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LETTER TO EDITOR  
Year : 2011  |  Volume : 54  |  Issue : 4  |  Page : 844-846
Prevalence of dengue and chickungunya fever and their co-infection


Department of Microbiology, Sri Venkateswara Institute of Medical Sciences, Tirupati, India

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Date of Web Publication6-Jan-2012
 

How to cite this article:
Kalawat U, Sharma KK, Reddy SG. Prevalence of dengue and chickungunya fever and their co-infection. Indian J Pathol Microbiol 2011;54:844-6

How to cite this URL:
Kalawat U, Sharma KK, Reddy SG. Prevalence of dengue and chickungunya fever and their co-infection. Indian J Pathol Microbiol [serial online] 2011 [cited 2019 Aug 25];54:844-6. Available from: http://www.ijpmonline.org/text.asp?2011/54/4/844/91518


Sir,

Dengue and chikungunya are arboviral infections transmitted by Aedes aegypti. Chikungunya is a self-limiting and nonfatal acute illness, whereas dengue has severe complications. [1] The symptoms of dengue fever closely resemble the symptoms of chikungunya. They include fever, joint and bone pain, nausea, vomiting, headache, and fatigue. A rash may also occur about three to four days after the onset of fever.

Aedes aegypti mosquitoes are the common vectors for dengue and chikungunya virus. In areas where both viruses co-circulate, they can be transmitted together. This study was conducted to know the prevalence of dengue, chickungunya and their co-infection, the clinical presentations and seasonal trends of these fevers at a tertiary care hospital in south India.

Retrospective analysis of the samples received from various clinical departments for testing the presence of antibodies to dengue and chikungunya virus was done. Patients' medical records were screened for further information regarding the clinical presentation and other investigation reports.

Test for dengue fever was done using Dengue IgM Microwell Serum ELISA kit of IVD Research Inc., Quality Diagnostic Products, USA which is a semi quantitative enzyme immunoassay for detection of antibodies to dengue virus.

Test for ckikungunya fever was done using Onsite Chikungunya IgM Rapid test -Cassette (Serum/ELISA) Kit of CTK Biotech, Inc., USA which is a lateral flow chromatographic immunoassay for qualitative detection of IgM anti-chikungunya virus in human serum and plasma.

Samples received for dengue were 331, of which, 196 (59.21) were males and 135 (40.78%) females. Age ranged between 03 to 89 years (mean age 38.1±16.8). Among the 170 samples received for chikungunya test, 96 (56%) were from males and 74 (44%) from females. Patients' age ranged between 13 to 89 years (mean age 42.91±16.9).

Of the 331 samples received for Detecting IgM antibodies for dengue virus, 40 (12.08%) samples were positive, whereas out of 170 samples received for Detecting IgM antibodies for chikungunya virus, 33 (19.4%) were positive. Only 72 samples were received for testing the presence of both dengue and chikungunya antibodies and 2 (2.7%) among these were positive for both the infections [Table 1]. Signs and symptoms of the patients are shown in [Table 2].
Table 1: Results of samples sent for both dengue and chikungunya no. 72

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Table 2: Clinical presentations of dengue and chikungunya positive patients

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In Asia, the chikungunya virus affected areas overlap with dengue fever -endemic areas [2] and provide opportunities for mosquitoes to become infected with both the viruses. The first case report of chikungunya and dengue co-infection confirmed by molecular assays was from Sri Lanka. [3]

In 1967, co-infections with dengue and chikungunya viruses were reported in Calcutta, India. Subsequent serologic investigations in southern India indicated that the two viruses can co-exist in the same host. [4]

In our study, co-infection with dengue and chikungunya fever was found in 2.7% of the cases. The clinical spectrum of the two infections is very much similar as reported previously and also evident from our study. Therefore, missing of one is always plausible if diagnostic tests for both are not performed and the presence of one does not rule out the other. Seasonal trend was observed with both the fevers with rise of the cases during the post monsoon period. Ae. aegypti is sensitive to changes in temperature and available moisture, they decrease in number in dry and cool seasons, and increase when temperatures increase and when the wet season begins. [5]

In Indian setting, overcrowding, low socioeconomic conditions, and poor sanitary conditions, mixed population of mosquitoes thriving together cannot be excluded. Therefore, while screening, considering both dengue and chickungunya infections is necessary because though the clinical features are similar, the outcomes may be different.


   Acknowledgment Top


We are thankful to Dr Alok Sachan, Associate Professor and Head of Department of Endocrinology SVIMS, for carrying out the statistical analysis and all our clinical colleagues who have sent the samples for carrying out the tests.

 
   References Top

1.Pialoux G, Alex-Gauzere B, Jaureguiberry S, Strobel M. Chikungunya: An epidemic arbovirosis.Lancet Infect Dis 2007;7:319-272.   Back to cited text no. 1
    
2.Mackenzie JS, Chua KB, Daniels PW, Eaton BT, Field HE, Hall RA, et al. Emerging viral diseases of Southeast Asia and the Western Pacific. Emerg Infect Dis 2001;7:497-504.  Back to cited text no. 2
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3.Hapuarachchi HA, Bandara KB, Hapugoda MD, Williams S, Abeyewickreme W. Laboratory confirmation of dengue and chikungunya co- infection. Ceylon Med J 2008;53:104-5.   Back to cited text no. 3
[PUBMED]    
4.Yergolkar PN, Tandale BV, Arankalle VA, Sathe PS, Sudeep AB, Gandhe SS, et al. Chikungunya outbreaks caused by African genotype, India. Emerg Infect Dis 2006;12:1580-3  Back to cited text no. 4
    
5.Schultz GW. Seasonal abundance of dengue vectors in Manila, Republic of the Philippines. Southeast Asian Trop Med Public Health 1993;24:369-75.  Back to cited text no. 5
    

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Correspondence Address:
Usha Kalawat
Department of Microbiology, Sri Venkateswara Institute of Medical Sciences, Tirupati (AP)-517 507
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0377-4929.91518

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