Dengue Co-infection Research Articles

Dengue Shock Syndrome Unusual Appearance With Multisystem Inflammatory Syndrome in Children: A Case Report

Background: Dengue and coronavirus disease 2019 (COVID-19) have recently become endemic in various tropical countries. Multisystem inflammatory syndrome in children (MIS-C) is a clinical manifestation of COVID-19 with a life-threatening syndrome of hyperinflammation, multiorgan failure, and shock, and it closely resembles the manifestations of severe dengue. Many attempts have been made in research to differentiate the two. Here we aims to describe a case of a patient with dengue coinfection with MIS-C. Case Presentation: A 17-year-old woman came in a state of shock, with cold extremities, fever, jaundice, shortness of breath, acute abdominal pain, and hematuria, decreased urine output. Further investigations reveal increased parameters of hepato-renal organ damage, c-reactive protein, and anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin G (IgG). Patient was positive for anti-dengue IgM and IgG, but negative for COVID-19 based on SARS-CoV-2 antigen and polymerase chain reaction. Conclusion: This case demonstrates the possibility of dengue coinfection and MIS-C co-occurring, causing the patient to develop a hyperinflammatory syndrome and clinical deterioration.

Coinfection of COVID-19 and dengue: a case report

Dengue hemorrhagic fever (DHF) and corona virus disease 2019 (COVID-19) are two viral infectious diseases that can occur simultaneously and have the potential to complicate each other. Therefore, sustained attention to this phenomenon is required. A 9 y.o. boy was diagnosed with dengue and COVID-19 at the Panti Rapih Hospital in Yogyakarta, Indonesia, in the early phase of the COVID-19 pandemic. Both viral infectious diseases have distinctive clinical and laboratory features. Acute fever, vomiting, weakness, thrombocytopenia, and hemoconcentration that improve from day 5 after infection are typical symptoms of DHF in children. Complaints of fever, runny nose, cough, and pain when swallowing that usually occurs in COVID-19 also appeared. Medical investigations with serological tests for DHF and COVID-19 at the beginning of the COVID-19 pandemic can be used to diagnose these two infections because standard diagnostic tools using the PCR swab test cannot yet be performed. Symptomatic therapy for moderate degrees of these two viral infections is appropriate.

CO-INFECTION OF DENGUE AND CHIKUNGUNYA VIRUSES: A SEROLOGICAL STUDY IN A TERTIARY CARE HOSPITAL IN WARANGAL, TELANGANA, INDIA

Background: All around India, Dengue and Сhikungunya (CHIK) diseases seem to be rising. Aedes aegypti mosquitoes frequently transmit the CHIK virus and Dengue virus (DENV). Both viruses can spread together in regions where they cocirculate. Objectives: The objective of the current investigation is to determine the seroprevalence of coinfection with Dengue and Сhikungunya. Methods: The present study was conducted at the Virus Research and Diagnostic Laboratory, Kakatiya Medical College, Warangal, Telangana, India, from January to December 2022. The district health authority and the admitted cases provided the samples. The patients had symptoms typical of CHIK and DEN infections, including high fever (>39°C), chills, rashes, joint pain, joint swelling, nausea, and headache, myalgia, and pain behind the eyes. Results: Between January 2022 and December 2022, a total of 4892, 3344, and 2103 hospitalised patients underwent serological testing for the Dengue virus (DENV), the Сhikungunya virus (CHIKV), and both Dengue and Сhikungunya virus for co-infection, respectively. IgM Capture ELISA was used for all tests. 153 (7.8%) of the cases had both Dengue virus (DENV) and Сhikungunya virus IgM positivity. (CHIKV). Dengue virus (DENV) monoinfection, or 703 (14.3%), denotes the presence of Dengue virus. 313 (9.3%) individuals tested positive for the Сhikungunya virus, or mono-infected with the virus (CHIKV). Chikungunya IgM, Dengue IgM, and Co-infection Conclusion: Dengue and Chikungunya virus co-infections are clinically more serious than a single infection. However, in endemic regions, particularly during the monsoon season, clinically suspected cases should be tested for both viruses. To determine the severity and clinical result of co-infection, more thorough investigations are needed to analyse the pathophysiology and complications of co-infection.

