ABSTRACT
Abstract INTRODUCTION: We performed an epidemiological surveillance of the Chikungunya (CHIKV) lineages in Bahia after the 2014 East/Central/South African (ECSA) genotype outbreak. METHODS: Reverse-transcription polymerase chain reaction (RT-PCR), viral isolation, and phylogenetic analyses were conducted on serum samples from 605 patients with CHIKV-like symptoms during 2014-2018. RESULTS: Of the 605 samples, 167 were CHIKV-positive. Viral isolation was achieved for 20 samples; their phylogenetic analysis (E2 protein) revealed the presence of ECSA lineage and reinforced the phylogenetic relationship between ECSA and Indian Ocean lineages. CONCLUSIONS: The genomic surveillance of CHIKV showed that only ECSA lineage circulated in Bahia since the 2014 outbreak.
Subject(s)
Humans , Male , Female , Adult , Chikungunya virus/genetics , Genome, Viral/genetics , Chikungunya Fever/virology , Phylogeny , Brazil/epidemiology , Disease Outbreaks , Reverse Transcriptase Polymerase Chain Reaction , Epidemiological Monitoring , Chikungunya Fever/epidemiology , GenotypeABSTRACT
A localized Chikungunya virus (CHIKV; East/Central/South African genotype) outbreak (50 cases, 70% laboratory-confirmed; attack rate: 5.3 confirmed cases/100 people) occurred in a Salvador, Brazil neighborhood, between Apr-Jun/2017. Highly clustered cases in space and time, mostly along a single street, highlight an increased risk of CHIKV transmission among pockets of susceptible populations. This finding underscores the need for ongoing local level surveillance for arboviral outbreaks.
Subject(s)
Humans , Male , Female , Adult , Young Adult , Chikungunya virus/genetics , Chikungunya virus/immunology , Disease Outbreaks/statistics & numerical data , Chikungunya Fever/epidemiology , Phylogeny , Seasons , Brazil/epidemiology , Enzyme-Linked Immunosorbent Assay , Polymerase Chain Reaction , Chikungunya Fever/diagnosis , Chikungunya Fever/virology , Genotype , Middle AgedABSTRACT
Resumen Introducción: Los virus del dengue y chikungunya son transmitidos por la hembra de los mosquitos Aedes aegypti y Aedes albopictus, ampliamente distribuidos en zonas tropicales y subtropicales, lo que facilita la co-infección. Objetivo: Determinar la magnitud, la distribución geográfica y el cuadro clínico de la co-infección por dengue y chikungunya. Material y Métodos: Revisión narrativa. Búsqueda en las bases de datos PubMed y Lilacs, utilizando los términos MeSH "Chikungunya", "CHIKV", "DENV", "Dengue" y "coinfection. Se incluyeron los artículos de los últimos 20 años. Resultados: Se incluyeron 45 artículos. El mayor reporte de co-infección fue en Asia seguido de África. En las Américas la información es limitada por la reciente circulación del chikungunya. La magnitud de la co-infección varió entre 0 y 31,9%. No se encontraron diferencias en la distribución de la co-infección por sexo y edad. El cuadro clínico de la mono-infección y la co-infección fue similar. Algunos reportes de caso exponen cuadros graves con afección del sistema nervioso central, manifestaciones hemorrágicas y enfermedad de Still. Conclusión: Las manifestaciones clínicas de la co-infección por dengue y chikungunya son similares a la mono-infección, situación que dificulta el diagnóstico y la medición de su magnitud.
Background: Dengue and chikungunya viruses are transmitted by the female Aedes aegypti and Aedes albopictus, which are widely distributed in tropical and subtropical areas, facilitating coinfection. Aim: To determine the magnitude, geographical distribution and clinical picture of dengue and chikungunya coinfection. Material and Methods: Narrative review. A search in the PubMed and Lilacs databases was made, using the MeSH terms "Chikungunya", "CHIKV", "DENV", "Dengue" and "coinfection. The articles of the last 20 years were included. Results: A total of 45 articles were included. The largest coinfection report was in Asia followed by Africa. In the Americas, the information is limited because of the recent circulation of chikungunya. The magnitude of coinfection varies between 0% and 31.9%. No differences were found in the distribution of coinfection by sex and age. The clinical picture of monoinfection and coinfection was similar. Some case reports show severe cases with central nervous system involvement, hemorrhagic manifestations and Still's disease. Conclusion: The clinical manifestations of coinfection by dengue and chikungunya viruses are similar to those due to monoinfection, which difficult the diagnosis and measurement of its magnitude.
Subject(s)
Humans , Animals , Dengue/virology , Coinfection/virology , Chikungunya Fever/virology , Severity of Illness Index , Chikungunya virus/genetics , Dengue/diagnosis , Dengue/mortality , Dengue/transmission , Dengue Virus/genetics , Coinfection/diagnosis , Coinfection/mortality , Coinfection/transmission , Chikungunya Fever/diagnosis , Chikungunya Fever/mortality , Chikungunya Fever/transmission , Mosquito Vectors , Genotype , GeographyABSTRACT
The recent outbreaks of Chikungunya (CHIK-V) virus in endemic areas of dengue (DEN-V) could increase the risk of co-infection. CHIK infection has been considered not severe and with very unusual mortality, however DEN is associated with severe manifestations and increased mortality. Little is known about coinfection. It is possible that co-infection could generate severe cases. We present a case report of co-infection DEN-V -3 and CHIK-V in an elderly patient who developed acute renal failure, dengue shock syndrome (DSS), progresses to multiple organ failure and died. With the recent emergence of CHIK-V in Colombia, the possibility of co-infection with DEN-V should be suspected, especially in severe cases.
La aparición reciente del virus Chikungunya (CHIK-V) en áreas endémicas de dengue (DEN-V) podría aumentar el riesgo de co-infección. Generalmente, se considera que la infección por CHIK-V es de menor gravedad y mortalidad que DEN-V. Poco se conoce sobre la co-infección de DEN-V y CHIK-V, sin embargo, se ha planteado que la co-infección podría ser de mayor gravedad. Se presenta un caso clínico de co-infección por DENV-3 y CHIK-V en un adulto mayor quien desarrolló falla renal aguda, síndrome de choque del dengue, progresión a disfunción orgánica múltiple y muerte. Con la reciente emergencia de CHIK-V en Colombia, es necesario estar atentos ante la posibilidad de co-infección con DEN-V, en especial en casos graves.