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Abstract

We report clinical features and histopathological findings in fatal cases with dengue (DENV) and chikungunya (CHIKV) co-infection identified at the Colombian National Institute of Health between September 2014 and October 2015. Seven such cases were documented. Dengue serotype 2 virus was identified in six cases. All patients were adults and comorbidities were present in four. Fever, arthralgia or myalgia was present in all cases. The frequency of rash, haemorrhage, oedema, and gastrointestinal symptoms was variable. Laboratory findings such as thrombocytopenia, renal failure, and leukocyte count were also inconsistent between cases. Post-mortem tissue examination documented focal hepatocellular coagulative necrosis in three cases, incipient acute pericarditis in one and tubulointerstitial nephritis in one. This study provides evidence of mortality in patients with DENV and CHIKV co-infection. Fatal cases were characterised by variable clinical and laboratory features. Evaluation of histopathology of autopsy tissues provided evidence of the pathological consequences of the disease.

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/content/10.2807/1560-7917.ES.2016.21.22.30244
2016-06-02
2018-05-23
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2016.21.22.30244
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References

  1. Gubler DJ. The global emergence/resurgence of arboviral diseases as public health problems. Arch Med Res. 2002;33(4):330-42.  https://doi.org/10.1016/S0188-4409(02)00378-8  PMID: 12234522 
  2. Weaver SC, Reisen WK. Present and future arboviral threats. Antiviral Res. 2010;85(2):328-45.  https://doi.org/10.1016/j.antiviral.2009.10.008  PMID: 19857523 
  3. Murray NE, Quam MB, Wilder-Smith A. Epidemiology of dengue: past, present and future prospects. Clin Epidemiol. 2013;5:299-309. PMID: 23990732 
  4. Thiberville SD, Moyen N, Dupuis-Maguiraga L, Nougairede A, Gould EA, Roques P, et al. Chikungunya fever: epidemiology, clinical syndrome, pathogenesis and therapy. Antiviral Res. 2013;99(3):345-70.  https://doi.org/10.1016/j.antiviral.2013.06.009  PMID: 23811281 
  5. Weaver SC. Arrival of chikungunya virus in the new world: prospects for spread and impact on public health. PLoS Negl Trop Dis. 2014;8(6):e2921.  https://doi.org/10.1371/journal.pntd.0002921  PMID: 24967777 
  6. Chikungunya disease: gaps and opportunities in public health and research in the Americas. Wkly Epidemiol Rec. 2015;90(42):571-6. PMID: 26477060 
  7. Simmons CP, Farrar JJ, van Vinh Chau N, Wills B. Dengue. N Engl J Med. 2012;366(15):1423-32.  https://doi.org/10.1056/NEJMra1110265  PMID: 22494122 
  8. Pialoux G, Gaüzère BA, Jauréguiberry S, Strobel M. Chikungunya, an epidemic arbovirosis. Lancet Infect Dis. 2007;7(5):319-27.  https://doi.org/10.1016/S1473-3099(07)70107-X  PMID: 17448935 
  9. Economopoulou A, Dominguez M, Helynck B, Sissoko D, Wichmann O, Quenel P, et al. Atypical Chikungunya virus infections: clinical manifestations, mortality and risk factors for severe disease during the 2005-2006 outbreak on Réunion. Epidemiol Infect. 2009;137(4):534-41.  https://doi.org/10.1017/S0950268808001167  PMID: 18694529 
  10. Taraphdar D, Sarkar A, Mukhopadhyay BB, Chatterjee S. A comparative study of clinical features between monotypic and dual infection cases with Chikungunya virus and dengue virus in West Bengal, India. Am J Trop Med Hyg. 2012;86(4):720-3.  https://doi.org/10.4269/ajtmh.2012.11-0704  PMID: 22492160 
  11. Omarjee R, Prat C, Flusin O, Boucau S, Tenebray B, Merle O, et al. Importance of case definition to monitor ongoing outbreak of chikungunya virus on a background of actively circulating dengue virus, St Martin, December 2013 to January 2014. Euro Surveill. 2014;19(13):20753.  https://doi.org/10.2807/1560-7917.ES2014.19.13.20753  PMID: 24721537 
