Institute of Tropical Pathology and Public Health, Federal University of Goias, Goiania 74605-050, Brazil.
Faculty of Pharmacy, Federal University of Goias, Goiania 74605-170, Brazil.
Viruses. 2020 Oct 21;12(10):1201. doi: 10.3390/v12101201.
Brazil is one of the countries which has been most affected by dengue epidemics. This scenario became more challenging with the emergence of Zika virus after 2014. The cocirculation of dengue and Zika viruses makes their diagnosis and treatment a challenge for health professionals, especially due to their similar clinical outcomes. From 2015 to 2019, we followed a cohort of 2017 participants in Goiania, Goias, Central Brazil. Febrile cases were monitored weekly, and after identification of fever, the physician performed a home visit for clinical evaluation and collection of blood/urine for diagnosis of acute dengue/Zika infection in suspected cases. Dengue acute infection was investigated by NS1 antigen and real time RT-PCR and seroconversion of anti-dengue IgM. ZIKV infection was confirmed by real time RT-PCR. Six cases of Zika/dengue coinfection among participants were reported. The clinical outcomes were suggestive for both DENV and ZIKV infection. No coinfected patient had neurological clinical manifestation, warning signs or need for hospitalization. A continuous specific laboratory confirmation for both dengue and Zika viruses should be enforced as part of the surveillance systems even in the presence of very suggestive cases of dengue fever, minimizing the risk of a late detection of ZIKV circulation.
巴西是受登革热疫情影响最严重的国家之一。自 2014 年寨卡病毒出现以来，这种情况变得更加严峻。登革热和寨卡病毒的共同流行使得卫生专业人员在诊断和治疗方面面临挑战，尤其是因为它们具有相似的临床结果。2015 年至 2019 年，我们对巴西中南部戈亚尼亚的 2017 名参与者进行了一项队列研究。每周监测发热病例，在发现发热后，医生会进行家访进行临床评估，并采集血液/尿液样本，以对疑似病例进行急性登革热/寨卡感染的诊断。通过 NS1 抗原和实时 RT-PCR 检测登革热急性感染，并通过血清转换检测抗登革热 IgM 进行诊断。通过实时 RT-PCR 检测寨卡病毒感染。报告了 6 例参与者中的寨卡/登革热合并感染。临床结果提示同时存在 DENV 和 ZIKV 感染。没有合并感染的患者出现神经临床症状、警告症状或需要住院治疗。即使在非常疑似登革热的情况下，也应加强对登革热和寨卡病毒的持续特异性实验室确认，以作为监测系统的一部分，从而最大限度地降低寨卡病毒传播的漏检风险。
