Dengue and Chikungunya Coinfection – The Emergence of an Underestimated Threat

Abstract

Both Dengue (DENV) and Chikungunya (CHIKV) viruses can be transmitted by Aedes mosquito species and the diseases that they cause have several clinical symptoms in com‐ mon. Co-circulation of DENV and CHIKV is increasing around the world and must therefore be considered as an emerging threat with an important public health concern. At present, very little is known about the clinical manifestations and biological conse‐ quences of coinfection by both viruses. Thus, numerous questions such as clinical severi‐ ty and dynamics of viral replication of DENV and CHIKV coinfections, as well as vectorial competence, have yet to be addressed in this important and challenging re‐ search area. The ensuring knowledge will enhance the clinical surveillance and the devel‐ opment of diagnostic tools able to differentiate DENV and CHIKV in order to early detect virus invasion and local transmission, as well as to improve patient care and timely con‐ trol measures. In this review, we highlight the current knowledge on DENV and CHIKV coinfections. We also discuss research perspectives and challenges in order to further un‐ derstand the ecology and biology of this phenomenon.