Q COSTA RICA — Chikungunya resurfaced in Costa Rica in 2016 after nearly a decade without transmission, resulting in 438 cases treated at the Caja Costarricense de Seguro Social (CCSS). Chikungunya is a mosquito-borne viral disease characterized by the sudden onset of a high fever and severe, often debilitating joint pain. While the clinical presentation is highly similar to Dengue and Zika, the joint pain associated with chikungunya is uniquely intense. Avoid Aspirin and NSAIDs : Do not use aspirin, ibuprofen, or naproxen until a doctor has explicitly ruled out dengue fever. : Do not use aspirin, ibuprofen, or naproxen until a doctor has explicitly ruled out dengue fever.