Serological and molecular epidemiology of the Dengue, Zika and Chikungunya viruses in a risk area in Brazil

Abstract

Background The co-circulation of types of arbovirus in areas where they are endemic increased the risk of outbreaks and limited the diagnostic methods available. Here, we analyze the epidemiological profile of DENV, CHIKV and ZIKV at the serological and molecular level in patients with suspected infection with these arboviruses in the city of Juazeiro do Norte, Ceará, Brazil. Methods In 2016, the Central Public Health Laboratory (LACEN) of Juazeiro do Norte received 182 plasma samples from patients who visited health facilities with symptoms compatible with arbovirus infection. The LACEN performed serological tests for detection of IgM/IgG to DENV and CHIKV. They then sent these samples to the Retrovirology Laboratory of the Federal University of São Paulo and Faculty of Medical of the ABC where molecular analyses to confirm the infection by DENV, ZIKV and CHIKV were performed. The prevalence of IgM/IgG antibodies and of infections confirmed by RT-qPCR were presented with 95% confidence interval. Results In serologic analysis, 125 samples were positive for antibodies against CHIKV and all were positive for antibodies against DENV. A higher prevalence of IgG against CHIKV (63.20% with 95% CI: 45.76–70.56) than against DENV (95.05% with 95% CI: 78.09–98.12) was observed. When the samples were submitted to analysis by RT-qPCR, we observed the following prevalence: mono-infection by ZIKV of 19.23% (95% CI: 14.29–34.82) patients, mono-infection by CHIKV of 3.84% (95% CI: 2.01–5.44) and co-infection with ZIKV and CHIKV of 1.09% (95% CI: 0.89–4.56). Conclusion The serologic and molecular tests performed in this study were effective in analyzing the epidemiological profile of DENV, CHIKV and ZIKV in patients with suspected infection by these arboviruses in the city of Juazeiro do Norte, Ceará/Brazil.

Performance Evaluation of VIDAS® Diagnostic Assays Detecting Anti-Chikungunya Virus IgM and IgG Antibodies: An International Study

“…In this first performance evaluation study, VIDAS ® anti-CHIKV IgM and IgG results were comparable to those of competitor IgM and IgG ELISAs, with positive and negative agreements between 97.5% and 100.0%. Given that existing commercial anti-CHIKV IgM and IgG ELISA are recognised for their ability to accurately detect anti-CHIKV antibodies [5,6,10,11,19,20,[22][23][24], our study, therefore, demonstrates the good clinical performance of the VIDAS ® anti-CHIKV IgM and IgG assays. Our study also confirmed the superior performance of ELISA over RDT, in accordance with the existing literature [5,6,10,11,19,20,[22][23][24].…”

“…Given that existing commercial anti-CHIKV IgM and IgG ELISA are recognised for their ability to accurately detect anti-CHIKV antibodies [5,6,10,11,19,20,[22][23][24], our study, therefore, demonstrates the good clinical performance of the VIDAS ® anti-CHIKV IgM and IgG assays. Our study also confirmed the superior performance of ELISA over RDT, in accordance with the existing literature [5,6,10,11,19,20,[22][23][24]. Moreover, the significant difference between the PPA of VIDAS ® and RDT assays (each compared to competitor ELISA) demonstrates for the first time the superior performance of VIDAS ® anti-CHIKV assays over that of RDT.…”

“…Like dengue virus (DENV) and Zika virus (ZIKV), CHIKV is a single-stranded RNA arbovirus with similar epidemiology and transmission cycles [ 8 ]. Accordingly, co-circulation of these arboviruses in overlapping endemic regions and co-infection cases have been described [ 7 , 8 , 9 , 10 , 11 ]. Moreover, following infection by these arboviruses, clinical symptoms at disease onset are often similar and clinically non-specific, including fever, headache, myalgia, arthralgia, and maculopapular rash [ 7 , 8 , 12 , 13 ].…”

The Chikungunya virus: A reemerging cause of acute febrile illness in the high jungle of northern Peru

“…The Chikungunya virus (CHIKV) is considered an emerging pathogen that causes acute febrile illness (AFI) in many regions of Peru [ 8 ]. However, the prevalence of this pathogen may be underestimated due to its clinical similarity with other arboviral infections, such as DENV and ZIKV, which can circulate in the same geographical regions and are transmitted by the same vector [ 17 ]. One of the main limitations in these areas is the lack of access to reliable diagnostic tests, such as molecular and serological techniques; therefore, a study was conducted to evaluate the prevalence of CHIKV in febrile patients from the high jungle of the northern area of Peru.…”

“…Studies from other countries in Latin America report differing frequencies of this pathogen; for example, Lima et al [ 17 ] reported a prevalence of 3.84% of CHIKV cases among 182 patients, while a study in Puerto Rico that was conducted during a 3-year study period found that CHIKV corresponded to the 18.2% of the febrile patients [ 19 ]. These differences are related to various factors, among which are the seasonality on which the volume of rainfall and temperature depend, and the use of serological techniques for diagnosis, since antibodies are detectable for a longer time [ 17 ]. It should be mentioned that the prevalence of CHIKV is heterogeneous among the different Latin American countries and even in different regions within the same country; therefore, molecular diagnosis is critical for the epidemiological surveillance of this virus [ 1 , 20 ].…”