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Farias PCS, Pastor AF, Gonçales JP, do Nascimento IDS, de Souza Ferraz ES, Lopes TRR, do Carmo RF, Côelho MRCD, Silva Júnior JVJ. Epidemiological profile of arboviruses in two different scenarios: dengue circulation vs. dengue, chikungunya and Zika co-circulation. BMC Infect Dis 2023; 23:177. [PMID: 36949383 PMCID: PMC10035144 DOI: 10.1186/s12879-023-08139-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 03/06/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND The severity and distribution of dengue virus (DENV) infections have been attributed to a complex interaction among viral, host and environmental factors. Herein, we investigated the influence of chikungunya (CHIKV) and Zika (ZIKV) viruses on the epidemiological profile of dengue cases, using Recife, Pernambuco state, Brazil, as a study model. In addition, we described and compared the epidemiological profile related to each arbovirus (DENV vs. CHIKV vs. ZIKV). METHODS All cases of dengue, chikungunya and Zika reported to the Pernambuco Health Department in 2011-2013 (DENV circulation) and 2016-2018 (DENV, CHIKV and ZIKV co-circulation) were included in our study. The cases were classified by sex, age and race/color and their distribution was analyzed by the χ2 test. Furthermore, the data were also analyzed for co-infections. Temperature, humidity and rainfall data were analyzed using one-way ANOVA and paired t-test. RESULTS During 2011-2013, 15,315 dengue cases were diagnosed, most of them female, brown and 20-29 age group. Between 2016 and 2018, 15,870 dengue cases were described, which presented the same profile described above. In the two triennia, the female/male dengue ratio fluctuated significantly, ranging from 1.07 to 1.52. Regarding chikungunya, 7076 cases were reported, most of them female and brown. The female/male ratio also fluctuated significantly, ranging from 1.62 to 2.1. Two main age groups were observed in chikungunya: ≤ 19 years (minority of diagnoses) and ≥ 20 years (majority of diagnoses). In the same triennium, 266 Zika cases were reported to the Pernambuco Health Department, mainly in females and in the 0-9 and 20-39 age groups. In general, 119 co-infections were identified: 117 DENV-CHIKV, 1 CHIKV-ZIKV and 1 DENV-CHIKV-ZIKV. Concerning climate data, only the humidity in 2011 was significantly different from the other years. CONCLUSION The epidemiological profile of dengue cases did not change after the introduction of CHIKV and ZIKV. Females were the most diagnosed with dengue, chikungunya or Zika, however we found important differences in the age profile of these arboviruses, which should be considered by public health policies, as well as investigated in future studies of virus-host interaction.
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Affiliation(s)
| | - André Filipe Pastor
- Federal Institute of Education, Science and Technology of Sertão Pernambucano, Floresta, Pernambuco, Brazil
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Juliana Prado Gonçales
- Virology Sector, Keizo Asami Institute, Federal University of Pernambuco, Recife, Pernambuco, Brazil
- SER Educational Group, Recife, Pernambuco, Brazil
| | | | | | - Thaísa Regina Rocha Lopes
- Virology Sector, Department of Preventive Veterinary Medicine, Federal University of Santa Maria, Av. Roraima, Camobi, Santa Maria, Rio Grande do Sul, 97105-900, Brazil
| | - Rodrigo Feliciano do Carmo
- Collegiate of Pharmaceutical Sciences, Federal University of Vale do São Francisco, Petrolina, Pernambuco, Brazil
| | | | - José Valter Joaquim Silva Júnior
- Virology Sector, Keizo Asami Institute, Federal University of Pernambuco, Recife, Pernambuco, Brazil.
- Virology Sector, Department of Preventive Veterinary Medicine, Federal University of Santa Maria, Av. Roraima, Camobi, Santa Maria, Rio Grande do Sul, 97105-900, Brazil.
- Department of Clinical Analysis, Health Sciences Center, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil.
