Epidemiological, virological and clinical characterization of a Dengue/Zika outbreak in the Caribbean region of Costa Rica 2017–2018
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| المؤلفون: | , , , , , , , |
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| التنسيق: | artículo original |
| تاريخ النشر: | 2024 |
| الوصف: | The increase in incidence and geographical expansion of viruses transmitted bythe Aedes mosquitoes, such as dengue (DENV) and zika (ZIKV) in the Americas,represents a burden for healthcare systems in tropical and subtropical regions.These and other under-detected arboviruses co-circulate in Costa Rica, addingadditional complexity to their management due to their shared epidemiologicalbehavior and similarity of symptoms in early stages. Since diagnostics of febrileillness is mostly based on clinical symptoms alone, we gathered acute-phaseserum and urine from 399 samples of acute dengue-like cases from twohealthcare facilities of Costa Rica, during an outbreak of arboviruses from July2017 to May 2018, and tested them using molecular and serological methods.The analyses showed that of the clinically presumptive arbovirus cases that werereported, only 39.4% (n=153) of the samples were confirmed positive by RT-PCRto be DENV (DENV (10.3%), CHIKV (0.2%), ZIKV (27.3%), or mixed infections (1.5%).RT-PCR for other alphaviruses and flaviviruses, and PCR for Leptospira sp werenegative. Furthermore, to assess flavivirus positivity in post-acute patients, thenegative sera were tested against Dengue-IgM. 20% of sera were found positive,confounding even more the definitive number of cases, and emphasizing theneed of several distinct diagnostic tools for accurate diagnostics. Molecularcharacterization of the prM and E genes from isolated viruses revealed that theAmerican/Asian genotype of DENV-2 and the Asian lineage of ZIKV werecirculating during this outbreak. Two different clades of DENV-2 American/Asian genotype were identified to co-circulate in the same region and adifference in the platelet and leukocyte count was noted between peopleinfected with each clade, suggesting a putative distinct virulence. Our studysheds light on the necessity for healthcare strategies in managing arbovirusoutbreaks, emphasizing the importance of comprehensive molecular andserological diagnostic approaches, as well as molecular characterization. Thisapproach aids in enhancing our understanding of the clinical andepidemiological aspects of arboviral diseases during outbreaks. Our researchhighlights the need to strengthen training programs for health professionals andthe need to increase research-based on laboratory evidence for diagnosticaccuracy, guidance, development and implementation of public healthinterventions and epidemiological surveillance. |
| البلد: | Kérwá |
| المؤسسة: | Universidad de Costa Rica |
| Repositorio: | Kérwá |
| اللغة: | Inglés |
| OAI Identifier: | oai:kerwa.ucr.ac.cr:10669/104293 |
| الوصول للمادة أونلاين: | https://hdl.handle.net/10669/104293 https://doi.org/10.3389/fcimb.2024.1421744 |
| كلمة مفتاحية: | Dengue Costa Rica Outbreak Zika arboviruses chikungunya RT-qPCR phylogenetics |