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Co-circulation and simultaneous co-infection of dengue, chikungunya, and zika viruses in patients with febrile syndrome at the Colombian-Venezuelan border.
BMC Infect Dis 2018; 18(1):61BI

Abstract

BACKGROUND

In Colombia, the dengue virus (DENV) has been endemic for decades, and with the recent entry of the chikungunya virus (CHIKV) (2014) and the Zika virus (ZIKV) (2015), health systems are overloaded because the diagnosis of these three diseases is based on clinical symptoms, and the three diseases share a symptomatology of febrile syndrome. Thus, the objective of this study was to use molecular methods to identify their co-circulation as well as the prevalence of co-infections, in a cohort of patients at the Colombian-Venezuelan border.

METHODS

A total of 157 serum samples from patients with febrile syndrome consistent with DENV were collected after informed consent and processed for the identification of DENV (conventional PCR and real-time PCR), CHIKV (conventional PCR), and ZIKV (real-time PCR). DENV-positive samples were serotyped, and some of those positive for DENV and CHIKV were sequenced.

RESULTS

Eighty-two patients were positive for one or more viruses: 33 (21.02%) for DENV, 47 (29.94%) for CHIKV, and 29 (18.47%) for ZIKV. The mean age range of the infected population was statistically higher in the patients infected with ZIKV (29.72 years) than in those infected with DENV or CHIKV (21.09 years). Both co-circulation and co-infection of these three viruses was found. The prevalence of DENV/CHIKV, DENV/ZIKV, and CHIKV/ZIKV co-infection was 7.64%, 6.37%, and 5.10%, with attack rates of 14.90, 12.42, and 9.93 cases per 100,000 inhabitants, respectively. Furthermore, three patients were found to be co-infected with all three viruses (prevalence of 1.91%), with an attack rate of 4.96 cases per 100,000 inhabitants.

CONCLUSION

Our results demonstrate the simultaneous co-circulation of DENV, CHIKV, ZIKV and their co-infections at the Colombian-Venezuelan border. Moreover, it is necessary to improve the differential diagnosis in patients with acute febrile syndrome and to study the possible consequences of this epidemiological overview of the clinical outcomes of these diseases in endemic regions.

Authors+Show Affiliations

Grupo de Investigación en Ciencias Animales-GRICA, Universidad Cooperativa de Colombia, Calle 30A #, 33-51, Bucaramanga, Colombia. Universidad de Santander UDES, Facultad de Ciencias de la Salud, Programa de Bacteriología y Laboratorio clínico, Grupo de investigación en manejo clínico - CLINIUDES, Bucaramanga, Colombia. Maestría en Investigación en Enfermedades Infecciosas, Universidad de Santander, Bucaramanga, Colombia. Doctorado en Ciencias Básicas Biomedicas, Universidad de Antioquia, Medellin, Colombia.Grupo de Investigación en Ciencias Animales-GRICA, Universidad Cooperativa de Colombia, Calle 30A #, 33-51, Bucaramanga, Colombia.Laboratorio Clínico, E.S.E. Jorge Cristo Sahium Hospital, Norte de Santander, Cúcuta, Colombia.Universidad de Santander UDES, Facultad de Ciencias de la Salud, Programa de Bacteriología y Laboratorio clínico, Grupo de investigación en manejo clínico - CLINIUDES, Bucaramanga, Colombia.Grupo de Investigación en Ciencias Animales-GRICA, Universidad Cooperativa de Colombia, Calle 30A #, 33-51, Bucaramanga, Colombia. marlen.martinezg@campusucc.edu.co.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29382300

