Seroprevalance of dengue and chikungunya co infection and its clinical correlation in bangalore city hospitals

Introduction: Arthropod-borne viruses or arboviruses are one of the major public health problems worldwide. Out of many arboviruses, chikungunya virus (CHIKV) and dengue virus (DENV) are the two most rapidly spreading arboviruses. Serological investigations in Southern India indicate that the two viruses can co-exist in the same host. Many risk factors for chikungunya virus (CHIKV) and dengue virus (DENV) infections are the same or similar. OBJECTIVES: The present study is conducted to know the seroprevalance of dengue and chikungunya co infection and its clinical correlation. Materials and Methods: The blood samples collected from patients were sent along with details of the patient, clinical findings, and investigations done from various Bangalore city hospitals from the month of January 2013 to December2013, to check for the presence of IgM antibodies in serum against Dengue or Chikungunya were subjected to an enzyme-linked immunosorbent assay (ELISA) test to detect the presence of immunoglobulin M (IgM) antibodies against both CHIKV and DENV. Results: Out of 4296 serum samples studied 205 (7.6%) samples were positive for both Dengue and Chikungunya. Majority of the cases were from the age group of 11-20 years (31.21%). A seasonal peak was seen in the months of June to August. Of the total number of affected cases, 89(43.41%) were females and 116 (56.58%) were males. Fever and was seen in almost all the cases (99 %), thrombocytopenia in 92.17%, and myalgia in 56.1% of seropositive cases. Chills, headache, arthralgia, vomiting were observed in 60.48%, 48.8 %, 40.4% and 35.6% seropositive cases respectively. Features of dengue complications like hypotension, hypoalbuminemia, rising hematocrit and hemorrhagic manifestations were seen in 7.8%, 1.4%, 2.4% and 7.3% cases respectively. Conclusion: With the urbanization that is occurring in India, the incidence of dengue infection is increasing dramatically. With the expectation that cases of co infection with DENV and CHIKV will become more prevalent in the future due to increased transmission of both viruses in various areas of India, enhanced surveillance to clinically and diagnostically differentiate CHIKV and DENV infections is needed for early recognition of virus invasion and local transmission, better patient care, and timely control measures. With clinical examination of CHIKV/DENV coinfected patients has not yet allowed the identification of specific or severe symptoms, such observations should be interpreted with caution. Our findings may add to the recognition of CHIKV/DENV coinfections and suggest that tests to detect the presence of both viruses should be carried out in individuals showing clinical signs of an infection with either CHIKV or DENV.