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2.
J Med Case Rep ; 15(1): 439, 2021 Aug 30.
Article in English | MEDLINE | ID: covidwho-1379799

ABSTRACT

BACKGROUND: Dengue fever and coronavirus disease 2019 have now begun to overlap within tropical and subtropical regions. This is due to the high prevalence of dengue fever in these regions and the current severe acute respiratory syndrome coronavirus 2 pandemic situation. The similarity of symptoms between the two diseases can confuse diagnoses, but coinfection can also occur. CASE PRESENTATION: We present two cases of patients with dengue and severe acute respiratory syndrome coronavirus 2 coinfection. The first case is that of a 24-year-old Hispanic woman with acute fever, odynophagia, and diarrhea, without respiratory symptoms and with positive molecular tests for both dengue and severe acute respiratory syndrome coronavirus 2. The second case is that of a 59-year-old Hispanic male patient with fever and respiratory symptoms of 2 weeks duration, negative molecular tests, and positive serological tests for both viruses. The clinical and epidemiological characteristics of both viral infections can help elucidate diagnoses and prognoses. CONCLUSIONS: Severe dengue infection is common in young adults, while coronavirus disease 2019 is generally asymptomatic. In older people, the severity of dengue fever will depend on their comorbidities or the infectious serotype, but coronavirus disease 2019 is consistently more severe in this group. The accurate diagnosis of both infections can better guide clinical management, as well as public health actions in transmission control, now especially important during the coronavirus disease 2019 pandemic.


Subject(s)
COVID-19 , Coinfection , Dengue , Severe Dengue , Adult , Aged , Coinfection/diagnosis , Dengue/complications , Dengue/diagnosis , Female , Humans , Male , Middle Aged , Pandemics , SARS-CoV-2 , Young Adult
3.
Diagn Microbiol Infect Dis ; 101(4): 115517, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1347571

ABSTRACT

Dengue and COVID-19 cocirculation presents a diagnostic conundrum for physicians evaluating patients with acute febrile illnesses, both in endemic regions and among returning travelers. We present a case of a returning traveler from Pakistan who, following repeated negative SARS-CoV-2 tests, was found to have a Dengue virus serotype 2 infection.


Subject(s)
COVID-19/diagnosis , Dengue/diagnosis , SARS-CoV-2 , Adult , COVID-19/epidemiology , California/epidemiology , Dengue/epidemiology , Dengue Virus/classification , Dengue Virus/genetics , Female , Genome, Viral , Humans , Pakistan/epidemiology , Phylogeny , Reverse Transcriptase Polymerase Chain Reaction , Serogroup , Travel
4.
BMC Infect Dis ; 21(1): 729, 2021 Aug 02.
Article in English | MEDLINE | ID: covidwho-1339119

ABSTRACT

BACKGROUND: Dengue is the most common arboviral disease in the tropical and sub-tropical regions of the world. Like other regions, dengue-endemic areas have faced the additional public health and socio-economic impact of the ongoing coronavirus disease 2019 (COVID-19) pandemic. COVID-19 and dengue co-infections have been reported, with complicated patient management and care requirements. This review aimed to collate and synthesise current knowledge on the clinical features and outcomes of COVID-19 and dengue virus co-infection, a potentially important new dimension to be considered in public health management of the COVID-19 pandemic. METHODS: A systematic literature review was conducted using PubMed, Web of Science and Scopus databases from 1st January to 21st November 2020. The key search terms used were "dengue" and "coronavirus". Descriptive analysis with graphical illustrations were used to present the clinical and laboratory parameters of the co-infection. RESULTS: Thirteen published papers and four news articles were included in the review. Most studies were case reports with a detailed description of the clinical and laboratory characteristics of the co-infection. All cases were in adults with the exception of a six-year old child. The common symptoms of co-infection were fever, dyspnea, headache, and cough. Common laboratory results included thrombocytopenia, lymphocytopenia, elevated transaminases, and leukopenia. Serious outcomes of co-infection included septic shock, acute respiratory disease syndrome and multi-organ failure, leading to death in some patients. CONCLUSIONS: COVID-19 and dengue co-infection was associated with severe disease and fatal outcomes. The correct diagnosis and treatment of co-infection poses a substantial challenge due to the overlapping clinical and laboratory parameters. Therefore, confirmative diagnostic tests are necessary for accurate and timely diagnosis and patient management.