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Santos LL, de Aquino EC, Fernandes SM, Ternes YMF, Feres VCDR. Dengue, chikungunya, and Zika virus infections in Latin America and the Caribbean: a systematic review. Rev Panam Salud Publica 2023; 47:e34. [PMID: 36788963 PMCID: PMC9910557 DOI: 10.26633/rpsp.2023.34] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 11/03/2022] [Indexed: 02/11/2023] Open
Abstract
Objectives To characterize the distribution profile of dengue, chikungunya, and Zika virus infections in Latin America and the Caribbean and to identify possible factors associated with the risk of dissemination and severity of these arboviruses. Methods The protocol of this review was registered on the PROSPERO platform. Searches were carried out in the following databases: Virtual Health Library, MEDLINE/PubMed, and Embase. The search terms were: Zika virus, Zika virus infection, dengue, dengue virus, chikungunya virus, chikungunya fever, epidemiology, observational study, Latin America, and Caribbean region. Studies that addressed the distribution of these arboviruses and the risk factors associated with dengue, Zika virus disease, and chikungunya, published between January 2000 and August 2020 in English, Portuguese, and Spanish, were included. Results Of 95 studies included, 70 identified risk factors, clinical manifestations, and outcomes for arbovirus infections and 25 described complications and/or deaths. The highest frequency of confirmed cases was for dengue. Brazil reported most cases of the three arboviruses in the period analyzed. Environmental and socioeconomic factors facilitated the proliferation and adaptation of vectors, and host-related factors were reported to aggravate dengue. Most deaths were due to chikungunya, Zika virus disease caused most neurological alterations, and dengue resulted in greater morbidity leading to more frequent hospitalization. Conclusions The review provides a broad view of the three arboviruses and the intrinsic aspects of infections, and highlights the factors that influence the spread of these viruses in the populations studied.
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Affiliation(s)
- Letícia L.M. Santos
- Molecular Biology Laboratory and Technologies Applied to Laboratory DiagnosisFaculty of PharmacyFederal University of GoiasGoiâniaBrazilMolecular Biology Laboratory and Technologies Applied to Laboratory Diagnosis, Faculty of Pharmacy, Federal University of Goias, Goiânia, Brazil.
| | - Erika Carvalho de Aquino
- Public Health DepartmentInstitute of Tropical Pathology and Public HealthFederal University of GoiasGoiâniaBrazilPublic Health Department, Institute of Tropical Pathology and Public Health, Federal University of Goias, Goiânia, Brazil.
| | - Suleimy Marinho Fernandes
- Laboratory of Virology and Cell CultureInstitute of Tropical Pathology and Public HealthFederal University of GoiasGoiâniaBrazilLaboratory of Virology and Cell Culture, Institute of Tropical Pathology and Public Health, Federal University of Goias, Goiânia, Brazil.
| | - Yves Mauro F. Ternes
- Public Health DepartmentInstitute of Tropical Pathology and Public HealthFederal University of GoiasGoiâniaBrazilPublic Health Department, Institute of Tropical Pathology and Public Health, Federal University of Goias, Goiânia, Brazil.
| | - Valéria C. de R. Feres
- Molecular Biology Laboratory and Technologies Applied to Laboratory DiagnosisFaculty of PharmacyFederal University of GoiasGoiâniaBrazilMolecular Biology Laboratory and Technologies Applied to Laboratory Diagnosis, Faculty of Pharmacy, Federal University of Goias, Goiânia, Brazil.
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Lying in wait: the resurgence of dengue virus after the Zika epidemic in Brazil. Nat Commun 2021; 12:2619. [PMID: 33976183 PMCID: PMC8113494 DOI: 10.1038/s41467-021-22921-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 04/07/2021] [Indexed: 12/19/2022] Open
Abstract
After the Zika virus (ZIKV) epidemic in the Americas in 2016, both Zika and dengue incidence declined to record lows in many countries in 2017–2018, but in 2019 dengue resurged in Brazil, causing ~2.1 million cases. In this study we use epidemiological, climatological and genomic data to investigate dengue dynamics in recent years in Brazil. First, we estimate dengue virus force of infection (FOI) and model mosquito-borne transmission suitability since the early 2000s. Our estimates reveal that DENV transmission was low in 2017–2018, despite conditions being suitable for viral spread. Our study also shows a marked decline in dengue susceptibility between 2002 and 2019, which could explain the synchronous decline of dengue in the country, partially as a result of protective immunity from prior ZIKV and/or DENV infections. Furthermore, we performed phylogeographic analyses using 69 newly sequenced genomes of dengue virus serotype 1 and 2 from Brazil, and found that the outbreaks in 2018–2019 were caused by local DENV lineages that persisted for 5–10 years, circulating cryptically before and after the Zika epidemic. We hypothesize that DENV lineages may circulate at low transmission levels for many years, until local conditions are suitable for higher transmission, when they cause major outbreaks. Zika and dengue incidence in the Americas declined in 2017–2018, but dengue resurged in 2019 in Brazil. This study uses epidemiological, climatological and genomic data to show that the decline of dengue may be explained by protective immunity from pre-exposure to ZIKV and/or DENV in prior years.
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