Effective Preventative Measures are Essential to Lower Disease Burden From Dengue and COVID-19 Co-infection in Bangladesh.

Bangladesh is widely recognized as one of the dengue prone nations, and empirical evidence has consistently demonstrated an upward trend in the severity of the disease over time. With the persistent occurrence of dengue in Bangladesh and the ongoing presence of COVID-19, which has not been fully eradicated and may persist for an uncertain period of time, there is a high probability of co-infection between these 2 illnesses. Given the circumstances, the concurrent occurrence of the COVID-19 and dengue epidemics, along with the potential co-infection, may pose an overwhelming burden on healthcare systems that are already grappling with challenges in meeting the existing demand. Due to a lack of awareness, an inadequate health infrastructure, and ineffective disease prevention initiatives, the country is now more susceptible to the threat posed by a co-infection that has been found to be associated with more severe outcomes, marked by significant morbidity and mortality. The objective of this opinion piece is to explore the gravity of co-infection in Bangladesh, as well as the potential challenges to overcome and the preventative measures that need to be implemented to address the severity. This opinion piece proposes a set of modern preventative strategies that, when integrated with conventional methods, have the potential to mitigate disease severity, avert the occurrence of co-infection between COVID-19 and dengue, and halt the co-epidemics of COVID-19 and dengue.

268. Dengue - SARS-CoV-2 co-infection: Experience in hospitalized patients during COVID-19 pandemic

Abstract Background Dengue fever and COVID-19 co-infection constitute a significant public health concern in Latin America, becoming a clinical challenge to distinguish these two entities in early stages of the disease. Clinical outcomes of coinfected hospitalized patients have not been well established. Methods A cross-sectional study was conducted. We included suspected patients diagnosed with COVID-19/dengue co-infection admitted at Hospital Fundación Valle del Lili, Cali – Colombia, from March 2020 to March 2021. All dengue patients had positive NS1 and/or IgM dengue antibodies. SARS-CoV-2 infection was confirmed by RT-PCR or antigen rapid test from nasopharyngeal swab. Laboratory and clinical data were recollected from the clinical laboratory database, clinical charts, and institutional COVID-19 registry. Results A total of 90 COVID-19 patients were included. 72 patients were confirmed only with COVID-19, and 18 with dengue co-infection. Most patients were male: 46 (63.9%) vs. 13 (72.2%). None of these study patients were vaccinated against COVID-19 or dengue. The median time from symptoms onset and the diagnosis was five days, and fever was the most common symptom for both groups. There were significant differences between COVID-19 patients and coinfected patients regarding presence of dyspnea (22.2% vs. 61.1%; p=0.003), desaturation (13.4% vs. 53.3%; p=0.002) and a higher neutrophil/lymphocyte ratio (NLR) (3.84 vs. 5.59; p = 0.038). The co-infection was associated with a worse presentation of the COVID-19 infection (p=0.002), an increased requirement of initial supplemental oxygen therapy (p=0.007), mechanical ventilation (p=0.0004), ICU management at the admission (p=0.002), and ICU final management (p=0.002). Overall mortality in patients with co-infection was 44.4% vs. 6.9% in only COVID-19 infected patients (p< 0.001). Conclusion Despite the pandemic era, the possibility of co-infection of these two entities must be considered. Admitted coinfected patients were associated with worse clinical outcomes and higher mortality. According to our results, patients with co-infection present with severe respiratory symptoms and an elevated NLR. The impact of the Covid 19 vaccination on this coinfection is unknown. Disclosures Olga Agudelo, n/a, Fundación valle del lili: Board Member.

Dengue and COVID-19 co-infections: an important consideration in the tropics.

