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

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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. Serum samples and medical record registers documenting signs and symptoms 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 yielded poor performance to confirm patient cases. ZIKV infection was detected in 5 patients (1.4%) 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.

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Keywords

Dengue fever, Chikungunya fever, RT-PCR, Serology, Arbovirus

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