Influenza Illness among Case-Patients Hospitalized for Suspected Dengue, El Salvador, 2012

Chacón, Rafael Barrera; Clara, Alexey; Jara, Jorge; Armero, Julio; Lozano, Celina de; Omeiri, Nathalie El; Widdowson, Marc‐Alain; Azziz‐Baumgartner, Eduardo

doi:10.1371/journal.pone.0140890

Cited by 7 publications

(6 citation statements)

References 7 publications

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“…The criteria for suspicion of dengue were (i) a recent report of fever (maximum seven days) with no apparent bacterial infection; (ii) the presence of a rash; (iii) the presence of cavity effusion and/or bleeding ( Cavalcanti et al 2016 ). For influenza, the criteria used were a sudden onset of fever and sore throat reports, cough or dyspnea ( Chacon et al 2015 ). The bodies were necropsied after family consent, and samples of tissues and secretions were collected and sent to the Central Public Health Laboratory for testing for dengue and influenza to clarify the cause of death.…”

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confidence: 99%

Coinfection with influenza A(H1N1)pdm09 and dengue virus in fatal cases

Perdigão

Ramalho

Guedes

et al. 2016

Mem. Inst. Oswaldo Cruz

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We report on four patients with fatal influenza A(H1N1)pdm09 and dengue virus coinfections. Clinical, necropsy and histopathologic findings presented in all cases were characteristic of influenza-dengue coinfections, and all were laboratory-confirmed for both infections. The possibility of influenza and dengue coinfection should be considered in locations where these two viruses’ epidemic periods coincide to avoid fatal outcomes. Dengue is a mosquito-borne viral infection caused by one of the four dengue viruses (DENV-1 to 4). Each of these viruses is capable of causing nonspecific febrile illnesses, classic dengue fever and dengue haemorrhagic fever (Gubler 1998). As a result, dengue is often difficult to diagnose clinically, especially because peak dengue season often coincides with that of other common febrile illnesses in tropical regions (Chacon et al. 2015). In April 2009, a new virus, inﬂuenza A/H1N1/pandemic (FluA/H1N1/09pdm), caused a severe outbreak in Mexico. The virus quickly spread throughout the world, and in June 2009, the World Health Organization declared a pandemic (WHO 2010). In Brazil, the first laboratory confirmed case of FluA/H1N1/09pdm was in July 2009 (Pires Neto et al. 2013). The state of Ceará, in Northeast Brazil, is a dengue endemic area. In this state, the virus influenza A(H1N1)pdm09 has circulated since 2009, and through the first half of 2012, 11 deaths caused by the virus were confirmed (Pires Neto et al. 2013). The influenza and dengue seasons in Ceará overlap, which led to diagnostic difficulties. We report four cases of laboratory-confirmed coinfection of deadly influenza A(H1N1)pdm09 with DENV, which occurred during the dengue and influenza season in 2012 and 2013 in Ceará.

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confidence: 99%

Coinfection with influenza A(H1N1)pdm09 and dengue virus in fatal cases

Perdigão

Ramalho

Guedes

et al. 2016

Mem. Inst. Oswaldo Cruz

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“…In El Salvador, during influenza season, 123 patients with suspected dengue were evaluated, finding that 19% tested positive for influenza and three cases were confirmed as a co-infection DENV-INFA. However, in this study, the severity of the disease was not evaluated [6].…”

Section: Discussionmentioning

confidence: 99%

“…In Colombia, the fact that DENV and INFA circulate all year and that both cause epidemics during the rainy seasons, the chance of presenting with both infections is likely, presenting a diagnostic challenge, given that both infections can cause similar symptoms [5]. There have been several reports of severe cases of co-infection but so far, this has not been reported during pregnancy [6,7,8].…”

Section: Introductionmentioning

confidence: 99%

Dengue Virus and Influenza A Virus Co-Infection in Pregnancy: A Case Report

et al. 2019

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Dengue is still an important cause of disease and mortality in tropical countries, as is influenza A virus, which is also a cause of epidemics all over the globe. In this article, we present the case of a 31-year-old woman who was in her second trimester of pregnancy and presented with severe dengue with hematological and neurological complications, and premature labor. She was misdiagnosed with bacterial infection and received antibiotic treatment with no improvement of the clinical manifestations and previous to death, she was diagnosed with dengue infection. She died from cardiorespiratory arrest. In the postmortem evaluation, influenza A co-infection was confirmed and characterization of the tissue damage and immune response in lung, liver, kidney, heart, spleen, and brain was determined, finding a severe inflammatory response in lung with T cells and macrophages infiltrating the tissue. This case report highlights the risks of accepting a single diagnosis, especially in endemic countries to multiple tropical diseases, which can lead to delay in appropriate treatment that could reduce morbidity and mortality.

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“…Besides the many troubles inherent to an overwhelmed health care system, concurrent epidemics also can complicate clinical-epidemiological diagnoses. Some studies show that dengue cases can be misdiagnosed as respiratory infections and vice-versa [20,21]. Coinfections during concurrent epidemics must also be considered as they may worsen clinical diseases.…”

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confidence: 99%