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has affected >370 million individuals worldwide. Dengue is endemic in many countries and leads to epidemics at frequent intervals. In the tropics and subtropics, it is possible that individuals may be concurrently infected with both dengue and SARS-CoV-2. Differentiation between the two infections may be difficult from both a clinical and laboratory perspective. We have outlined the currently published findings (as of the end of December 2021) on patients with dengue and SARS-CoV-2 co-infections and have discussed the observed outcomes and management of such patients. Co-infections were more common in males >25y of age, fever was not universal, 30-50% had medical comorbidities such as diabetes mellitus or hypertension and the case fatality rate was 16-28%.

Prevalence of Dengue and Chikungunya Virus Co-infection in Tertiary Care Hospital in Patiala, Punjab

Prevalence of Dengue and Chikungunya Virus Co-infection in Tertiary Care Hospital in Patiala, Punjab

Serological Evidence of Hepatitis B and E and Dengue Coinfection in Chadian Patients and Impact on Lipidemia Profile.

Objective Viral hepatitis is an endemic disease in Chad. However, few studies have documented coinfection cases and their impact on cardiovascular risk. This study is aimed at analyzing hepatitis B, E and dengue coinfection in a Chadian cohort and gauge its effect on lipidemia. Patients and Methods. From February to May 2021, 179 subjects were recruited from the Department of Gastroenterology and Internal Medicine of the National Reference University Hospital of N'Djamena and tested for viral hepatitis markers, including HBsAg and IgM/IgG anti-HEV and dengue infection, using the NS1/IgM/IgG kit. Serum transaminases and biomarkers of lipid profiles were assayed by colorimetry, and atherogenic indexes (AI) and coronary risk (CRI) were calculated. Results Of the 179 subjects surveyed, 21.22% (38/179) tested positive for hepatitis B, 20% (27/135) for hepatitis E, and 1.66% (2/120) for dengue. However, most of the patients were found to be asymptomatic. Hepatitis B/E coinfection was more frequent in the study population (5.02%; 9/179) than dengue/hepatitis E coinfection (0.83%; 1/120; IgM). The prevalence of anti-HEV IgG antibodies was higher (18.52%) than that of IgM (1.48%). Furthermore, IgG antibodies levels in HEV-monoinfected subjects (11.05 ± 1.93 IU/mL, N = 15) were significantly higher (p < 0.05) than in coinfected patients (5.40 ± 1.31 IU/mL, N = 9). Subjects coinfected with HEV/HBV were associated with a significantly higher risk of lipodystrophy (coronary risk: 88.89% vs. 35.3%, relative risk (RR) = 2.55; p = 0.014), than HEV-monoinfected subjects, as evidenced by higher mean levels of triglycerides levels (219.88 ± 14.67 mg/dL vs. 191.82 ± 4.66 mg/dL, p < 0.05), more reduced HDL-C levels (9.05 ± 1.62 mg/dL vs. 18.93 ± 2.35 mg/dL, p < 0.05), increased mean CRI (13.81 ± 2.39 vs. 6.89 ± 1.93, p < 0.01), and AI (1.46 ± 0.10 vs. 1.05 ± 0.05, p < 0.01) values. However, they had normal transaminase values and a lower risk of developing a liver injury, although not significant (alanine aminotransferase: 0% vs. 29.4%, RR = 1, p = 0.128; aspartate aminotransferase: 0% vs. 5.88%, p = 1) than this group. Conclusion HBV/HEV coinfection is frequent in the Chadian cohort and associated with an important risk of dyslipidemia. Further research is required to elucidate the mechanism of action.

Asymptomatic Wuchereria Bancrofti Filariasis Discovered from a Dengue Positive Patient: A Case Report from Tamil Nadu

Concurrent infection by dengue and filaria with in a single individual is rarely known. This type of case can present with a very challenging clinical profile to Clinicians and Hematologist. Filarial co-infection can be a risk factor of severity in dengue infection. Filaria is chronic infection while dengue is an acute infection. Filarial infection is endemic in the tropical regions and a public health problem in Africa, Asia. Co-infection with filarial nematodes, if unrecognized, can result in untoward therapeutic consequences. Both Infection is transmitted by mosquito vectors (Culex, Anopheles, Aedes and Mansonia species) and humans are the definitive host. We report a case of co-infection of Wuchereria bancrofti and Dengue, which was diagnosed by peripheral blood smear examination (W. Bancrofti) and NS 1 antigen positivity (Dengue). We present here a case of 20-year-old male with dengue and microfilaria co-infection with bilateral hydrocele.

