title: High rates of co-infection of Dengue and Chikungunya virus in Odisha and Maharashtra, India during 2013.
abstract: Dengue viral (DENV) infection is endemic in different parts of India and because of similar primary signs and symptoms, Chikungunya virus (CHIKV) is mostly undiagnosed. Hence, we investigated 204 suspected Dengue cases in a hospital based cross-sectional study in Odisha, India in 2013. It was observed that 50 samples were positive for DENV only, 28 were positive for CHIKV only and interestingly, 28 patients were co-infected with both DENV and CHIKV. Additionally, a total of 18 confirmed Dengue samples from Maharashtra, India were screened for CHIKV and out of those, 15 were co-infected. All CHIKV strains were of East Central South African (ECSA) type and serotype 2 (genotype IV) was predominant in the DENV samples. Additionally, Dengue serotype 1 and 3 were also detected during this time. Further, sequence analysis of E1 gene of CHIKV strains revealed that two substitution mutations (M269V and D284E) were observed in almost 50% strains and they were from co-infected patients. Similarly, sequence analysis of C-prM gene showed the presence of five substitution mutations, (G70S, L72F, N90S, S93N and I150L) in all serotype 1 and two consistent mutations (A101V and V112A) in serotype 2 Dengue samples. Together, it appears that a significantly high number of dengue patients (43, 44.8%) were co-infected with DENV and CHIKV during this study. This emphasizes the need of a routine diagnosis of CHIKV along with DENV for febrile patients. This will be useful in early and proper recognition of infecting pathogen to study the correlation of clinical symptoms with single or co-infection which will ultimately help to implement proper patient care in future.
authors.affiliation: Infectious Disease Biology, Institute of Life Sciences, Nalco Square, Bhubaneswar 751 023, Odisha, India.
authors.forename: Tanuja
authors.initials: T
authors.lastname: Saswat
authors.affiliation: Infectious Disease Biology, Institute of Life Sciences, Nalco Square, Bhubaneswar 751 023, Odisha, India.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Kumar
authors.affiliation: Infectious Disease Biology, Institute of Life Sciences, Nalco Square, Bhubaneswar 751 023, Odisha, India.
authors.forename: Sameer
authors.initials: S
authors.lastname: Kumar
authors.affiliation: Infectious Disease Biology, Institute of Life Sciences, Nalco Square, Bhubaneswar 751 023, Odisha, India.
authors.forename: Prabhudutta
authors.initials: P
authors.lastname: Mamidi
authors.affiliation: Infectious Disease Biology, Institute of Life Sciences, Nalco Square, Bhubaneswar 751 023, Odisha, India.
authors.forename: Sagarika
authors.initials: S
authors.lastname: Muduli
authors.affiliation: Department of Microbiology, IMS & Sum Hospital, Kalinga Nagar, Bhubaneswar 751003, Odisha, India.
authors.forename: Nagen Kumar
authors.initials: NK
authors.lastname: Debata
authors.affiliation: Department of Pathology, Mahatma Gandhi Mission Medical College, Aurangabad 431003, Maharashtra, India.
authors.forename: Niladri Shekhar
authors.initials: NS
authors.lastname: Pal
authors.affiliation: School of Biological Sciences, National Institute of Science Education & Research, Bhubaneswar 751005, Odisha, India.
authors.forename: B M
authors.initials: BM
authors.lastname: Pratheek
authors.affiliation: School of Biological Sciences, National Institute of Science Education & Research, Bhubaneswar 751005, Odisha, India.
authors.forename: Subhasis
authors.initials: S
authors.lastname: Chattopadhyay
authors.affiliation: Infectious Disease Biology, Institute of Life Sciences, Nalco Square, Bhubaneswar 751 023, Odisha, India. Electronic address: sochat.ils@gmail.com.
authors.forename: Soma
authors.initials: S
authors.lastname: Chattopadhyay
mesh_terms: D000293:Adolescent; D000328:Adult; D065632:Chikungunya Fever / Q000453:epidemiology* / Q000821:virology; D002646:Chikungunya virus / Q000145:classification* / Q000235:genetics; D060085:Coinfection / Q000453:epidemiology* / Q000821:virology; D003430:Cross-Sectional Studies; D003715:Dengue / Q000453:epidemiology* / Q000821:virology; D003716:Dengue Virus / Q000145:classification* / Q000235:genetics; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009154:Mutation; D010802:Phylogeny; D058974:Phylogeography; D017423:Sequence Analysis, RNA; D014764:Viral Proteins / Q000235:genetics; D055815:Young Adult
chemical_list: D014764:Viral Proteins
keywords: Alphavirus; Chikungunya virus; Co-infection; Dengue virus; Epidemiology; Flavivirus; Outbreak