Awal Sampreet Kaur, Swu Anato K
Department of Microbiology, Manipal Tata Medical College, Manipal Academy of Higher Education, Manipal, India.
Consultant Microbiologist & Head of Laboratory Services Putuonuo Hospital, Kohima, Nagaland, India.
Braz J Microbiol. 2024 Dec;55(4):3711-3719. doi: 10.1007/s42770-024-01493-w. Epub 2024 Aug 26.
The co-circulation of Chikungunya virus (CHIKV) and Dengue virus (DENV) in India poses a challenge for the diagnosing clinician, as they share similar clinical signs and symptoms and geographical distribution. Both arthropod-borne viruses are maintained in the environment by the Aedes mosquito, commonly found in tropical countries including India. Here we aim to investigate the clinical and laboratory aspects of Chikungunya/Dengue suspected cases in Punjab, India during 2021-2022, focusing on the differential diagnosis of Dengue.
All suspected cases were submitted to serological differential diagnosis approaches to arboviruses like Chikungunya and Dengue. For the detection of Chikungunya Infection, CHIK IgM Capture ELISA was employed. Whereas, for Dengue NS1 antigen ELISA and IgM Capture ELISA assays were employed.
A total of 370 cases suspected of arboviral infection were investigated and 38.3% (142/370) were confirmed as Chikungunya. Chikungunya cases were slightly more prevalent in males (54%) and the most frequently affected age group was adults between 16 and 30 years old (45.7%). Polyarthralgia affected 79.5% of patients, 63.3% exhibited headache and 50% presented with retro-orbital pain. 28.9% (107/370) had serological evidence of DENV exposure by detection of specific anti-DENV IgM or NS1 and 9.1% (34/370) cases of co-detection of Chikungunya and Dengue were reported. Urban populations had a higher infection rate of co-detection of Chikungunya and Dengue than rural populations with 83% versus 17%, respectively.
Despite an initial clinical diagnosis of Dengue, most patients with fever and arthralgia were serologically confirmed as Chikungunya cases, with a notable prevalence of CHIKV/DENV co-detection. Strengthening differential diagnosis of circulating arboviruses is crucial for improving patient care and enhancing vector control and environmental management strategies.
基孔肯雅病毒（CHIKV）和登革病毒（DENV）在印度共同传播，这给临床诊断医生带来了挑战，因为它们具有相似的临床症状和地理分布。这两种节肢动物传播病毒都通过埃及伊蚊在环境中传播，埃及伊蚊在包括印度在内的热带国家很常见。在此，我们旨在调查2021 - 2022年印度旁遮普邦基孔肯雅热/登革热疑似病例的临床和实验室情况，重点关注登革热的鉴别诊断。
所有疑似病例均采用针对基孔肯雅热和登革热等虫媒病毒的血清学鉴别诊断方法。对于基孔肯雅热感染的检测，采用CHIK IgM捕获ELISA法。而对于登革热，采用NS1抗原ELISA法和IgM捕获ELISA法。
共调查了370例疑似虫媒病毒感染病例，其中38.3%（142/370）被确诊为基孔肯雅热。基孔肯雅热病例在男性中略为普遍（54%），最常受影响的年龄组是16至30岁的成年人（45.7%）。多关节痛影响了79.5%的患者，63.3%出现头痛，5憨%出现眶后疼痛。通过检测特异性抗登革病毒IgM或NS1，28.9%（107/370）有登革病毒暴露的血清学证据，报告了9.1%（憨4/370）的基孔肯雅热和登革热共同检测病例。城市人口中基孔肯雅热和登革热共同检测的感染率高于农村人口，分别为83%和17%。
尽管最初临床诊断为登革热，但大多数发热和关节痛患者血清学确诊为基孔肯雅热病例，基孔肯雅病毒/登革病毒共同检测的患病率显著。加强对传播中的虫媒病毒的鉴别诊断对于改善患者护理以及加强病媒控制和环境管理策略至关重要。
