Dengue and H1N1 infection

How to cite this article:
Joob B, Wiwanitkit V. Dengue and H1N1 infection. Ann Trop Med Public Health 2015;8:316


How to cite this URL:
Joob B, Wiwanitkit V. Dengue and H1N1 infection. Ann Trop Med Public Health [serial online] 2015 [cited 2020 Dec 2];8:316. Available from:

Dear Sir,

The recent report on dengue and hemagglutinin type 1 and neuraminidase type 1 (H1N1) infection is very interesting. [1] Behara et al. reported a case of concurrent dengue and H1N1 infection and concluded that “both dengue and H1N1 influenza are potentially fatal diseases and a high index of suspicion is necessary among the treating physicians for early diagnosis and best outcomes”. [1] Indeed, the problem of concomitant dengue and pandemic H1N1 influenza infection has been proposed for a few years. The first report was by Joob and Wiwanitkit [2] and there are other sporadic reports. [3],[4],[5] As noted by Hussain et al., [6] it is an actual diagnostic challenge diagnosing the coinfection between dengue and H1N1 influenza. It is no doubt that dengue can coinfect with other infections. The diagnosis of coinfection between dengue and H1N1 influenza should be further discussed. Based on our experience, the coinfection should be suspected in any case with:

  1. Fever that cannot be simply controlled by acetaminophen,
  2. Presentation of hemorrhagic complication, and
  3. Finding of unexplained thrombocytopenia with atypical lymphocytosis and hemoconcentration. Finally, it should be noted that other tropical infections can also coinfect with H1N1 influenza and the practitioner has to think about possible coinfection in managing any case of H1N1 influenza.

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Behera V, Naithani N, Nizami A, Ranjan R. A rare case of dengue and H1N1 co-infection: A deadly duo. Lung India 2015;32: 299-300.
Joob B, Wiwanitkit V. Concurrent dengue and novel H1N1 infection: The first world report. Ann Trop Med Public Health 2013; 6:686-7.
Borthakur B, Panwar D, Garg R, Pawar M. Viral co-infection with dengue and H1N1 virus in a critical care setting. J Anaesthesiol Clin Pharmacol 2011;27:236-8.
Perez MA, Gordon A, Sanchez F, Narvaez F, Gutierrez G, Ortega O, et al. Severe coinfections of dengue and pandemic influenza A H1N1 viruses. Pediatr Infect Dis J 2010;29:1052-5.
Lopez Rodriguez E, Tomashek KM, Gregory CJ, Munoz J, Hunsperger E, Lorenzi OD, et al. Co-infection with dengue virus and pandemic (H1N1) 2009 virus. Emerg Infect Dis 2010;16: 882-4.
Hussain R, Al-Omar I, Memish ZA. The diagnostic challenge of pandemic H1N1 2009 virus in a dengue-endemic region: A case report of combined infection in Jeddah, Kingdom of Saudi Arabia. J Infect Public Health 2012;5:199-202.

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.162631

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