Subject(s)
COVID-19 , Coinfection , Dengue , Adult , Child , Coinfection/epidemiology , Dengue/complications , Dengue/diagnosis , Dengue/epidemiology , Humans , Pandemics , SARS-CoV-2
5.
Viruses ; 13(7)2021 07 19.
Article in English | MEDLINE | ID: covidwho-1325784

ABSTRACT

As demonstrated with the novel coronavirus pandemic, rapid and accurate diagnosis is key to determine the clinical characteristic of a disease and to improve vaccine development. Once the infected person is identified, hematological findings may be used to predict disease outcome and offer the correct treatment. Rapid and accurate diagnosis and clinical parameters are pivotal to track infections during clinical trials and set protection status. This is also applicable for re-emerging diseases like dengue fever, which causes outbreaks in Asia and Latin America every 4 to 5 years. Some areas in the US are also endemic for the transmission of dengue virus (DENV), the causal agent of dengue fever. However, significant number of DENV infections in rural areas are diagnosed solely by clinical and hematological findings because of the lack of availability of ELISA or PCR-based tests or the infrastructure to implement them in the near future. Rapid diagnostic tests (RDT) are a less sensitive, yet they represent a timely way of detecting DENV infections. The purpose of this study was to determine whether there is an association between hematological findings and the probability for an NS1-based DENV RDT to detect the DENV NS1 antigen. We also aimed to describe the hematological parameters that are associated with the diagnosis through each test.


Subject(s)
COVID-19/diagnosis , COVID-19/epidemiology , Dengue/diagnosis , Adolescent , Adult , Asia/epidemiology , Child , Child, Preschool , Colombia/epidemiology , Dengue/virology , Dengue Virus/isolation & purification , Diagnostic Tests, Routine/methods , Enzyme-Linked Immunosorbent Assay , Female , Humans , Infant , Male , Pandemics , Polymerase Chain Reaction , Reagent Kits, Diagnostic , SARS-CoV-2/isolation & purification , Young Adult
6.
J Med Virol ; 93(11): 6073-6076, 2021 11.
Article in English | MEDLINE | ID: covidwho-1318724

ABSTRACT

The Cook Island government has made several efforts to ensure zero confirmed cases and transmission of COVID-19, especially among visiting travelers. However, the Cook Island ministry of health has to deal with the new strain of dengue fever outbreak, known as dengue fever type 2 (DEN-2), by adopting several measures to control its spread, especially in the affected parts of the subtropical country. This paper aims to describe the dengue fever response taken in Cook Island and suggest recommendations to control the risk of transmission in endemic parts of the world.


Subject(s)
Dengue/epidemiology , Disease Outbreaks , COVID-19/diagnosis , COVID-19/epidemiology , Dengue/diagnosis , Dengue/prevention & control , Dengue/virology , Dengue Virus/classification , Endemic Diseases , Humans , Mosquito Control , Polynesia/epidemiology , Serogroup
7.
Am J Trop Med Hyg ; 105(3): 745-750, 2021 07 09.
Article in English | MEDLINE | ID: covidwho-1304789