Citation

Carrillo-Hernández, Marlen Yelitza, et al. "Co-circulation and Simultaneous Co-infection of Dengue, Chikungunya, and Zika Viruses in Patients With Febrile Syndrome at the Colombian-Venezuelan Border." BMC Infectious Diseases, vol. 18, no. 1, 2018, p. 61.
Carrillo-Hernández MY, Ruiz-Saenz J, Villamizar LJ, et al. Co-circulation and simultaneous co-infection of dengue, chikungunya, and zika viruses in patients with febrile syndrome at the Colombian-Venezuelan border. BMC Infect Dis. 2018;18(1):61.
Carrillo-Hernández, M. Y., Ruiz-Saenz, J., Villamizar, L. J., Gómez-Rangel, S. Y., & Martínez-Gutierrez, M. (2018). Co-circulation and simultaneous co-infection of dengue, chikungunya, and zika viruses in patients with febrile syndrome at the Colombian-Venezuelan border. BMC Infectious Diseases, 18(1), p. 61. doi:10.1186/s12879-018-2976-1.
Carrillo-Hernández MY, et al. Co-circulation and Simultaneous Co-infection of Dengue, Chikungunya, and Zika Viruses in Patients With Febrile Syndrome at the Colombian-Venezuelan Border. BMC Infect Dis. 2018 01 30;18(1):61. PubMed PMID: 29382300.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Co-circulation and simultaneous co-infection of dengue, chikungunya, and zika viruses in patients with febrile syndrome at the Colombian-Venezuelan border. AU - Carrillo-Hernández,Marlen Yelitza, AU - Ruiz-Saenz,Julian, AU - Villamizar,Lucy Jaimes, AU - Gómez-Rangel,Sergio Yebrail, AU - Martínez-Gutierrez,Marlen, Y1 - 2018/01/30/ PY - 2016/10/04/received PY - 2018/01/23/accepted PY - 2018/2/1/entrez PY - 2018/2/1/pubmed PY - 2018/4/19/medline KW - Chikungunya virus KW - Co-circulation KW - Co-infection KW - Dengue virus KW - Zika virus SP - 61 EP - 61 JF - BMC infectious diseases JO - BMC Infect. Dis. VL - 18 IS - 1 N2 - BACKGROUND: In Colombia, the dengue virus (DENV) has been endemic for decades, and with the recent entry of the chikungunya virus (CHIKV) (2014) and the Zika virus (ZIKV) (2015), health systems are overloaded because the diagnosis of these three diseases is based on clinical symptoms, and the three diseases share a symptomatology of febrile syndrome. Thus, the objective of this study was to use molecular methods to identify their co-circulation as well as the prevalence of co-infections, in a cohort of patients at the Colombian-Venezuelan border. METHODS: A total of 157 serum samples from patients with febrile syndrome consistent with DENV were collected after informed consent and processed for the identification of DENV (conventional PCR and real-time PCR), CHIKV (conventional PCR), and ZIKV (real-time PCR). DENV-positive samples were serotyped, and some of those positive for DENV and CHIKV were sequenced. RESULTS: Eighty-two patients were positive for one or more viruses: 33 (21.02%) for DENV, 47 (29.94%) for CHIKV, and 29 (18.47%) for ZIKV. The mean age range of the infected population was statistically higher in the patients infected with ZIKV (29.72 years) than in those infected with DENV or CHIKV (21.09 years). Both co-circulation and co-infection of these three viruses was found. The prevalence of DENV/CHIKV, DENV/ZIKV, and CHIKV/ZIKV co-infection was 7.64%, 6.37%, and 5.10%, with attack rates of 14.90, 12.42, and 9.93 cases per 100,000 inhabitants, respectively. Furthermore, three patients were found to be co-infected with all three viruses (prevalence of 1.91%), with an attack rate of 4.96 cases per 100,000 inhabitants. CONCLUSION: Our results demonstrate the simultaneous co-circulation of DENV, CHIKV, ZIKV and their co-infections at the Colombian-Venezuelan border. Moreover, it is necessary to improve the differential diagnosis in patients with acute febrile syndrome and to study the possible consequences of this epidemiological overview of the clinical outcomes of these diseases in endemic regions. SN - 1471-2334 UR - https://www.unboundmedicine.com/medline/citation/29382300/Co_circulation_and_simultaneous_co_infection_of_dengue_chikungunya_and_zika_viruses_in_patients_with_febrile_syndrome_at_the_Colombian_Venezuelan_border_ L2 - https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-018-2976-1 DB - PRIME DP - Unbound Medicine ER -