Annals of Tropical Medicine and Public Health

LETTER TO EDITOR
Year
: 2017  |  Volume : 10  |  Issue : 3  |  Page : 757--758

Triple coinfection – dengue, chikungunya, and Zika virus infection: Risk and next possibility for “more than three” combination


Beuy Joob1, Viroj Wiwanitkit2,  
1 Sanitation 1 Medical Academic Center, Bangkok, Thailand
2 Faculty of Medicine, University of Nis, Nis, Serbia; Hainan Medical University, Hainan, China

Correspondence Address:
Beuy Joob
Sanitation 1 Medical Academic Center, Bangkok
Thailand




How to cite this article:
Joob B, Wiwanitkit V. Triple coinfection – dengue, chikungunya, and Zika virus infection: Risk and next possibility for “more than three” combination.Ann Trop Med Public Health 2017;10:757-758


How to cite this URL:
Joob B, Wiwanitkit V. Triple coinfection – dengue, chikungunya, and Zika virus infection: Risk and next possibility for “more than three” combination. Ann Trop Med Public Health [serial online] 2017 [cited 2019 Sep 17 ];10:757-758
Available from: http://www.atmph.org/text.asp?2017/10/3/757/188508


Full Text



Dear Editor,

The complex situation of Zika virus coinfected with other infection is an interesting issue in the present day. The coinfection has been sporadically reported and most are double coinfection. However, the recent report by Faccini-Martínez et al.[1] showed an interesting triple coinfection – dengue, chikungunya, and Zika virus infection. Indeed, the circulation of the three virus in the same place at the same time is confirmed,[2] hence, the chance of triple coinfection is possible. The left question is how about the risk. Indeed, a recent report from Thailand already answered the question on the possibility.[3] Wikan et al.[3] reported the immunoreactivity among 21 sera from cases with acute febrile illness. In that report, possible triple coinfection dengue, chikungunya, and Zika virus infection are evidenced in 41.62%. This implies the high rate of chance to expose to all three virus in a patient. Another important concern is on the “more than three” combination. On the basis of the report by Wikan et al., the possible quadruple coinfection – dengue, chikungunya, Japanese encephalitis, and Zika virus infection are evidenced in one-third of all cases.[3] Based on the mentioned information, the risk of possible multiple arboviral coinfection in tropical world seems to be very high.

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Conflicts of interest

There are no conflicts of interest.

References

1Faccini-Martínez ÁA, Botero-García CA, Benítez-Baracaldo FC, Pérez-Díaz CE, With regard about the case of Dengue, Chikungunya and Zika co-infection in a patient from Colombia. J Infect Public Health 2016;i:S1876-0341(16)00012-5
2Pessôa R, Patriota JV, Lourdes de Souza Md, Felix AC, Mamede N, Sanabani SS, Investigation into an outbreak of dengue-like illness in Pernambuco, Brazil, revealed a cocirculation of Zika, chikungunya, and dengue virus type 1. Medicine (Baltimore) 2016;95:e3201. doi: 10.1097/MD.0000000000003201
3Wikan N, Suputtamongkol Y, Yoksan S, Smith DR, Auewarakul P. Immunological evidence of Zika virus transmission in Thailand. Asian Pac J Trop Med 2016;9:141-44.