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Clinical and Laboratory Profile of Zika and Dengue Infected Patients: Lessons Learned From the Co-circulation of Dengue, Zika and Chikungunya in Brazil.
Azeredo, Elzinandes Leal; Dos Santos, Flavia Barreto; Barbosa, Luciana Santos; Souza, Thiara Manuele Alves; Badolato-Corrêa, Jessica; Sánchez-Arcila, Juan Camilo; Nunes, Priscila Conrado Guerra; de-Oliveira-Pinto, Luzia Maria; de Filippis, Ana Maria; Dal Fabbro, Márcia; Hoscher Romanholi, Izilyanne; Venancio da Cunha, Rivaldo.
Afiliação
  • Azeredo EL; Viral Immunology Laboratory, Oswaldo Cruz Institute, Rio de Janeiro, Brazil.
  • Dos Santos FB; Viral Immunology Laboratory, Oswaldo Cruz Institute, Rio de Janeiro, Brazil.
  • Barbosa LS; Viral Immunology Laboratory, Oswaldo Cruz Institute, Rio de Janeiro, Brazil; UFRJ- Federal University of Rio de Janeiro, Laboratory of Genetics, IPPMG - Martagão Gesteira Child Care and Pediatrics Institute, Rio de Janeiro, Brazil.
  • Souza TMA; Viral Immunology Laboratory, Oswaldo Cruz Institute, Rio de Janeiro, Brazil.
  • Badolato-Corrêa J; Viral Immunology Laboratory, Oswaldo Cruz Institute, Rio de Janeiro, Brazil.
  • Sánchez-Arcila JC; Laboratory of Viral Immunology, Fundação Instituto Oswaldo Cruz, Rio de Janeiro, Brazil.
  • Nunes PCG; Viral Immunology Laboratory, Oswaldo Cruz Institute, Rio de Janeiro, Brazil.
  • de-Oliveira-Pinto LM; Fundação Oswaldo Cruz, Research, Immunology, Rio de Janeiro, Brasil.
  • de Filippis AM; Flavivirus Laboratory, Oswaldo Cruz Institute, Rio de Janeiro, Brazil.
  • Dal Fabbro M; Medical Clinic Department, Federal University of Mato Grosso do Sul, Campo,Grande, MS, Brazil.
  • Hoscher Romanholi I; Faculdade de Medicina, Universidade Federal de Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brasil.
  • Venancio da Cunha R; Medical Clinic Department, Federal University of Mato Grosso do Sul, Campo,Grande, MS, Brazil.
PLoS Curr ; 102018 Feb 15.
Article em En | MEDLINE | ID: mdl-29588874
ABSTRACT

BACKGROUND:

The current triple epidemic caused by dengue, zika and chikungunya constitutes a serious health problem in Brazil. The aim of this study was to investigate acute samples (up to the 7 days of symptoms) from patients presenting acute fever syndrome suspected as arboviral infection and characterize the clinical and laboratorial profile during the co-circulation of dengue, zika and chikungunya in Campo Grande, Mato Grosso do Sul (MS), midwest region of Brazil.

METHODS:

All suspected cases (n=134) were tested by using serological and molecular diagnostic tests including DENV, ZIKV and CHIKV RT-PCR, Dengue nonstructural protein 1 (NS1) antigen capture ELISA, anti- DENV IgM ELISA and anti-CHIKV IgM ELISA. In addition, clinical, hematological and biochemical parameters of infected patients were analyzed.

RESULTS:

 It was observed that 79.1% of the blood samples were confirmed for ZIKV and/or DENV infection Of those, 38.0% patients were DENV monoinfected, 26.8% were ZIKV monoinfected and 13.4% were DENV/ZIKV co-infected. Seven patients presented Chikungunya IgM antibodies indicating a previous CHIKV infection. Common symptoms included fever, rash, arthralgia, myalgia, prostration, headache and conjunctivitis. Statistical analysis showed that pruritus and edema were associated with ZIKV infection while prostration and vomiting were more associated with dengue. Additionally, total protein and ALT levels were significantly different in DENV patients compared to ZIKV ones. Some DENV infected patients as well as co-infected needed hospitalization and venous hydration. Otherwise, most ZIKV infected patients presented mild clinical course. Among the pregnant women studied (n=11), three were ZIKV monoinfected while four were DENV monoinfected and two were DENV-1/ZIKV coinfected. In general, normal birth outcomes were observed except for the death due to respiratory insufficiency of one baby born to a mother coinfected with DENV-1/ZIKV.

CONCLUSIONS:

 Herein, we provide evidence of the co-circulation of DENV, ZIKV and CHIKV infections in the Campo Grande, MS, Brazil, with a high frequency of DENV-1/ZIKV coinfection. Laboratorial diagnosis poses a challenge where those arboviruses are endemic and differential diagnosis proved to imperative for cases characterization. The knowledge about disease severity during arbovirus coinfections is still scarce and there are several issues emphasizing the importance of adequate management of patients at risk areas.

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE País/Região como assunto: America do sul / Brasil Idioma: En Revista: PLoS Curr Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Brasil

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE País/Região como assunto: America do sul / Brasil Idioma: En Revista: PLoS Curr Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Brasil