severe, the joint problems develop into a chronic disease that causes symptoms for years after the Sindbis fever has subsided.

A high fever can also occur. In individual cases, the body temperature rises to 41°C or higher and the affected person suffers from serious circulatory problems. The accompanying gastrointestinal symptoms can cause deficiency symptoms and dehydration, among other things. If left untreated, both can lead to serious health complications and death in children, the elderly and sick people.

Other possible consequences of Sindbis fever are conjunctivitis, temporary sensitivity to light and protracted skin rashes. During treatment, the risks come from the painkillers administered. Preparations such as ibuprofen and diclofenac can cause unwanted side effects such as stomach bleeding or body aches.

Severe gastrointestinal complaints, impaired blood formation and skin irritations cannot be ruled out either. If the disease is not cured properly, chronic symptoms can set in. Occasionally there is long-lasting joint inflammation, pneumonia and recurring pain.

When should you go to the doctor?

Sindbis fever should always be evaluated by a doctor. In the worst case, if left untreated, the affected person can die, so that early therapy always has a positive effect on the further course of the disease. A doctor should therefore be consulted as soon as the first complaints and symptoms of this disease appear. A doctor should be consulted if the affected person suffers from a high fever. In addition to the fever, there is also severe pain in the bones or joints and most of those affected are severely tired.

Especially in African areas, these symptoms can indicate Sindbis fever and should be examined by a doctor. Furthermore, the disease also leads to inflammation of the conjunctiva, which must also be treated by a doctor. Most patients show a severe rash on the skin, which also indicates Sindbis fever.

In the case of Sindbis fever, a hospital or a general practitioner can be visited in the first place. As a rule, the disease can be treated relatively well, although full treatment does not lead to a reduced life expectancy for the affected person.

Treatment & Therapy

The human immune system is usually good at countering an infection with Sindbis viruses, so that in many cases special therapy is not required. Symptoms usually resolve on their own after a few weeks with no permanent damage.

Treatment of patients suffering from Sindbis fever aims to alleviate the symptoms. In particular, painkillers are administered that have an antipyretic effect. Non-steroidal preparations (which do not contain cortisone) such as ibuprofen and diclofenac are best suited for this purpose. However, the active ingredient ibuprofen, which belongs to the anti-inflammatory anti -rheumatic drugs, can cause side effects such as stomach bleeding, since the preparation inhibits the synthesis of prostaglandins, which are responsible for blood clotting, among other things.

The active ingredient diclofenac is an analgesic (painkiller) that is used for moderate pain and inflammation. However, side effects such as gastrointestinal complaints, impaired blood formation and sensitivity to sunlight can occur. A causal therapy directly targeting the Sindbis virus does not yet exist.


Since there is no vaccine against Sindbis fever, the only way to prevent the disease is to use mosquito repellent. This includes sufficiently dense clothing that is as light as possible, close-meshed mosquito nets and insect repellent. Mosquito-repellent preparations should be rubbed into the ankles, hands, and neck-face area in particular.

In areas where the disease is more common, eliminating potential mosquito breeding sites near houses is an important prophylactic measure to prevent Sindbis fever.


First and foremost, Sindbis fever should be diagnosed and treated early so that there are no complications or other symptoms as the disease progresses. The measures and the options for direct follow-up care are significantly limited in the case of Sindbis fever, so that a doctor should be contacted as soon as the first symptoms and signs of this disease appear.

It cannot heal itself, so treatment by a doctor is always necessary. The affected person should protect themselves particularly well against mosquitoes and ideally avoid the high-risk area and not stay in it. Long clothing should also be worn, and sprays and creams against mosquitoes are also very helpful.

As a rule, Sindbis fever can be cured relatively well by taking medication. The person concerned should primarily ensure that the dosage is correct and that the medication is taken regularly in order to permanently relieve the symptoms. Even after successful treatment, regular checks and examinations must be carried out. As a rule, Sindbis fever does not reduce the life expectancy of the affected person if it is recognized and treated in time.

You can do that yourself

If you are staying in an African area, you should make sure before you start your journey that adequate protective measures against contagious diseases or insects have been taken. If possible, use insect repellents or home remedies that provide adequate protection against bites or stings. Wearing protective clothing is recommended. Wide and long clothing offers the body sufficient security.

Since Sindbis fever can lead to numerous complications or a life-threatening condition if the course of the disease is difficult, a doctor should be consulted at the first health problems after an insect bite. Medication is needed to start relieving the symptoms. In particular, people with previous illnesses or a weakened immune system need medical help as soon as possible.

Cold compresses and compresses can help bring down the fever. It is also important to ensure that a sufficient amount of liquid is consumed. It is imperative to protect the body from dehydration. In addition, the organism should be supplied with sufficient vitamins and nutrients, even if there is a loss of appetite. This is the only way to provide additional support for the immune system in the fight against pathogens. Sleep hygiene should also be optimized. Oxygen supply is important and bedding should be aired and changed regularly.

Sindbis Fever