CROSS-REACTIVITY OR DUAL INFECTION OF CHIKUNGUNYA AND DENGUE IN AN ENDEMIC AREA OF DENGUE
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Keywords
Dengue, Chikungunya, Dual infection, Cross-reactivity, ELISA, Co-infection
Abstract
Background: Dengue and Chikungunya are significant mosquito-borne viral infections endemic in India, transmitted primarily by Aedes aegypti and Aedes albopictus mosquitoes. Due to shared vectors and overlapping symptoms, co-infections and cross-reactivity between these viruses pose diagnostic challenges.
Objectives: To determine the prevalence of cross-reactivity or dual infection of Dengue and Chikungunya viruses in an endemic area and compare findings with previous studies.
Methods: A cross-sectional study was conducted from October to December 2017 at Lokmanya Tilak Municipal Medical College and General Hospital (LTMMC & GH), Sion, Mumbai. A total of 300 patients clinically suspected of Dengue infection were tested for Dengue NS1 antigen and IgM antibodies using ELISA. Confirmed Dengue-positive samples were further tested for Chikungunya IgM antibodies using ELISA. Data were analyzed and compared with findings from previous studies.
Results: Out of 300 suspected cases, 121 (40.33%) were confirmed positive for Dengue infection. Among these, 51 (42.15%) samples were positive for Chikungunya IgM antibodies. The highest co-positivity was observed in patients with 4-7 days of fever duration (50%). These findings are higher compared to previous studies reporting co-infection rates ranging from 6% to 22%.
Conclusion: A significant proportion of Dengue-confirmed patients also tested positive for Chikungunya IgM antibodies, indicating considerable cross-reactivity or dual infection in the studied region. This emphasizes the need for accurate differential diagnosis using advanced molecular techniques to ensure appropriate clinical management.
References
2. World Health Organization. Dengue and Severe Dengue [Internet]. Geneva: World Health Organization; 2017 [April 2017]. Available from: http://www.who.int/ mediacentre/ factsheets/fs117/en/
3. National Vector Borne Disease Control Programme. Dengue Cases and Deaths in the Country since 2010 [Internet]. Available from: https://nvbdcp.gov.in/index4.php? lang=1&level=0& linkid=431&lid=3715
4. Centers for Disease Control and Prevention. Chikungunya Virus [Internet]. Available from: https://www.cdc.gov/chikungunya/index.html
5. National Vector Borne Disease Control Programme. Chikungunya Cases in the Country since 2010 [Internet]. Available from: https://nvbdcp.gov.in/index4. php?lang=1&level= 0&linkid= 486&lid=3751
6. Mardekian SK, Roberts AL. Diagnostic options and challenges for dengue and chikungunya viruses. BioMed Research International. 2015;2015:834371.
7. Chen LH, Wilson ME. Dengue and chikungunya infections in travelers. Current Opinion in Infectious Diseases. 2015 Oct;28(5):438-44.
8. Chahar HS, Bharaj P, Dar L, Guleria R, Kabra SK, Broor S. Co-infections with chikungunya virus and dengue virus in Delhi India. Emerging Infectious Diseases. 2009 Jul;15(7):1077-80.
9. Ravi V. Re-emergence of chikungunya virus in India. Indian Journal of Medical Microbiology. 2006 Apr;24(2):83-4.
10. Hapuarachchi HC, Koo C, Rajarethinam J, et al. Epidemic resurgence of dengue fever in Singapore in 2013-2014: a virological and entomological perspective. BMC Infectious Diseases. 2016 Jun;16:300.
11. Centers for Disease Control and Prevention. Dengue: Clinical Guidance [Internet]. Available from: https://www.cdc.gov/dengue/clinicallab/clinical.html
12. Johnson BW, Kosoy O, Martin DA, Noga AJ, Russell BJ, Johnson AA. Evaluation of Chikungunya virus real-time reverse transcriptase PCR assays for detection of emergent Asian genotype strains. Journal of Clinical Microbiology. 2010 Aug;48(8):2919-22.
13. World Health Organization. Guidelines for the diagnosis, treatment, prevention and control of dengue [Internet]. 2009. Available from: https://www.who.int/tdr/publications/ documents/ dengue-diagnosis.pdf
14. Masyeni S, Yohan B, Trimarsanto H, et al. Dengue and chikungunya virus co-infection in an outbreak in Jambi, Indonesia, in 2014. Acta Tropica. 2018 Jan;185:39-43.
15. Majumder, Senjuti. "Dengue and Chikungunya co-infection: An emerging threat to Bangladesh." Journal of Pharmacognosy and Phytochemistry 8.5 (2019): 824-828.
16. Batista, Raquel Pereira et al. “Development and validation of a clinical rule for the diagnosis of chikungunya fever in a dengue-endemic area.” PloS one vol. 18,1 e0279970. 6 Jan. 2023, doi:10.1371/journal.pone.0279970
17. de Andrade Vieira Alves, Felipe et al. “The Innate Immune Response in DENV- and CHIKV-Infected Placentas and the Consequences for the Fetuses: A Minireview.” Viruses vol. 15,9 1885. 6 Sep. 2023, doi:10.3390/v15091885
18. Furuya-Kanamori, Luis et al. “Co-distribution and co-infection of chikungunya and dengue viruses.” BMC infectious diseases vol. 16 84. 3 Mar. 2016, doi:10.1186/s12879-016-1417-2
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Dr. Shripad Taklikar
Additional professor at Department of Microbiology, Lokmanya Tilak Municipal Medical College & General Hospital, Sion, Mumbai
Dr. Pradnya Kale
Senior Resident at Department of Microbiology, Lokmanya Tilak Municipal Medical College & General Hospital, Sion, Mumbai
Dr. Arghadip Samaddar
Senior Resident at Department of Microbiology, Lokmanya Tilak Municipal Medical College & General Hospital, Sion, Mumbai
Dr. Sujata Baveja
Professor and Head at Department of Microbiology, Lokmanya Tilak Municipal Medical College & General Hospital, Sion, Mumbai