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Viremia and Clinical Presentation in Nicaraguan Patients Infected With Zika Virus, Chikungunya Virus, and Dengue Virus.

Title: Viremia and Clinical Presentation in Nicaraguan Patients Infected With Zika Virus, Chikungunya Virus, and Dengue Virus.
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Name(s): Waggoner, Jesse J, author
Gresh, Lionel, author
Vargas, Maria Jose, author
Ballesteros, Gabriela, author
Tellez, Yolanda, author
Soda, K James, author
Sahoo, Malaya K, author
Nuñez, Andrea, author
Balmaseda, Angel, author
Harris, Eva, author
Pinsky, Benjamin A, author
Type of Resource: text
Genre: Journal Article
Text
Date Issued: 2016-12-15
Physical Form: computer
online resource
Extent: 1 online resource
Language(s): English
Abstract/Description:  Zika virus (ZIKV), chikungunya virus (CHIKV), and dengue virus (DENV) cocirculate in Nicaragua. In this study, we sought to compare the quantified viremia and clinical presentation of patients infected with 1 or more of these viruses.  Acute-phase serum samples from 346 patients with a suspected arboviral illness were tested using a multiplex real-time reverse-transcription polymerase chain reaction for ZIKV, CHIKV, and DENV. Viremia was quantitated for each detected virus, and clinical information from request forms submitted with each sample was recorded.  A total of 263 patients tested positive for 1 or more viruses: 192 patients tested positive for a single virus (monoinfections) and 71 patients tested positive for 2 or all 3 viruses (coinfections). Quantifiable viremia was lower in ZIKV infections compared with CHIKV or DENV (mean 4.70 vs 6.42 and 5.84 log copies/mL serum, respectively; P < .001 for both comparisons), and for each virus, mean viremia was significantly lower in coinfections than in monoinfections. Compared with patients with CHIKV or DENV, ZIKV patients were more likely to have a rash (P < .001) and less likely to be febrile (P < .05) or require hospitalization (P < .001). Among all patients, hospitalized cases had higher viremia than those who did not require hospitalization (7.1 vs 4.1 log10 copies/mL serum, respectively; P < .001).  ZIKV, CHIKV, and DENV result in similar clinical presentations, and coinfections may be relatively common. Our findings illustrate the need for accurate, multiplex diagnostics for patient care and epidemiologic surveillance.
Identifier: FSU_pmch_27578819 (IID), 10.1093/cid/ciw589 (DOI), PMC5146717 (PMCID), 27578819 (RID), 27578819 (EID), ciw589 (PII)
Keywords: Zika virus, Chikungunya virus, Coinfection, Dengue virus, Viremia
Grant Number: K08 AI110528, R01 AI099631, U54 AI065359
Publication Note: This NIH-funded author manuscript originally appeared in PubMed Central at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5146717.
Subject(s): Adult
Chikungunya Fever/complications
Chikungunya Fever/physiopathology
Chikungunya Fever/virology
Coinfection
Dengue/complications
Dengue/physiopathology
Dengue/virology
Female
Humans
Male
Nicaragua
Viremia/physiopathology
Viremia/virology
Young Adult
Zika Virus Infection/complications
Zika Virus Infection/physiopathology
Zika Virus Infection/virology
Persistent Link to This Record: http://purl.flvc.org/fsu/fd/FSU_pmch_27578819
Owner Institution: FSU
Is Part Of: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.
1537-6591
Issue: iss. 12, vol. 63

Choose the citation style.
Waggoner, J. J., Gresh, L., Vargas, M. J., Ballesteros, G., Tellez, Y., Soda, K. J., … Pinsky, B. A. (2016). Viremia and Clinical Presentation in Nicaraguan Patients Infected With Zika Virus, Chikungunya Virus, and Dengue Virus. Clinical Infectious Diseases : An Official Publication Of The Infectious Diseases Society Of America. Retrieved from http://purl.flvc.org/fsu/fd/FSU_pmch_27578819