  12. Caron M, Paupy C, Grard G, Becquart P, Mombo I, Nso BB, et al. Recent introduction and rapid dissemination of Chikungunya virus and Dengue virus serotype 2 associated with human and mosquito coinfections in Gabon, central Africa. Clin Infect Dis. 2012;55(6):e45-53.  https://doi.org/10.1093/cid/cis530  PMID: 22670036 
  13. Chahar HS, Bharaj P, Dar L, Guleria R, Kabra SK, Broor S. Co-infections with chikungunya virus and dengue virus in Delhi, India. Emerg Infect Dis. 2009;15(7):1077-80.  https://doi.org/10.3201/eid1507.080638  PMID: 19624923 
  14. De la Hoz F, Martínez-Duran ME, Pacheco-García OE, Quijada-Bonilla H. Protocolo de vigilancia en salud pública. Dengue. [Public health surveillance protocol. Dengue]. Bogotá: Instituto Nacional de Salud; 2014. Spanish. Available from: http://www.ins.gov.co/lineas-de-accion/Subdireccion-Vigilancia/sivigila/Protocolos%20SIVIGILA/PRO%20Dengue.pdf
  15. Protocolo de vigilancia en salud pública. Chikunguña. [Public health surveillance protocol. Chikungunya]. Bogotá: Instituto Nacional de Salud; 2015. Spanish. Available from: http://www.ins.gov.co/lineas-de-accion/Subdireccion-Vigilancia/sivigila/Protocolos%20SIVIGILA/PRO%20Chikungunya.pdf
  16. Gaviria-Uribe A, Ruíz-Gómez F, Burgos-Bernal G, Ospina-Martínez ML, De Jesús-Osorio Saldarriaga E, Muñóz-Ramírez MA, et al. Propuesta metodológica para el análisis y clasificación de muertes atribuibles a la enfermedad por virus Chikungunya. [Proposed method for the analysis and classification of deaths attributable to the disease caused by chikungunya virus]. Bogotá: Ministerio de Salud y Protección Social de Colombia; 2015. Instituto Nacional de Salud. Spanish. Available from: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/ED/Propuesta-metodologica-analisis-clasificacion-muertes-Chikungunya.pdf
  17. Usme-Ciro JA, Gómez-Castañeda AM, Gallego-Gómez JC. Molecular detection and typing of dengue virus by RT-PCR and nested PCR using degenerated oligonucleotides. Salud Uninorte. 2012;28(1):1-15.
  18. Lanciotti RS, Kosoy OL, Laven JJ, Panella AJ, Velez JO, Lambert AJ, et al. Chikungunya virus in US travelers returning from India, 2006. Emerg Infect Dis. 2007;13(5):764-7.  https://doi.org/10.3201/eid1305.070015  PMID: 17553261 
  19. Leroy EM, Nkoghe D, Ollomo B, Nze-Nkogue C, Becquart P, Grard G, et al. Concurrent chikungunya and dengue virus infections during simultaneous outbreaks, Gabon, 2007. Emerg Infect Dis. 2009;15(4):591-3.  https://doi.org/10.3201/eid1504.080664  PMID: 19331740 
  20. Raut CG, Rao NM, Sinha DP, Hanumaiah H, Manjunatha MJ. Chikungunya, dengue, and malaria co-infection after travel to Nigeria, India. Emerg Infect Dis. 2015;21(5):908-9.  https://doi.org/10.3201/eid2105.141804  PMID: 25898147 
  21. Nkoghe D, Kassa RF, Bisvigou U, Caron M, Grard G, Leroy EM. No clinical or biological difference between Chikungunya and Dengue Fever during the 2010 Gabonese outbreak. Infect Dis Rep. 2012;4(1):e5.  https://doi.org/10.4081/idr.2012.e5  PMID: 24470935 
  22. Villamil-Gómez WE, González-Camargo O, Rodriguez-Ayubi J, Zapata-Serpa D, Rodriguez-Morales AJ. Dengue, chikungunya and Zika co-infection in a patient from Colombia. J Infect Public Health. 2016. pii: S1876-0341(15)00221-X. http://dx.doi.org/10.1016/j.jiph.2015.12.002
  23. Pan American Health Organization (PAHO), World Health Organization (WHO) Regional Office for the Americas. Information for healthcare providers on chikungunya fever. Washington: PAHO/WHO; 2014. Available from: http://www.paho.org/hq/index.php?option=com_docman&task=doc_download&Itemid=270&gid=23974&lang=en
  24. Hoz JM, Bayona B, Viloria S, Accini JL, Juan-Vergara HS, Viasus D. Fatal cases of Chikungunya virus infection in Colombia: Diagnostic and treatment challenges. J Clin Virol. 2015;69:27-9.  https://doi.org/10.1016/j.jcv.2015.05.021  PMID: 26209372 