COINFECTION OF DENGUE AND CHIKUNGUNYA VIRUSES: A PREVALENCE STUDY IN A TERTIARY HOSPITAL AT HYDERABAD, INDIA.

Background &amp; objectives: Dengue and Chikungunya fever are the endemic arboviral infections appearing to be increasing in all parts of India. This study aims to determine the prevalence of Dengue and Chikungunya co-infection among acute febrile illness cases. A prospective observational study was conducted including patients with an acute febrile illnessMethods: whose blood samples were collected and subjected to tests like IgM &amp; IgG ELISA for dengue virus and IgM Capture ELISA for Chikungunya virus. Among the 90 samples that were subjected to both Dengue and Chikungunya virus tests for coinfections, 18 samples testedResults: positive for both Dengue and Chikungunya tests conrming coinfections. Chikungunya virus can be confusedInterpretation and conclusion: with diseases such as Dengue based on the similarity of the symptoms and sharing of vectors. Thus the differential diagnosis of these infections is essential for clinical management and epidemiological study in the tropics.

Correction to: Mathematical Modeling of Covid-19 and Dengue Co-Infection Dynamics in Bangladesh: Optimal Control and Data-Driven Analysis

Correction to: Mathematical Modeling of Covid-19 and Dengue Co-Infection Dynamics in Bangladesh: Optimal Control and Data-Driven Analysis

Emerging co-infections in dengue

Background: Infection with two agents might cause overlapping symptoms, confusing the treating physician. This study aims to determine the current coinfections rates in dengue patients in a tertiary care Govt. General Hospital, Anathapuramu. Method: From July 2021 to November 2021, an observational study was conducted at the Government Medical College &amp; Hospital in Ananthapuramu. A total of 100 clinically suspected Dengue patients were included in this research. Blood samples from 100 patients who visited the General Medicine and Pediatrics OPD were taken and sent to the lab for the diagnosis of Dengue and other co-infections. Result: In our study, Out of 100 samples, 32 samples tested positive for Dengue by RTPCR. Out of 32 samples tested positive by RTPCR, two samples were positive for DENV-1, 26 samples were positive for DENV-2, and four samples were positive for DENV-3, according to RTPCR results. Dengue with co-infection was detected in 21 individuals, with 1 (3.125%) being MP-ICT positive, 2 (6.25%) being salmonella WIDAL positive, 1 (3.125%) being Scrub typhus IgM reactive, 4 (12.5%) being chikungunya IgM positive, 9 (28.125%) being UTI positive, and 4 (12.5%) having Blood Stream Infections.

Is dengue and COVID-19 coinfection or misdiagnosis possible? A review on reported cases

Novel coronavirus has continued to spread throughout the world where there are other endemic diseases that have been a burden to public health for many years. As any infection, it was expected there could be coinfection between these. Tropical and subtropical countries are currently managing with dengue as peaks increase with shorter periods of time. To summarize the evidence that exists in the co-infection related to SARS-CoV-2 and the dengue virus. We conducted a narrative review in data bases about reports of coinfection and misdiagnosis of SARS-CoV-2 and dengue virus given the fact that rainy season every year increase the prevalence of viral infections in endemic countries. Recent reports have even described positive cases in one of these infections that later resulted in false positive. A positive test for COVID-19 or dengue fever in endemic areas should not exclude the other infection. From now on, these two should be considered as a differential diagnosis and this should raise public health concern for COVID-19 and dengue coinfection in endemic countries to reinforce promotion and prevention to communities to prevent these diseases.

