Background: Dengue and Zika are members of the flavivirus family of arthropod-borne viruses. Given shared ecology and mosquito vectors, Zika is emerging in areas with endemic dengue virus transmission. Immunity studies indicate that dengue shows substantial cross-reaction to Zika and increases the chances of Zika infection, posing a rising global public health threat. Current diagnostic technologies take place in a centralised laboratory and are usually expensive, time-consuming and requiring specialist equipment and personnel. Continued emergence of dengue and Zika viruses, coupled with a lack of effective global surveillance, raises the need for a quantitative, rapid and sample-to-answer diagnostic device. We therefore aim to develop an integrated and innovative diagnostic device, deployable in a wide range of healthcare settings for populations suffering from epidemic diseases.Methods & Materials: Our approach relies on ultrasensitive and precise nucleic acid amplification coupled with pH-sensing complementary metal-oxide semiconductor (CMOS) technology integrated in a lab-on-chip platform. The pH-sensing microchip integrates more than 4000 sensors and employs label-free loopmediated isothermal amplification (LAMP). The hydrogen ions released during the amplification reaction are measured in realtime and are proportional to the amount of double-stranded DNA produced. Specific LAMP primers for dengue and Zika viruses were investigated based on their nucleotide sequence alignment, which includes more than 500 recent outbreak strains of each virus.Results: We report the molecular detection and quantification of 4 serotypes of dengue and Zika viruses by our lab-on-chip platform. Experiments were conducted with a real-time PCR instrument and the platform simultaneously. Time to positive was achieved from 10 to 40 mins from 10 5 to 10 1 copies per reaction, confirming both rapid detection and sensitivity. Conclusion:We have developed a first of its kind portable diagnostic device able to detect the 4 dengue serotypes and Zika in a quantitative and rapid way using our lab-on-chip platform. The information collected from the device has the potential to improve diagnosis and treatment for infectious diseases and contribute to real-time surveillance and epidemiology. Clinical tests for this new technology will be conducted in dengue and Zika epidemic countries, including Thailand and Taiwan.

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