ABSTRACT

The differentiation between dengue and COVID-19 diagnoses is a challenge in tropical regions because of the similarity of symptoms and limited access to specific diagnostic tests for each disease. The objective of this study was to describe the initial symptoms and laboratory test values of patients who presented to the emergency department with dengue or COVID-19. A cross-sectional study was performed in a single center in Cali, Colombia. The inclusion criteria were patients with a diagnosis of dengue or COVID-19 who were older than 14 years of age. All patients experienced fever or other symptoms for fewer than 10 days. Linear regression was performed to evaluate the differences in the neutrophil-lymphocyte ratio (NLR) between patients diagnosed with COVID-19 and dengue, and was adjusted for sex and age group (≤ 31 and > 31 years). The sample size was calculated to test the hypothesis that the median NLR in COVID-19 patients is higher than that in dengue patients. A P value < 0.05 was considered statistically significant for all analyses. A total of 93 patients were included: 70 with dengue and 23 with COVID-19. Dengue patients were younger than COVID-19 patients. There were significant differences between dengue and COVID-19 patients regarding platelet count (P < 0.01), neutrophil count (P < 0.01), NLR (P < 0.01), and abnormal alanine transaminase (ALT) (P = 0.03). The NLR was significantly higher in COVID-19 patients than in dengue patients (P < 0.01). In conclusion, during the first week of symptoms, absolute neutrophil count, NLR, and platelet count could help guide the initial differential approach between dengue and COVID-19. These findings could be useful in geographical areas with a lack of resources.


Subject(s)
COVID-19/diagnosis , Dengue/diagnosis , SARS-CoV-2 , Adolescent , Adult , COVID-19/blood , Cross-Sectional Studies , Dengue/blood , Diagnosis, Differential , Female , Humans , Lymphocytes , Male , Middle Aged , Neutrophils , Young Adult
8.
Viruses ; 13(6)2021 06 16.
Article in English | MEDLINE | ID: covidwho-1286940

ABSTRACT

Dengue fever, caused by the mosquito-borne dengue virus (DENV), has been endemic in Myanmar since 1970 and it has become a significant public health burden. It is crucial that circulating DENV strains are identified and monitored, and that their transmission efficiency and association with disease severity is understood. In this study, we analyzed DENV-1, DENV-2, DENV-3, and DENV-4 serotypes in 1235 serum samples collected in Myanmar between 2017 and 2019. Whole-genome sequencing of DENV-1-4 demonstrated that most DENV-1-4 strains had been circulating in Myanmar for several years. We also identified the emergence of DENV-3 genotype-I in 2017 samples, which persisted through 2018 and 2019. The emergence of the strain coincided with a period of increased DENV-3 cases and marked changes in the serotype dynamics. Nevertheless, we detected no significant differences between serum viral loads, disease severity, and infection status of individuals infected with different DENV serotypes during the 3-year study. Our results not only identify the spread of a new DENV-3 genotype into Yangon, Myanmar, but also support the importance of DENV evolution in changing the epidemic dynamics in endemic regions.


Subject(s)
Communicable Diseases, Emerging/epidemiology , Communicable Diseases, Emerging/virology , Dengue Virus/classification , Dengue Virus/genetics , Dengue/epidemiology , Dengue/virology , Genotype , Adolescent , Amino Acid Substitution , Child , Child, Preschool , Dengue/diagnosis , Dengue/history , Dengue Virus/isolation & purification , Disease Outbreaks , Genetic Variation , Genome, Viral , History, 21st Century , Humans , Myanmar , Phylogeny , Seroepidemiologic Studies , Serogroup , Whole Genome Sequencing
10.
J Med Microbiol ; 70(6)2021 Jun.
Article in English | MEDLINE | ID: covidwho-1263735

ABSTRACT

Co-endemicity of SARS-CoV-2 and dengue virus (DV) infection is becoming a matter of serious concern as it has been already reported that antibodies (Ab) elicited by SARS-CoV-2 infection can produce false-positive results in dengue IgG and IgM rapid tests and vice versa. Here we communicate that five of thirteen DV antibody-positive serum samples from Kolkata, archived in 2017 (predating the COVID-19 outbreak), produced false-positive results in SARS-CoV-2 IgG/IgM lateral flow-based rapid tests. Our results emphasize the importance of implementing tests with higher specificity to conduct sero-surveillance for accurate estimation of SARS-CoV-2/DV prevalence in regions where both viruses now co-exist.


