A viral infection transmitted by mosquitoes could be misdiagnosed as dengue, British experts have warned.
This has implications for treatments and disease control, they warned.
New research by the London School of Hygiene & Tropical Medicine says that the symptoms for chikungunya are similar to the acute phase of dengue, which can make the diseases indistinguishable.
Because there is no specific antiviral drug treatment or vaccine, treatment is directed primarily at alleviating symptoms, so misdiagnosis could have an effect on how the symptoms of each disease are relieved.
In this study – the first systemic review of dengue-chikungunya co-infection – the study team created global maps that represent the geographical spread of both viruses, identifying their current geographical limits, as well as countries at risk of future infection.
They identified 154 countries that reported dengue and 99 countries that reported chikungunya. Out of 98 countries which reported both diseases, 13 recorded co-infections.
Writing in BMC Infectious Diseases, the team noted a rapid expansion in the global extent of chikungunya and found that co-infection persists in Africa and South-East Asia and spreads through international travel and transport of goods.
An investigation into the distribution of disease vectors found that the mosquito Aedes aegypti spreads both dengue and chikungunya and it is endemic to 174 countries.
They also found that Aedes albopictus, which also spreads both viruses, is adaptable to less extreme climates than Aedes aegypti, and is endemic to 88 countries. A total of 68 countries reported the presence of both species.
Laith Yakob, lecturer in disease vector biology and lead author of the study, said: “The vector species that spread these pathogens – and also the Zika virus – are the same, yet the number of countries that have reported dengue cases is considerably higher than countries that have reported chikungunya. Our study highlights that this may be an aberration caused by continuing and pervasive misdiagnosis of chikungunya as dengue.”
The findings demonstrate the urgent need for improved and inexpensive diagnostic tests, as well as effective control procedures, say the team.
However, more research is needed to determine if infection with one virus makes a host more or less susceptible to infection with the other, or if co-infection exacerbates disease symptoms, which could not be confirmed in this study.
Furuya-Kanamori L, Liang S, Milinovich G et al. Co-distribution and co-infection of chikungunya and dengue viruses. BMC Infectious Diseases 3 March 2016; DOI: 10.1186/s12879-016-1417-2 [abstract]
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