Coinfection and circulation of chikungunya virus and dengue virus in pediatric patients in Myanmar, 2019

Mya Myat Ngwe Tun; Aung Kyaw Kyaw; Takeshi Nabeshima; Shyam Prakash Dumre; Aung Min Soe; Khine Mya Nwe; Su Su Myaing; Ei Phyu Lwin; Ye Thu Win; Shingo Inoue; Yuki Takamatsu; Takeshi Urano; Hlaing Myat Thu; Kyaw Zin Thant; Zaw Than Htun; Kouichi Morita

doi:10.1016/j.micinf.2023.105129

Coinfection and circulation of chikungunya virus and dengue virus in pediatric patients in Myanmar, 2019

Microbes Infect. 2023 Jul-Aug;25(6):105129. doi: 10.1016/j.micinf.2023.105129. Epub 2023 Apr 6.

Authors

Affiliations

¹ Department of Tropical Viral Vaccine Development, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Department of Virology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Center for Vaccines and Therapeutic Antibodies for Emerging Infectious Diseases, Shimane University, Izumo, Japan. Electronic address: myamyat@tm.nagasaki-u.ac.jp.
² Department of Medical Research, Ministry of Health, Myanmar.
³ Kenya Research Station, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan.
⁴ Central Department of Microbiology, Tribhuvan University, Katmandu, Nepal.
⁵ Department of Virology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan.
⁶ 550-bedded Children Hospital (Mandalay), Department of Medical Services, Ministry of Health, Myanmar.
⁷ Center for Vaccines and Therapeutic Antibodies for Emerging Infectious Diseases, Shimane University, Izumo, Japan.
⁸ Myanmar Academy of Medical Science, Yangon, Myanmar.
⁹ Department of Tropical Viral Vaccine Development, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Department of Virology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; DEJIMA Infectious Disease Research Alliance, Nagasaki University, Nagasaki, Japan.

PMID: 37030472
DOI: 10.1016/j.micinf.2023.105129

Abstract

Myanmar is an endemic country for arboviruses, and outbreaks occur frequently. A cross-sectional analytical study was conducted during the peak season of the chikungunya virus (CHIKV) outbreak in 2019. A total of 201 patients with acute febrile illness who were admitted to the 550-bedded Mandalay Children Hospital in Myanmar were enrolled in the study, and virus isolation, serological tests, and molecular tests for the dengue virus (DENV) and CHIKV were performed for all samples. Out of 201 patients, 71 (35.3%) were only DENV-infected, 30 (14.9%) were only CHIKV-infected and 59 (29.4%) were coinfected with DENV and CHIKV. The viremia levels of the DENV- and CHIKV- mono-infected groups were significantly higher than those of the group coinfected with DENV and CHIKV. Genotype I of DENV-1, genotypes I and III of DENV-3, genotype I of DENV-4 and the East/Central/South African genotype of CHIKV were co-circulating during the study period. Two novel epistatic mutations of CHIKV (E1:K211E and E2:V264A) were noted. This study highlighted that there were many coinfection cases during the outbreak and that the co-circulation of both viruses in DENV-endemic regions warrants effective monitoring of these emerging pathogens via comprehensive surveillance to facilitate the implementation of effective control measures.

Keywords: 2019; Chikungunya; Co-infection; Dengue; Myanmar; Viremia.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Chikungunya Fever* / epidemiology
Chikungunya virus* / genetics
Child
Coinfection* / epidemiology
Cross-Sectional Studies
Dengue Virus*
Dengue* / epidemiology
Humans
Myanmar / epidemiology