Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/31486
Title: Concomitant transmission of dengue, chikungunya and Zika viruses in Brazil: Clinical and epidemiological findings from surveillance for acute febrile illness
Authors: Silva, Monaíse Madalena Oliveira
Tauro, Laura Beatriz
Kikuti, Mariana
Anjos, Rosângela Oliveira dos
Santos, Viviane Corrêa
Gonçalves, Thaiza Soares Ferreira
Paploski, Igor Adolfho Dexheimer
Moreira, Patrícia Sousa dos Santos
Nascimento, Leile Camila Jacob
Campos, Gúbio Soares
Ko, Albert Icksang
Weaver, Scott C
Reis, Mitermayer Galvão dos
Kitron, Uriel
Ribeiro, Guilherme de Sousa
Affilliation: Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Instituto Nacional de Medicina Tropical. Puerto Iguazú, Argentina.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil.
Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil / University of Minnesota. USA.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil.
Universidade Federal da Bahia. Instituto de Ciências da Saúde. Salvador, BA, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Yale School of Public Health. New Haven, USA.
University of Texas Medical Branch. Galveston, USA.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Faculdade de Medicina. Salvador, BA, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Emory University. Atlanta, USA.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil / Universidade Federal da Bahia. Faculdade de Medicina. Salvador, BA, Brasil.
Abstract: Since their emergence in the Americas, chikungunya (CHIKV) and Zika (ZIKV) viruses co-circulate with dengue virus (DENV), hampering clinical diagnosis. We investigated clinical and epidemiological characteristics of arboviral infections during the introduction and spread of CHIKV and ZIKV through northeastern Brazil. Methods. Surveillance for arboviral diseases among febrile patients was performed at an emergency health unit of Salvador, Brazil between Sep/2014-Jul/2016. We interviewed patients to collect data on symptoms, reviewed medical records to obtain the presumptive diagnoses, and performed molecular and serological testing to confirm DENV, CHIKV, ZIKV, or non-specific flavivirus (FLAV) diagnosis. Results. Of 948 participants, 247 (26.1%) had an acute infection, of which 224 (23.6%) were single infections (DENV: 32, or 3.4%; CHIKV: 159, 16.7%; ZIKV: 13, 1.4%; and FLAV: 20, 2.1%), and 23 (2.4%) co-infections (DENV/CHIKV: 13, 1.4%; CHIKV/FLAV: 9, 0.9%; and DEN/ZIKV: 1, 0.1%). An additional 133 (14.0%) patients had serological evidence for a recent arboviral infection. Patients with Zika presented rash (69.2%) and pruritus (69.2%) more frequently than those with dengue (37.5% and 31.2%, respectively) and chikungunya (22.9% and 14.7%, respectively) (P<0.001 for both comparisons). Conversely, arthralgia was more common in chikungunya (94.9%) and FLAV/CHIKV (100.0%) than in dengue (59.4%) and Zika (53.8%) (P<0.001). A correct presumptive clinical diagnosis was made for 9-23% of the confirmed patients.
Keywords: Dengue virus
Chikungunya virus
Zika virus
Arbovirus
Co-infection
keywords: Vírus da dengue
Vírus chikungunya
Vírus zika
Arbovírus
Co-infecção
Issue Date: 2018
Publisher: Oxford University Press
Citation: SILVA, Monaíse Madalena Oliveira et al. Concomitant transmission of dengue, chikungunya and Zika viruses in Brazil: Clinical and epidemiological findings from surveillance for acute febrile illness. Clinical of Infectious Diseases, p. 1-24, Dec. 18. 2018.
DOI: 10.1093/cid/ciy1083
ISSN: 1058-4838
Copyright: open access
Appears in Collections:BA - IGM - Preprint

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