Flávia Fonseca Bagno1, Maria Marta Figueiredo2, Jannely Villarreal3, Glauco de Carvalho Pereira4, Lara Carvalho Godoi5, Flávio Guimarães da Fonseca6. 1. Departmento de Microbiologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Centro de Tecnologia de Vacinas, Belo Horizonte, Brazil. Electronic address: flavia.bagno@gmail.com. 2. Centro de Tecnologia de Vacinas, Belo Horizonte, Brazil. Electronic address: mariamartafigueiredo@gmail.com. 3. Department of Molecular and Cellular Biology, Harvard University, Cambridge, United States. Electronic address: jvillarreal@college.harvard.edu. 4. Fundação Ezequiel Dias (FUNED), Belo Horizonte, Brazil. Electronic address: glaiconep@gmail.com. 5. Centro de Tecnologia de Vacinas, Belo Horizonte, Brazil; Colégio Técnico da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. Electronic address: lcarvalhogodoi@gmail.com. 6. Departmento de Microbiologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Centro de Tecnologia de Vacinas, Belo Horizonte, Brazil. Electronic address: fdafonseca@icb.ufmg.br.
Abstract
BACKGROUND: Chikungunya virus (CHIKV) causes a disease characterized by acute onset of fever accompanied by arthralgia. Clinical similarities and co-circulation of other arboviruses such as Dengue virus (DENV) and Zika virus (ZIKV), have complicated their differentiation, making their diagnoses a challenge for the health authorities. Misdiagnosis is a serious issue to the management of patients and development of public health measures. OBJECTIVES: We carried out further screening of CHIKV, DENV and ZIKV cases in Minas Gerais, Brazil, after diagnostics were already issued by a state laboratory and according to the Brazilian Ministry of Health (BMH) policy. Our aim was to look for possible co-infections or previous arboviruses' exposure. STUDY DESIGN: Sera from 193 patients with symptoms of arboviral infections were tested for DEV, ZKV and/or CHIKV by the State laboratory, according to clinical suspicion and following standard BMH guidelines. After an official diagnosis was issued for each patient, we retested samples applying a broader panel of ELISA-based serological tests. RESULTS: We identified 13 patients with concurrent or consecutive infections (IgM positive for more than one arbovirus), including 11 individuals that were positive for CHIKV and other previously confirmed arbovirus infection. DISCUSSION: Guidelines established in many arbovirus-endemic countries prioritizes the diagnosis of Zika and Dengue and no further analyzes are done when samples are positive for those viruses. As a result, possible cases of co-infections with chikungunya are neglected, which affects the epidemiological assessments of virus circulation, patient management, and the development of public health policies.
BACKGROUND:Chikungunya virus (CHIKV) causes a disease characterized by acute onset of fever accompanied by arthralgia. Clinical similarities and co-circulation of other arboviruses such as Dengue virus (DENV) and Zika virus (ZIKV), have complicated their differentiation, making their diagnoses a challenge for the health authorities. Misdiagnosis is a serious issue to the management of patients and development of public health measures. OBJECTIVES: We carried out further screening of CHIKV, DENV and ZIKV cases in Minas Gerais, Brazil, after diagnostics were already issued by a state laboratory and according to the Brazilian Ministry of Health (BMH) policy. Our aim was to look for possible co-infections or previous arboviruses' exposure. STUDY DESIGN: Sera from 193 patients with symptoms of arboviral infections were tested for DEV, ZKV and/or CHIKV by the State laboratory, according to clinical suspicion and following standard BMH guidelines. After an official diagnosis was issued for each patient, we retested samples applying a broader panel of ELISA-based serological tests. RESULTS: We identified 13 patients with concurrent or consecutive infections (IgM positive for more than one arbovirus), including 11 individuals that were positive for CHIKV and other previously confirmed arbovirus infection. DISCUSSION: Guidelines established in many arbovirus-endemic countries prioritizes the diagnosis of Zika and Dengue and no further analyzes are done when samples are positive for those viruses. As a result, possible cases of co-infections with chikungunya are neglected, which affects the epidemiological assessments of virus circulation, patient management, and the development of public health policies.
Authors: Noa Krawczyk; Pedro Luis do Nascimento Silva; Raquel B De Boni; Jurema Mota; Mauricio Vascncellos; Neilane Bertoni; Carolina Coutinho; Francisco I Bastos Journal: Glob Public Health Date: 2019-06-13
Authors: Ludmila Lobkowicz; Demócrito de Barros Miranda-Filho; Ulisses Ramos Montarroyos; Celina Maria Turchi Martelli; Thalia Velho Barreto de Araújo; Wayner Vieira De Souza; Luciana Caroline Albuquerque Bezerra; Rafael Dhalia; Ernesto T A Marques; Nuria Sanchez Clemente; Jayne Webster; Aisling Vaughan; Emily L Webb; Elizabeth B Brickley; Ricardo Arraes de Alencar Ximenes Journal: Am J Trop Med Hyg Date: 2022-04-11 Impact factor: 3.707
Authors: Flávia Fonseca Bagno; Lara Carvalho Godoi; Natalia Salazar; Glauco de Carvalho Pereira; Maria Marta Figueiredo; Flávio Guimarães da Fonseca Journal: Data Brief Date: 2019-05-23
Authors: Ankita Reddy; Irene Bosch; Nol Salcedo; Bobby Brooke Herrera; Helena de Puig; Carlos F Narváez; Diana María Caicedo-Borrero; Ivette Lorenzana; Leda Parham; Kimberly García; Marcela Mercado; Angélica María Rico Turca; Luis A Villar-Centeno; Margarita Gélvez-Ramírez; Natalia Andrea Gómez Ríos; Megan Hiley; Dawlyn García; Michael S Diamond; Lee Gehrke Journal: Viruses Date: 2020-09-01 Impact factor: 5.048