Was It Chikungunya? Laboratorial and Clinical Investigations of Cases Occurred during a Triple Arboviruses’ Outbreak in Rio de Janeiro, Brazil

Autor: Thiara Manuele Alves de Souza, Raquel Curtinhas de Lima, Victor Edgar Fiestas Solórzano, Paulo Vieira Damasco, Luiz José de Souza, Juan Camilo Sanchez-Arcila, Gabriel Macedo Costa Guimarães, Iury Amâncio Paiva, Monique da Rocha Queiroz Lima, Fernanda de Bruycker-Nogueira, Larissa Cristina Teixeira Tomé, Mariana Rosa Inácio Coelho, Sandro Patroca da Silva, Luzia Maria de Oliveira-Pinto, Elzinandes Leal de Azeredo, Flavia Barreto dos Santos
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Pathogens, Vol 11, Iss 2, p 245 (2022)
Druh dokumentu: article
ISSN: 11020245
2076-0817
DOI: 10.3390/pathogens11020245
Popis: The co-circulation of chikungunya virus (CHIKV), dengue virus (DENV) and Zika virus (ZIKV) in Rio de Janeiro (RJ), Brazil, caused a challenging triple epidemic, as they share similar clinical signs and symptoms and geographical distribution. Here, we aimed to investigate the clinical and laboratorial aspects of chikungunya suspected cases assisted in RJ during the 2018 outbreak, focusing on the differential diagnosis with dengue and zika. All suspected cases were submitted to molecular and/or serological differential diagnostic approaches to arboviruses. A total of 242 cases suspected of arbovirus infection were investigated and 73.6% (178/242) were molecular and/or serologically confirmed as chikungunya. In RT-qPCR confirmed cases, cycle threshold (Ct) values ranged from 15.46 to 35.13, with acute cases presenting lower values. Chikungunya cases were mainly in females (64%) and the most frequently affected age group was adults between 46 to 59 years old (27%). Polyarthralgia affected 89% of patients, especially in hands and feet. No dengue virus (DENV) and Zika virus (ZIKV) infections were confirmed by molecular diagnosis, but 9.5% (23/242) had serological evidence of DENV exposure by the detection of specific anti-DENV IgM or NS1, and 42.7% (76/178) of chikungunya positive cases also presented recent DENV exposure reflected by a positive anti-DENV IgM or NS1 result. A significantly higher frequency of arthritis (p = 0.023) and limb edema (p < 0.001) was found on patients with CHIKV monoinfection compared to dengue patients and patients exposed to both viruses. Lastly, phylogenetic analysis showed that the chikungunya cases were caused by the ECSA genotype. Despite the triple arboviruses’ epidemic in the state of RJ, most patients with fever and arthralgia investigated here were diagnosed as chikungunya cases, and the incidence of CHIKV/DENV co-detection was higher than that reported in other studies.
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