title: Co-distribution and co-infection of chikungunya and dengue viruses.
abstract: BACKGROUND
  Chikungunya and dengue infections are spatio-temporally related. The current review aims to determine the geographic limits of chikungunya, dengue and the principal mosquito vectors for both viruses and to synthesise current epidemiological understanding of their co-distribution.
  
  
  METHODS
  Three biomedical databases (PubMed, Scopus and Web of Science) were searched from their inception until May 2015 for studies that reported concurrent detection of chikungunya and dengue viruses in the same patient. Additionally, data from WHO, CDC and Healthmap alerts were extracted to create up-to-date global distribution maps for both dengue and chikungunya.
  
  
  RESULTS
  Evidence for chikungunya-dengue co-infection has been found in Angola, Gabon, India, Madagascar, Malaysia, Myanmar, Nigeria, Saint Martin, Singapore, Sri Lanka, Tanzania, Thailand and Yemen; these constitute only 13 out of the 98 countries/territories where both chikungunya and dengue epidemic/endemic transmission have been reported.
  
  
  CONCLUSIONS
  Understanding the true extent of chikungunya-dengue co-infection is hampered by current diagnosis largely based on their similar symptoms. Heightened awareness of chikungunya among the public and public health practitioners in the advent of the ongoing outbreak in the Americas can be expected to improve diagnostic rigour. Maps generated from the newly compiled lists of the geographic distribution of both pathogens and vectors represent the current geographical limits of chikungunya and dengue, as well as the countries/territories at risk of future incursion by both viruses. These describe regions of co-endemicity in which lab-based diagnosis of suspected cases is of higher priority.
authors.affiliation: Research School of Population Health, Australian National University, Acton, ACT 2601, Australia. luis.furuya-kanamori@anu.edu.au.
authors.forename: Luis
authors.initials: L
authors.lastname: Furuya-Kanamori
authors.affiliation: Environmental Health Institute, National Environment Agency, Singapore, 138667, Singapore. LIANG_Shaohong@nea.gov.sg.
authors.forename: Shaohong
authors.initials: S
authors.lastname: Liang
authors.affiliation: School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, QLD, 4059, Australia. g.milinovich@gmail.com.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Milinovich
authors.affiliation: School of Veterinary Science, University of Queensland, Gatton, QLD, 4343, Australia. r.magalhaes@uq.edu.au.|UQ Children's Health Research Centre, University of Queensland, South Brisbane, QLD, 4101, Australia. r.magalhaes@uq.edu.au.
authors.forename: Ricardo J
authors.initials: RJ
authors.lastname: Soares Magalhaes
authors.affiliation: Research School of Population Health, Australian National University, Acton, ACT 2601, Australia. director.rsph@anu.edu.au.
authors.forename: Archie C A
authors.initials: AC
authors.lastname: Clements
authors.affiliation: School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, QLD, 4059, Australia. w2.hu@qut.edu.au.
authors.forename: Wenbiao
authors.initials: W
authors.lastname: Hu
authors.affiliation: Instituto Nacional de Infectologia Evandro Chagas/ Fiocruz, Rio de Janeiro, Brazil. patricia.brasil@ini.fiocruz.br.
authors.forename: Patricia
authors.initials: P
authors.lastname: Brasil
authors.affiliation: School of Biomedical Sciences and Institute for Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD, 4059, Australia. francesca.frentiu@qut.edu.au.
authors.forename: Francesca D
authors.initials: FD
authors.lastname: Frentiu
authors.affiliation: Formerly School of Biomedical Sciences, University of Queensland, St Lucia, QLD, 4072, Australia. Rebecca_dunning@hotmail.com.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Dunning
authors.affiliation: Department of Disease Control, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK. Laith.Yakob@lshtm.ac.uk.
authors.forename: Laith
authors.initials: L
authors.lastname: Yakob
mesh_terms: D000349:Africa / Q000453:epidemiology; D001210:Asia, Southeastern / Q000453:epidemiology; D065632:Chikungunya Fever / Q000453:epidemiology*; D060085:Coinfection / Q000453:epidemiology*; D003715:Dengue / Q000453:epidemiology*; D014943:Global Health; D006801:Humans