Mathematical Modeling of Covid-19 and Dengue Co-Infection Dynamics in Bangladesh: Optimal Control and Data-Driven Analysis

This paper aims to explore the transmission dynamics of COVID-19 with dengue co-infection using mathematical modeling. In this study, SIR model is developed that explains the trajectory of the epidemic to boost a plan for an effective control strategy for COVID-19 in Bangladesh. The model is extended to optimal control strategies. Pontryagin’s Principle is used to establish the appropriate conditions for the existence of optimal control and the optimality system for the co-infection model. Coinfected cases were reduced with control greater than without control. Using Omicron incidence cases from 1st January – 13th April 2022, the maximum likelihood estimate of R0 with a 95% confidence interval is1.89 [ 95% CI: 1.88, 1.91]. The R0 estimated from the exponential growth method is 2.08 [95% CI: 2.07,2.09]and time-dependent estimate is 2.10[95% CI: 1.72,2.58]. The generalized logistic growth model predicted 19, 52,131 cumulative cases on day 103 (April 13, 2022), and a relatively flat curve of cumulative growth of COVID-19 cases implies a declining trend of new cases. The study also found from sensitivity analysis that, R0 is proportional to the mean generation time. This paper attempted to focus on suppressing the COVID-19 co-infections by preventing dengue and COVID-19. The results of the study show that by implementing optimal control spread of dengue and COVID-19 could be minimized. The logistic growth model suggests that the infection rate of COVID-19 is decreasing.

Outcome of Adult Malarial Co-infections in Eastern India.

Introduction:Co-infection with different agents such as bacterial, viral, and Rickettsia is being increasingly recognized due to greater availability and utilization of the diagnostic tests among malaria patients.Methods:Consecutive admitted malarial cases were included and were subjected to test for general investigations, bacteria, typhoid, dengue, chikungunya, and rest for specific diagnosis. All patients were followed up till discharge or death and appropriate statistical tests were performed.Results:A total of 152 malaria patients were recruited and 27 (18.8%) had concurrent infections. It included 40.7% dengue only, 18.7% pneumonia, 11.1% urinary tract infection (UTI), 7.4% enteric fever, 3.7% leptospirosis, chikungunya, and tuberculous meningitis each, and 3.7% each of dengue with pneumonia and UTI. The organisms isolated were Streptococcus pneumoniae, Klebsiella pneumoniae, Escherichia coli, Salmonella typhi, and Mycobacterium tuberculosis. The mean duration of fever was 6.33 ± 3.63 days with a range of 3–20 days. Blood culture grew in 2 cases S. typhi and K. pneumonia,e. Dengue co-infections had significantly higher clinical and laboratory features of dengue and complications such as bleeding, jaundice, and cholecystitis, whereas rest concurrent infections had a significantly higher proportion of nausea and vomiting, convulsion, altered sensorium, productive cough, urinary symptoms, shock, acute kidney injury, anemia, and mean neutrophil count. There was significantly higher mortality among malaria–dengue concurrent infection group with 2 (15.4%) than malaria mono-infection group 3 (2.4%).Conclusion:Co-infections with malaria are not uncommon, especially dengue fever and other bacterial infections. The dominant clinical picture is of the superimposed infection. Decision should be clinically guided adjunct with specific diagnostic tests, and timely treatment has favorable outcome.

Malaria and Dengue Coinfection

Concurrent infection of malaria and dengue may be difficult to diagnose because of overlapping signs and symptoms. An 11-year-old boy presenting in the causality with blanching rash, respiratory distress, and hypotension was initially managed as dengue shock syndrome. Due to high-grade fever and hepatosplenomegaly, peripheral blood film for malarial parasite was sent, which came out to be positive for vivax malaria. This case report emphasizes the need to consider about the possibility of dengue–malaria coinfection in the endemic areas and highlights the challenges related to management among these patients.

