These findings added a new dimension in diagnosis, treatment, epidemiology and control of dengue and malaria. The possible risk of concurrent dengue and malaria infections should always be kept in mind in endemic areas for early diagnosis employing modern technology and prompt and effective treatment to avoid serious complications.
Fever of unknown origin broke out in several districts of West Bengal, from August 2007 to December 2007. The cases were suffering from high fever, severe joint pain lasting for several weeks after clinical cure and appearance of skin rashes. Patients' sera were collected at least five days after fever and were analyzed to detect specific IgM antibodies. A total of 800 patients were investigated and 321 (40.13%) were found to be reactive for Chikungunya antibodies. Of the patients, 66% were male. Predominant signs and symptoms observed in the sero-positive cases were fever (100%), arthralgia (96%) and diffuse erythematous skin rash (94%). Of the patients, 3% had haemorrhagic manifestations. Re-emerging Chikungunya virus spread in epidemic form in several districts of West Bengal after a gap of four decades.
Serodiagnostic tests dengue-specific NS1 antigen and IgM and IgG antibodies when conducted simultaneously would be able to diagnose confirmed dengue cases categorising primary and secondary dengue along with the duration of the disease, whether early or prolonged.
After its first appearance in Kolkata (Calcutta) during 1963-1965, chikungunya occurred in epidemic form in India in 17 states and union territories. There were 13,90,322 cases suspected to be suffering from chikungunya in 2006, 59,535 in 2007 and 11,222 in 2008; in 2006, 2007 and 2008 there were 15,961, 7,837 and 262 samples, respectively, sent to the National Institute of Virology, Pune, and the National Institute of Communicable Disease, Delhi, for serological diagnosis. Of these, 2001, 1826 and 44, respectively, were confirmed as chikungunya. There were no deaths (data from the National Vector Borne Disease Control Programme, Government of India).
Kolkata, India is endemic for mosquito borne diseases like dengue, chikungunya and malaria. For monitoring, altogether 252 serum samples of fever cases were examined for dengue specific NS1 antigen and IgM and IgG antibodies and chikungunya specific IgM antibody. Their blood samples were also tested for malarial parasites. Out of 252 cases, 15 (5.95%), 16 (6.34%) and 18 (7.13%) were infected with dengue, chikungunya and malaria respectively. Amongst 15 dengue cases 10 (3.96%) were positive for both dengue IgM and IgG antibodies and 5 (1.98%) for NS1 antigen. Out of 18 malaria victims 14 (5.55%) and 4 (1.58%) were positive for Plasmodium vivax and Plasmodium falciparum respectively. During the present study, one case of concurrent infections of dengue and chikungunya and another case of concurrent infections of dengue, chikungunya and falciparum malaria were detected. Detail case report of the later has been described. This is the first ever report of concurrent infections of dengue, chikungunya and malaria.
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