RESUMEN
Occurrence of Chagas disease and arbovirus coinfections is unknown, despite the vast co-endemic areas throughout the Americas. This study examined the proportion of individuals positive for Trypanosoma cruzi and coinfections with dengue, chikungunya, and Zika viruses in Machala, Ecuador (January 2014-December 2015). Chagas seropositivity was evaluated with five commercially available assays. Dengue infections were identified by nonstructural protein 1 rapid test and enzyme linked immunosorbent assay (ELISA), immunoglobulin M ELISA, and reverse transcription PCR (RT-PCR); chikungunya and Zika infections were identified by RT-PCR. Of 658 individuals, six were positive for T. cruzi (0.91%), including one T. cruzi/dengue coinfection and one T. cruzi/chikungunya/dengue coinfection. The clinical manifestations of coinfected individuals corresponded to severe dengue and dengue with warning signs, respectively. We observed discrepant results by using the Hemagen Chagas kit and the rapid test Chagas Detect Plus (false positives: 3.9% and 15.4%), highlighting the need to assess diagnostic assays in geographic regions with distinct taxonomic units of T. cruzi.
Asunto(s)
Antígenos Virales/sangre , Enfermedad de Chagas/epidemiología , Fiebre Chikungunya/epidemiología , Dengue/epidemiología , ARN Viral/sangre , Infección por el Virus Zika/epidemiología , Adulto , Anciano , Enfermedad de Chagas/diagnóstico , Enfermedad de Chagas/parasitología , Fiebre Chikungunya/diagnóstico , Fiebre Chikungunya/parasitología , Virus Chikungunya/genética , Virus Chikungunya/inmunología , Virus Chikungunya/aislamiento & purificación , Coinfección , Dengue/diagnóstico , Dengue/parasitología , Virus del Dengue/genética , Virus del Dengue/inmunología , Virus del Dengue/aislamiento & purificación , Ecuador/epidemiología , Ensayo de Inmunoadsorción Enzimática/normas , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa/normas , Trypanosoma cruzi/inmunología , Trypanosoma cruzi/aislamiento & purificación , Virus Zika/genética , Virus Zika/inmunología , Virus Zika/aislamiento & purificación , Infección por el Virus Zika/diagnóstico , Infección por el Virus Zika/parasitologíaRESUMEN
Arboviral diseases have risen significantly over the last 40 years, increasing the risk of co-infection with other endemic disease such as malaria. However, nothing is known about the impact arboviruses have on the host response toward heterologous pathogens during co-infection. Here, we investigate the effects of Chikungunya virus (CHIKV) co-infection on the susceptibility and severity of malaria infection. Using the Plasmodium berghei ANKA (PbA) experimental cerebral malaria (ECM) model, we show that concurrent co-infection induced the most prominent changes in ECM manifestation. Concurrent co-infection protected mice from ECM mortality without affecting parasite development in the blood. This protection was mediated by the alteration of parasite-specific CD8+ T-cell trafficking through an IFNγ-mediated mechanism. Co-infection with CHIKV induced higher splenic IFNγ levels that lead to high local levels of CXCL9 and CXCL10. This induced retention of CXCR3-expressing pathogenic CD8+ T cells in the spleen and prevented their migration to the brain. This then averts all downstream pathogenic events such as parasite sequestration in the brain and disruption of blood-brain barrier that prevents ECM-induced mortality in co-infected mice.
Asunto(s)
Encéfalo/patología , Linfocitos T CD8-positivos/patología , Fiebre Chikungunya/patología , Virus Chikungunya/fisiología , Coinfección/patología , Malaria Cerebral/patología , Plasmodium berghei/fisiología , Animales , Encéfalo/parasitología , Encéfalo/virología , Linfocitos T CD8-positivos/parasitología , Linfocitos T CD8-positivos/virología , Movimiento Celular , Fiebre Chikungunya/parasitología , Fiebre Chikungunya/virología , Coinfección/parasitología , Coinfección/virología , Femenino , Malaria Cerebral/parasitología , Malaria Cerebral/virología , Masculino , Ratones , Ratones Endogámicos C57BL , Neuropatología , Factores ProtectoresRESUMEN
Background: Although Chikungunya virus has rapidly expanded to several countries in sub-Saharan Africa, little attention has been paid to its control and management. Until recently, Chikungunya has been regarded as a benign and self-limiting disease. In this report we describe the first case of severe Chikungunya disease in an adult patient in Pemba, Mozambique. Case presentation: A previously healthy 40 year old male of Makonde ethnicity with no known past medical history and resident in Pemba for the past 11 years presented with a severe febrile illness. Despite administration of broad spectrum intravenous antibiotics the patient rapidly deteriorated and became comatose while developing anaemia, thrombocytopenia and later, melaena. Laboratory testing revealed IgM antibodies against Chikungunya virus. Malaria tests were consistently negative. Conclusions: This report suggests that Chikungunya might cause unsuspected severe disease in febrile patients in Mozambique and provides insights for the improvement of national protocols for management of febrile patients in Mozambique. We recommend that clinicians should consider Chikungunya in the differential diagnosis of febrile illness in locations where Aedes aegypti mosquitos are abundant...
Asunto(s)
Animales , Adolescente , Índice de Severidad de la Enfermedad , Melena/diagnóstico , Fiebre/diagnóstico , Fiebre Chikungunya/diagnóstico , Leucocitosis/diagnóstico , Antibacterianos , Inmunoglobulina M/sangre , Melena/patología , Melena/terapia , Melena/virología , Fiebre/parasitología , Fiebre/terapia , Fiebre/virología , Fiebre Chikungunya , Fiebre Chikungunya/parasitología , Fiebre Chikungunya/terapia , Fiebre Chikungunya/virología , Leucocitosis/terapia , Leucocitosis/virología , MozambiqueRESUMEN
The Asian tiger mosquito Aedes albopictus (Skuse), is one of the most invasive mosquito species worldwide. In Mexico it is now recorded in 12 states and represents a serious public health problem, given the recent introduction of Chikungunya on the southern border. The aim of this study was to analyze the population genetics of A. albopictus from all major recorded foci, and model its ecological niche. Niche similarity with that from its autochthonous distribution in Asia and other invaded countries were analyzed and its potential future expansion and potential human exposure in climate change scenarios measured. We analyzed 125 sequences of a 317 bp fragment of the cyt b gene from seven A. albopictus populations across Mexico. The samples belong to 25 haplotypes with moderate population structuring (Fst=0.081, p<0.02) and population expansion. The most prevalent haplotype, found in all principal sites, was shared with the USA, Brazil, France, Madagascar, and Reunion Island. The ecological niche model using Mexican occurrence records covers 79.7% of the country, and has an 83% overlap with the Asian niche projected to Mexico. Both Neotropical and Nearctic regions are included in the Mexican niche model. Currently in Mexico, 38.6 million inhabitants are exposed to A. albopictus, which is expected to increase to 45.6 million by 2070. Genetic evidence supports collection information that A. albopictus was introduced to Mexico principally by land from the USA and Central and South America. Prevalent haplotypes from Mexico are shared with most invasive regions across the world, just as there was high niche similarity with both natural and invaded regions. The important overlap with the Asian niche model suggests a high potential for the species to disperse to sylvatic regions in Mexico.