Dengue and Typhoid co-infection Study

Undifferentiated acute febrile illness is a common presentation specially during monsoons in India.The overlapping presentations of arboviruses and vector borne diseases have been noted in endemic areas with increasing incidences. There have been rare reports of these presentations with overlapping symptoms making the final nailing of diagnosis further difficult. The exact incidence of dengue and typhoid co-infection is not known and the similarity of symptoms, makes accurate clinical diagnosis and treatment difficult without a laboratory confirmation. Meticulous history taking, careful clinical examination and right choice of laboratory tests for the diagnosis of these co-infections not only helps in timely diagnosis but also prevents fatal outcomes. Keywords: Concurrent infection, Dengue, Febrile, Typhoid.

Chikungunya virus: An emerging public health challenge for Pakistan

Chikungunya virus: An emerging public health challenge for Pakistan

Global prevalence of dengue and chikungunya coinfection: A systematic review and meta-analysis of 43,341 participants

Dengue and chikungunya virus are important arboviruses of public health concern. In the past decades, they have accounted for numerous outbreaks of dengue and chikungunya in different parts of the world. Several cases of concurrent infection of dengue and chikungunya have been documented. However, the true burden of this concurrent infection is unknown. Here, a systematic review and meta-analysis of published data on the prevalence of dengue and chikungunya coinfection in the human population was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Six electronic databases (Web of science, Embase, PubMed, ScienceDirect, Scopus, and Google Scholar) were searched without year or language restrictions for relevant studies. The study protocol was registered with PROSPERO (CRD42020175344). Eighty-three studies involving a total of 43,341 participants were included. The random-effects model was employed to calculate the summary estimates. A pooled global prevalence of 2.5% (95% CI: 1.8–3.4) was obtained for dengue and chikungunya coinfection. Males and females appear to be coinfected at a fairly similar rate. Among the regions, Asia accounted for the highest prevalence (3.3%, 95% CI: 2.3–4.6) while North America was the least (0.8%, 95% CI: 0.3–2.4). The prevalence estimates varied across different countries. A much higher prevalence rates were obtained for Colombia (37.4%, 95% CI: 9.1–78.1), Madagascar (18.2%, 95% CI: 10.1–30.6), Laos (12.5%, 95% CI: 5.3–26.7), Maldives (4.5%, 95% CI: 1.5–13.0) and Thailand (3.7%, 95% CI: 0.4–26.3). This first extensive systematic review and meta-analysis reveals dengue and chikungunya coinfection as a global problem worthy of consideration. It is therefore pertinent that both infections be assessed during diagnosis, mosquito vector control practices be implemented, and vaccine development strides be supported globally.

SARS-CoV-2 and dengue virus co-infection: Epidemiology, pathogenesis, diagnosis, treatment, and management.

SARS‐CoV‐2 and dengue virus co‐infection cases have been on the rise in dengue‐endemic regions as coronavirus disease 2019 (COVID‐19) spreads over the world, posing a threat of a co‐epidemic. The risk of comorbidity in co‐infection cases is greater than that of a single viral infection, which is a cause of concern. Although the pathophysiologies of the two infections are different, the viruses have comparable effects within the body, resulting in identical clinical symptoms in the case of co‐infection, which adds to the complexity. Overlapping symptoms and laboratory features make proper differentiation of the infections important. However, specific biomarkers provide precise results that can be utilised to diagnose and treat a co‐infection, whether it is simply COVID‐19, dengue, or a co‐infection. Though their treatment is distinguished, it becomes more complicated in circumstances of co‐infection. As a result, regardless of whatever infection the first symptom points to, confirmation diagnosis of both COVID‐19 and dengue should be mandatory, particularly in dengue‐endemic regions, to prevent health deterioration in individuals treated for a single infection. There is still a scarcity of concise literature on the epidemiology, pathophysiology, diagnosis, therapy, and management of SARS‐CoV‐2 and dengue virus co‐infection. The epidemiology of SARS‐CoV‐2 and dengue virus co‐infection, the mechanism of pathogenesis, and the potential impact on patients are summarised in this review. The possible diagnosis with biomarkers, treatment, and management of the SARS‐CoV‐2 and dengue viruses are also discussed. This review will shed light on the appropriate diagnosis, treatment, and management of the patients suffering from SARS‐CoV‐2 and dengue virus co‐infection.