Subject(s)
Antibodies, Viral/blood , COVID-19 Serological Testing/methods , COVID-19/diagnosis , Cross Reactions , Dengue/diagnosis , Adult , COVID-19/epidemiology , Dengue/epidemiology , False Positive Reactions , Female , Humans , Immunoglobulin G/blood , Immunoglobulin M/blood , India/epidemiology , Male , Young Adult
11.
N Engl J Med ; 384(23): 2177-2186, 2021 06 10.
Article in English | MEDLINE | ID: covidwho-1263529

ABSTRACT

BACKGROUND: Aedes aegypti mosquitoes infected with the wMel strain of Wolbachia pipientis are less susceptible than wild-type A. aegypti to dengue virus infection. METHODS: We conducted a cluster-randomized trial involving releases of wMel-infected A. aegypti mosquitoes for the control of dengue in Yogyakarta, Indonesia. We randomly assigned 12 geographic clusters to receive deployments of wMel-infected A. aegypti (intervention clusters) and 12 clusters to receive no deployments (control clusters). All clusters practiced local mosquito-control measures as usual. A test-negative design was used to assess the efficacy of the intervention. Patients with acute undifferentiated fever who presented to local primary care clinics and were 3 to 45 years of age were recruited. Laboratory testing was used to identify participants who had virologically confirmed dengue (VCD) and those who were test-negative controls. The primary end point was symptomatic VCD of any severity caused by any dengue virus serotype. RESULTS: After successful introgression of wMel into the intervention clusters, 8144 participants were enrolled; 3721 lived in intervention clusters, and 4423 lived in control clusters. In the intention-to-treat analysis, VCD occurred in 67 of 2905 participants (2.3%) in the intervention clusters and in 318 of 3401 (9.4%) in the control clusters (aggregate odds ratio for VCD, 0.23; 95% confidence interval [CI], 0.15 to 0.35; P = 0.004). The protective efficacy of the intervention was 77.1% (95% CI, 65.3 to 84.9) and was similar against the four dengue virus serotypes. The incidence of hospitalization for VCD was lower among participants who lived in intervention clusters (13 of 2905 participants [0.4%]) than among those who lived in control clusters (102 of 3401 [3.0%]) (protective efficacy, 86.2%; 95% CI, 66.2 to 94.3). CONCLUSIONS: Introgression of wMel into A. aegypti populations was effective in reducing the incidence of symptomatic dengue and resulted in fewer hospitalizations for dengue among the participants. (Funded by the Tahija Foundation and others; AWED ClinicalTrials.gov number, NCT03055585; Indonesia Registry number, INA-A7OB6TW.).


Subject(s)
Aedes/microbiology , Communicable Disease Control/methods , Dengue/transmission , Mosquito Vectors , Wolbachia , Adolescent , Adult , Aedes/virology , Animals , Child , Child, Preschool , Dengue/diagnosis , Dengue/epidemiology , Dengue/prevention & control , Dengue Virus/isolation & purification , Female , Humans , Incidence , Indonesia/epidemiology , Male , Middle Aged , Mosquito Vectors/microbiology , Mosquito Vectors/virology , Young Adult
12.
Emerg Med Clin North Am ; 39(3): 453-465, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1263258

ABSTRACT

The role of the emergency provider lies at the forefront of recognition and treatment of novel and re-emerging infectious diseases in children. Familiarity with disease presentations that might be considered rare, such as vaccine-preventable and non-endemic illnesses, is essential in identifying and controlling outbreaks. As we have seen thus far in the novel coronavirus pandemic, susceptibility, severity, transmission, and disease presentation can all have unique patterns in children. Emergency providers also have the potential to play a public health role by using lessons learned from the phenomena of vaccine hesitancy and refusal.


