ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2019
Concomitant Transmission of Dengue, Chikungunya, and Zika Viruses in Brazil: Clinical and Epidemiological Findings From Surveillance for Acute Febrile Illness.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 85 papers, 4 of them syntheses that pooled it.
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Who cites it
85 citing papers in PubMed, 4 syntheses or guidelines pooled it, 136 citations in OpenAlex.
- Diagnostic accuracy of recombinase polymerase amplification-based assays for mosquito-borne virus detection in clinical samples: a systematic review and meta-analysis.Frontiers in cellular and infection microbiology · 2026Pooled it
- Clinical outcomes of chikungunya across age groups: A systematic review.PLoS neglected tropical diseases · 2025Pooled it
- Co-circulating pathogens of humans: a systematic review of mechanistic transmission models.Proceedings. Biological sciences · 2025Pooled it
- Clinical manifestations and health outcomes associated with Zika virus infections in adults: A systematic review.PLoS neglected tropical diseases · 2021Pooled it
- Cell type-dependent induction of type I interferon and PARP1 activation in astrocytes and neurons during chikungunya virus infection.Microbiology spectrum · 2026Article
- Identifying populations with high prevalence of non-malarial febrile illnesses across different demographic groups in Malawi.Malaria journal · 2026Article
- Co-circulation of multiple arboviruses in acute febrile patients in Yunnan, China, identified by metagenomic sequencing.Journal of clinical microbiology · 2026Article
- Factors Associated with the Odds, Duration, and Costs of Health-Related Absenteeism: A Population-Based Study in São Paulo City, Brazil.Healthcare (Basel, Switzerland) · 2026Article
- Article
- Mathematical modeling and analysis of the Dengue and Chikungunya co-infection.Scientific reports · 2026Article
- Performance of Three Commercial Rapid Diagnostic Tests for Detection of IgM and IgG Antibodies Against SARS-CoV-2.Immunity, inflammation and disease · 2026Article
- Overview of Chikungunya Virus Pathogenesis, Genome Variation, Epidemiology, and Control.Virus research · 2026Review
- A Global Perspective on the Emerging Threat of Zika and Dengue Co-infection.PLoS neglected tropical diseases · 2026Article
- Reverse vaccinology-based design of a universal multiepitope vaccine against chikungunya virus: Phylogenetic and immunoinformatics approaches.Scientific reports · 2026Article
- Proof-of-Concept Machine Learning Framework for Arboviral Disease Classification Using Literature-Derived Synthetic Data: Methodological Development Preceding Clinical Validation.Healthcare (Basel, Switzerland) · 2026Article
- Chikungunya in 2025: Comprehensive Insights into Virology, Diagnostics, Vaccines, and Antiviral Therapies.Viruses · 2026Review
- Acute Adult-Onset Still Disease Presenting as Fever of Unknown Origin and Severe Myalgia in a Resource-Limited Tertiary Hospital in Brazil.Case reports in medicine · 2026Article
- Unraveling chikungunya's viral tapestry through molecular mechanisms and clinical insights.Infectious diseases & immunity · 2026Review
- Eco-epidemiology of arbovirus infections among non-human primates in Southeastern Brazil.PLoS neglected tropical diseases · 2025Article
- Mathematical modeling of dengue virus transmission: exploring vector, vertical, and sexual pathways with sensitivity and bifurcation analysis.BMC infectious diseases · 2025Article
25 more citing papers are in PubMed but not listed here.
Corrections and comments
Authors and funding
15 authors at 5 institutions in 3 countries.
Funding
Abstract
backgroundSince their emergence in the Americas, chikungunya (CHIKV) and Zika (ZIKV) viruses co-circulate with dengue virus (DENV), hampering clinical diagnosis. We investigated clinical and epidemiological characteristics of arboviral infections during the introduction and spread of CHIKV and ZIKV through northeastern Brazil.
methodsSurveillance for arboviral diseases among febrile patients was performed at an emergency health unit of Salvador, Brazil, between September 2014 and July 2016. We interviewed patients to collect data on symptoms, reviewed medical records to obtain the presumptive diagnoses, and performed molecular and serological testing to confirm DENV, CHIKV, ZIKV, or nonspecific flavivirus (FLAV) diagnosis.
resultsOf 948 participants, 247 (26.1%) had an acute infection, of which 224 (23.6%) were single infections (DENV, 32 [3.4%]; CHIKV, 159 [16.7%]; ZIKV, 13 [1.4%]; and FLAV, 20 [2.1%]) and 23 (2.4%) coinfections (DENV/CHIKV, 13 [1.4%]; CHIKV/FLAV, 9 [0.9%]; and DENV/ZIKV, 1 [0.1%]). An additional 133 (14.0%) patients had serological evidence for a recent arboviral infection. Patients with ZIKV presented with rash and pruritus (69.2% each) more frequently than those with DENV (37.5% and 31.2%, respectively) and CHIKV (22.9% and 14.7%, respectively) (P < .001 for both comparisons). Conversely, arthralgia was more common in CHIKV (94.9%) and FLAV/CHIKV (100.0%) than in DENV (59.4%) and ZIKV (53.8%) (P < .001). A correct presumptive clinical diagnosis was made for 9%-23% of the confirmed patients.
conclusionsArboviral infections are frequent causes of febrile illness. Coinfections are not rare events during periods of intense, concomitant arboviral transmission. Given the challenge to clinically distinguish these infections, there is an urgent need for rapid, point-of-care, multiplex diagnostics.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.