Dengue-chikungunya coinfection outbreak in children from Cali, Colombia in 2018-2019

Int J Infect Dis. 2021 Jan:102:97-102. doi: 10.1016/j.ijid.2020.10.022. Epub 2020 Oct 16.

Abstract

Objective: To identify the arbovirus involved in febrile cases identified in a pediatric clinic in Cali, Valle del Cauca province, Colombia, and study the clinical characteristics.

Methods: A descriptive, prospective study enrolled 345 febrile children for 12 months in a pediatric clinic. Medical record registers documenting signs and symptoms, and serum samples were analyzed to detect DENV, CHIKV, and ZIKV by reverse transcription-polymerase chain reaction and serology methods. Diagnosis at the time of admission and discharge were compared based on laboratory test results.

Results: All patients were diagnosed as severe dengue at admission. Molecular detection and serology tests identified 143 CHIKV-positive (41.4%), 20 DENV-positive (5.8%), and 123 DENV-CHIKV coinfection patients (35.7%). DENV or CHIKV serology test results of these double-infected patients yield poor performance to confirm patient cases. ZIKV infection was detected in 5 patients (1.4%), every time as double or triple infections.

Conclusion: . A sustained CHIKV circulation and transmission was confirmed causing febrile illness in children and indicating that this virus spreads even during the regular DENV season, leading to double infections and altering clinical symptoms. Specific clinical tests are necessary to closely identify the arbovirus involved in causing infectious diseases that can help in better treatment and mosquito-transmitted virus surveillance.

Keywords: RT-PCR; arbovirus; chikungunya fever; dengue fever; serology.

MeSH terms

  • Adolescent
  • Animals
  • Chikungunya Fever / complications
  • Chikungunya Fever / epidemiology*
  • Chikungunya virus / isolation & purification*
  • Child
  • Child, Preschool
  • Coinfection
  • Colombia / epidemiology
  • Dengue / complications
  • Dengue / epidemiology*
  • Dengue Virus / isolation & purification*
  • Disease Outbreaks*
  • Female
  • Humans
  • Infant
  • Male
  • Prospective Studies
  • Serologic Tests