Emerging Tropical Viral Infections: Dengue, Chikungunya, and Zika

Endemic viral infections in immunocompromised hosts: Dengue, Chikungunya, Zika

“…The prevalence of these infections in immunocompetent and immunocompromised hosts is likely underestimated due to the wide range of clinical manifestations, including asymptomatic infections [4,9,10].…”

“…The incubation period ranges from 3 to 14 days, and the disease has classically 3 phases: a febrile phase, a critical phase, and a recovery phase. The critical phase occurs in around 4% of symptomatic cases [4]. The WHO categorizes patients into three groups: DENV without warning signs, DENV with warning signs, and severe DENV [3].…”

“…The symptoms of these infections may be nonspecific and unrecognizable in immunocompromised patients, leading to missed or delayed diagnosis [29]. The common symptoms of fever and malaise are frequent in a range of different illnesses in this population, demonstrating the need for high level of suspicion and appropriate diagnosis approach, especially in endemic areas [1,4]. In nonendemic areas, the investigation of epidemiological risk is mandatory.…”

“…Although many arboviruses are reemerging, DENV, CHIKV, and ZIKV pose the highest risk to populations as they have been recently associated with large epidemics of disease and are becoming endemic in a more comprehensive geographical range than ever before [1,2 && ,3]. The epidemiology of each different virus is highly variable and may manifest as isolated and localized cases, seasonal waves, or widespread epidemic outbreaks by arthropod bites [4]. These viruses generate high titer viremia in humans sufficient to maintain a human-mosquito-human transmission cycle, enabling large urban infection outbreaks [3].…”

“…These viruses generate high titer viremia in humans sufficient to maintain a human-mosquito-human transmission cycle, enabling large urban infection outbreaks [3]. However, over the past years, the circulation of these viruses has spread widely due to multiple factors, including population growth, travel, climate change, and insufficient vector control, resulting in an expansion of the geographic distribution; it also turned a concern for healthcareassociated transmission (transmission by infected blood, organs, tissues, and cells) [4][5][6]. So, diseases caused by arboviruses are challenging for immunocompromised recipients who travel or live in endemic regions or receive organs or tissues from donors traveling or living in such areas.…”