Subject(s)
Communicable Diseases, Emerging/epidemiology , Pediatrics , COVID-19/diagnosis , COVID-19/therapy , COVID-19/transmission , Chickenpox/diagnosis , Chickenpox/therapy , Chickenpox/transmission , Chikungunya Fever/diagnosis , Chikungunya Fever/therapy , Chikungunya Fever/transmission , Child , Communicable Diseases, Emerging/immunology , Decision Trees , Dengue/diagnosis , Dengue/therapy , Dengue/transmission , Emergency Medicine , Hemorrhagic Fever, Ebola/diagnosis , Hemorrhagic Fever, Ebola/therapy , Hemorrhagic Fever, Ebola/transmission , Humans , Incidence , Malaria/diagnosis , Malaria/therapy , Malaria/transmission , Measles/diagnosis , Measles/therapy , Measles/transmission , Physician's Role , Public Health , SARS-CoV-2 , Systemic Inflammatory Response Syndrome , Travel-Related Illness , Vaccination , Vaccination Refusal , Whooping Cough/diagnosis , Whooping Cough/therapy , Whooping Cough/transmission , Zika Virus Infection/diagnosis , Zika Virus Infection/therapy , Zika Virus Infection/transmission
13.
Trop Doct ; 51(4): 606-607, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1261234

ABSTRACT

As international travels and destinations increase, travel-related infections increase. It is reported that 6-87% of the travellers contract travel-related infection during or after the trip. Vector-associated pathogens comprise a significant percentage of travel-related infections. Apart from the ubiquitous COVID19, threats such as Dengue, Chikungunya and Zika virus and tick-borne agents have emerged or re-emerged in recent years. The fact that these infections are carried with similar vectors and cause similar symptoms makes diagnosis difficult. Herein, a case of travel-associated infection with nonspecific symptoms is presented.


Subject(s)
COVID-19 , Chikungunya Fever , Dengue , Malaria , Zika Virus Infection , Zika Virus , Chikungunya Fever/diagnosis , Dengue/diagnosis , Humans , Malaria/diagnosis , SARS-CoV-2 , Travel , Travel-Related Illness , Zika Virus/genetics , Zika Virus Infection/diagnosis
14.
Western Pac Surveill Response J ; 12(1): 35-39, 2021.
Article in English | MEDLINE | ID: covidwho-1259712

ABSTRACT

The rainy season in the Philippines is from June to October; this is when the number of dengue cases typically increases. In 2020 during this time, the world was facing the threat of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Coronavirus disease 2019 (COVID-19) and dengue viral infections have similar presentations and laboratory findings, including fever and thrombocytopenia, and there have been reports of coinfection with SARS-CoV-2 and arthropod-borne virus. Here, we report a case of SARS-CoV-2-dengue virus coinfection in the Philippines in a female aged 62 years, whose early symptom was fever and who was positive for SARS-CoV-2 and positive for dengue. Early recognition of such coinfection is important so that proper measures can be taken in the management of the patient.


Subject(s)
COVID-19/diagnosis , COVID-19/drug therapy , Coinfection , Dengue/diagnosis , Dengue/drug therapy , COVID-19/epidemiology , Dengue/epidemiology , Dengue Virus/isolation & purification , Dengue Virus/pathogenicity , Early Diagnosis , Female , Humans , Middle Aged , Philippines/epidemiology , SARS-CoV-2/isolation & purification , SARS-CoV-2/pathogenicity , Treatment Outcome
16.
PLoS Negl Trop Dis ; 15(4): e0008879, 2021 04.
Article in English | MEDLINE | ID: covidwho-1201424

