Zika and Chikungunya virus co-infection in a traveller returning from Colombia, 2016: virus isolation and genetic analysis

Abstract

Introduction:Zika virus (ZIKV) and Chikungunya virus (CHIKV) can share the same mosquito vector, and co-infections by these viruses can occur in humans. While infections with these viruses share commonalities, CHIKV is unique in causing arthritis and arthralgias that may persist for a year or more. These infections are commonly diagnosed by RT–PCR-based methods during the acute phase of infection. Even with the high specificity and sensitivity characteristic of PCR, false negatives can occur, highlighting the need for additional diagnostic methods for confirmation.Case presentation:On her return to the USA, a traveller to Colombia, South America developed an illness consistent with Zika, Chikungunya and/or Dengue. RT-PCR of her samples was positive only for ZIKV. However, arthralgias persisted for months, raising concerns about co-infection with CHIKV or Mayaro viruses. Cell cultures inoculated with her original clinical samples demonstrated two types of cytopathic effects, and both ZIKV and CHIKV were identified in the supernatants. On phylogenetic analyses, both viruses were found to be related to strains found in Colombia.Conclusion:These findings highlight the need to consider CHIKV co-infection in patients with prolonged rheumatological symptoms after diagnosis with ZIKV, and the usefulness of cell culture as an amplification step for low-viremia blood and other samples.

Beyond Fever and Pain: Diagnostic Methods for Chikungunya Virus

“…Inoculation of suspected arbovirus-containing human samples onto cell cultures may allow for replication of the virus to high titers, followed by confirmation using immu-nofluorescence or RT-PCR (6,88,89). Furthermore, the semiunbiased nature of viral culture has allowed detection of coinfections with unexpected viral pathogens while simultaneously documenting that these are replicating viruses in the human host (90,91). The isolation of CHIKV can be performed from serum collected up to 7 days after illness onset, and the virus has also been isolated from human cerebrospinal fluid (CSF) (92) and pools of adult female A. aegypti mosquitoes (93).…”

Toxoplasmosis cerebral congénita e infección por el virus del Zika y del chikunguña: reporte de un caso

“…Por otra parte, se ha reportado la circulación simultánea del CHIKV y el ZIKV en Nicaragua, Ecuador, Brasil y Colombia (25)(26)(27)(28). Específicamente en Nicaragua, un estudio serológico encontró que la infección simultánea se presentaba en el 4,6 % de las personas (25).…”

Virusassoziierte Arthritiden – Globalisierung von Überträgern und Erregern

“…zu falsch positiven Ergebnissen bei Flaviviren (Dengue, Zika) führen. Zudem werden in Endemiegebieten bei einer Reihe von Arbovirus-Infektionen regelmäßig Koinfektionen beobachtet [29,30].…”