  25. Torres JR, Castro JS, Rodríguez L, Saravia V, Arvelaez J, Ríos-Fabra A, et al. Leopoldo Códova G. Chikungunya fever: Atypical and lethal cases in the Western hemisphere: a Venezuelan experience. IDCases. 2015;2(1):6-10.  https://doi.org/10.1016/j.idcr.2014.12.002  PMID: 26793440 
  26. World Health Organization (WHO). Dengue: guidelines for diagnosis, treatment, prevention and control. Geneva: WHO; 2009. Available from: http://www.who.int/tdr/publications/documents/dengue-diagnosis.pdf
  27. Huerre MR, Lan NT, Marianneau P, Hue NB, Khun H, Hung NT, et al. Liver histopathology and biological correlates in five cases of fatal dengue fever in Vietnamese children. Virchows Arch. 2001;438(2):107-15. PMID: 11253111 
  28. Martina BE, Koraka P, Osterhaus AD. Dengue virus pathogenesis: an integrated view. Clin Microbiol Rev. 2009;22(4):564-81.  https://doi.org/10.1128/CMR.00035-09  PMID: 19822889 
  29. Das T, Jaffar-Bandjee MC, Hoarau JJ, Krejbich Trotot P, Denizot M, Lee-Pat-Yuen G, et al. Chikungunya fever: CNS infection and pathologies of a re-emerging arbovirus. Prog Neurobiol. 2010;91(2):121-9.  https://doi.org/10.1016/j.pneurobio.2009.12.006  PMID: 20026374 
  30. Saswat T, Kumar A, Kumar S, Mamidi P, Muduli S, Debata NK, et al. High rates of co-infection of Dengue and Chikungunya virus in Odisha and Maharashtra, India during 2013. Infect Genet Evol. 2015;35:134-41.  https://doi.org/10.1016/j.meegid.2015.08.006  PMID: 26247719 
  31. Parreira R, Centeno-Lima S, Lopes A, Portugal-Calisto D, Constantino A, Nina J. Dengue virus serotype 4 and chikungunya virus coinfection in a traveller returning from Luanda, Angola, January 2014. Euro Surveill. 2014;19(10):20730.  https://doi.org/10.2807/1560-7917.ES2014.19.10.20730  PMID: 24650864 
  32. Lanciotti RS, Valadere AM. Transcontinental movement of Asian genotype chikungunya virus. Emerg Infect Dis. 2014;20(8):1400-2.  https://doi.org/10.3201/eid2008.140268  PMID: 25076384 
  33. Leparc-Goffart I, Nougairede A, Cassadou S, Prat C, de Lamballerie X. Chikungunya in the Americas. Lancet. 2014;383(9916):514.  https://doi.org/10.1016/S0140-6736(14)60185-9  PMID: 24506907 
  34. Teixeira MG, Andrade AM, Costa MC, Castro JN, Oliveira FL, Goes CS, et al. East/Central/South African genotype chikungunya virus, Brazil, 2014. Emerg Infect Dis. 2015;21(5):906-7.  https://doi.org/10.3201/eid2105.141727  PMID: 25898939 
Clinical and histopathological features of fatal cases with dengue and chikungunya virus co-infection in Colombia, 2014 to 2015
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Marcela+Mercado&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Mercado Marcela</a>, <a href="/search?value1=Jorge+Acosta-Reyes&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Acosta-Reyes Jorge</a>, <a href="/search?value1=Edgar+Parra&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Parra Edgar</a>, <a href="/search?value1=Lissethe+Pardo&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Pardo Lissethe</a>, <a href="/search?value1=Ang%C3%A9lica+Rico&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Rico Angélica</a>, <a href="/search?value1=Alfonso+Campo&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Campo Alfonso</a>, <a href="/search?value1=Edgar+Navarro&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Navarro Edgar</a>, <a href="/search?value1=Diego+Viasus&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Viasus Diego</a></span>. Clinical and histopathological features of fatal cases with dengue and chikungunya virus co-infection in Colombia, 2014 to 2015. <a href="/content/ecdc">Euro Surveill.</a> 2016;21(22):pii=30244. <a href="https://doi.org/10.2807/1560-7917.ES.2016.21.22.30244" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2016.21.22.30244</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 28 Oct 2015;&nbsp;&nbsp; <span class="generated">Accepted</span>: 17 Mar 2016 </span> </p>
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