Dengue fever with chikungunya concurrent infection.

Dear Editor,

We read the publication on “Clinical profile of dengue fever and coinfection with chikungunya” with a great interest [1]. Singh et al. concluded that “joint-related symptoms (pain and restricted movements) were statistically significant in chikungunya monoinfection [1]” and “there was no significant added severity of clinical features and blood investigations in patients with coinfection with dengue and chikungunya compared to those with monoinfections [1].” In fact, both dengue and chikungunya infections are common tropical mosquito-borne infections. The clinical spectrums of the two diseases are overlapping, and the diagnosis is sometimes difficult [2]. The concurrent infection is not uncommon. Nevertheless, in the presented report, Singh et al. use immunodiagnosis for diagnosis of the cases. The possibility of cross-reactivity might lead to the incorrect diagnosis [2]. In addition, there is also a chance of the possible other additional concurrent infection such as Zika virus infection. According to the recent report from Thailand, the triple reactivity to all three infections, dengue, Zika, and chikungunya, in the same person is not uncommon [3].

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