ABSTRACT

BACKGROUND: As coronavirus 2019 (COVID-19) is spreading globally, several countries are handling dengue epidemics. As both infections are deemed to share similarities at presentation, it would be useful to distinguish COVID-19 from dengue in the context of co-epidemics. Hence, we performed a retrospective cohort study to identify predictors of both infections. METHODOLOGY/PRINCIPAL FINDINGS: All the subjects suspected of COVID-19 between March 23 and May 10, 2020, were screened for COVID-19 within the testing center of the University hospital of Saint-Pierre, Reunion island. The screening consisted in a questionnaire surveyed in face-to-face, a nasopharyngeal swab specimen for the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) reverse transcription polymerase chain-reaction and a rapid diagnostic orientation test for dengue. Factors independently associated with COVID-19 or with dengue were sought using multinomial logistic regression models, taking other febrile illnesses (OFIs) as controls. Adjusted Odds ratios (OR) and 95% Confidence Intervals (95%CI) were assessed. Over a two-month study period, we diagnosed 80 COVID-19, 61 non-severe dengue and 872 OFIs cases eligible to multivariate analysis. Among these, we identified delayed presentation (>3 days) since symptom onset (Odds ratio 1.91, 95% confidence interval 1.07-3.39), contact with a COVID-19 positive case (OR 3.81, 95%CI 2.21-6.55) and anosmia (OR 7.80, 95%CI 4.20-14.49) as independent predictors of COVID-19, body ache (OR 6.17, 95%CI 2.69-14.14), headache (OR 5.03, 95%CI 1.88-13.44) and retro-orbital pain (OR 5.55, 95%CI 2.51-12.28) as independent predictors of dengue, while smoking was less likely observed with COVID-19 (OR 0.27, 95%CI 0.09-0.79) and upper respiratory tract infection symptoms were associated with OFIs. CONCLUSIONS/SIGNIFICANCE: Although prone to potential biases, these data suggest that non-severe dengue may be more symptomatic than COVID-19 in a co-epidemic setting with higher dengue attack rates. At clinical presentation, nine basic clinical and epidemiological indicators may help to distinguish COVID-19 or dengue from each other and other febrile illnesses.


Subject(s)
COVID-19/diagnosis , Dengue/diagnosis , SARS-CoV-2/isolation & purification , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , COVID-19/physiopathology , COVID-19 Testing , Child , Child, Preschool , Cohort Studies , Dengue/epidemiology , Dengue/physiopathology , Diagnosis, Differential , False Negative Reactions , False Positive Reactions , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Retrospective Studies , Reunion/epidemiology , Young Adult
17.
PLoS Negl Trop Dis ; 15(4): e0009359, 2021 04.
Article in English | MEDLINE | ID: covidwho-1201403

ABSTRACT

BACKGROUND: Dengue is the world's most common mosquito-borne virus but remains diagnostically challenging due to its nonspecific presentation. Access to laboratory confirmation is limited and thus most reported figures are based on clinical diagnosis alone, the accuracy of which is uncertain. This systematic review assesses the diagnostic accuracy of the traditional (1997) and revised (2009) WHO clinical case definitions for dengue fever, the basis for most national guidelines. METHODOLOGY/PRINCIPAL FINDINGS: PubMed, EMBASE, Scopus, OpenGrey, and the annual Dengue Bulletin were searched for studies assessing the diagnostic accuracy of the unmodified clinical criteria. Two reviewers (NR/SL) independently assessed eligibility, extracted data, and evaluated risk of bias using a modified QUADAS-2. Additional records were found by citation network analysis. A meta-analysis was done using a bivariate mixed-effects regression model. Studies that modified criteria were analysed separately. This systematic review protocol was registered on PROSPERO (CRD42020165998). We identified 11 and 12 datasets assessing the 1997 and 2009 definition, respectively, and 6 using modified criteria. Sensitivity was 93% (95% CI: 77-98) and 93% (95% CI: 86-96) for the 1997 and 2009 definitions, respectively. Specificity was 29% (95% CI: 8-65) and 31% (95% CI: 18-48) for the 1997 and 2009 definitions, respectively. Diagnostic performance suffered at the extremes of age. No modification significantly improved accuracy. CONCLUSIONS/SIGNIFICANCE: Diagnostic accuracy of clinical criteria is poor, with significant implications for surveillance and public health responses for dengue control. As the basis for most reported figures, this has relevance to policymakers planning resource allocation and researchers modelling transmission, particularly during COVID-19.


Subject(s)
Dengue/diagnosis , COVID-19/diagnosis , Databases, Factual , Diagnosis, Differential , Humans , SARS-CoV-2/isolation & purification , Sensitivity and Specificity , World Health Organization
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