Comparison of clinical characteristics of Zika and dengue symptomatic infections and other acute illnesses of unidentified origin in Mexico.

<h4>Background</h4>Our purpose was to provide a detailed clinical description, of symptoms and laboratory abnormalities, and temporality in patients with confirmed Zika and dengue infections, and other acute illnesses of unidentified origin (AIUO).<h4>Methods/ principal findings<...

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Main Authors: Pablo F Belaunzarán-Zamudio, Allyson Mateja, Paola Del Carmen Guerra-de-Blas, Héctor A Rincón-León, Karla Navarro-Fuentes, Emilia Ruiz-Hernández, Sandra Caballero-Sosa, Francisco Camas-Durán, Zoila Priego-Smith, José G Nájera-Cancino, Alexander López-Roblero, Karina Del Carmen Trujillo-Murillo, John H Powers, Sally Hunsberger, Sophia Siddiqui, John H Beigel, Raydel Valdés-Salgado, Guillermo Ruiz-Palacios, Mexican Emerging Infectious Diseases Clinical Research Network (LaRed)
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2021-02-01
Series:PLoS Neglected Tropical Diseases
Online Access:https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0009133&type=printable
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author Pablo F Belaunzarán-Zamudio
Allyson Mateja
Paola Del Carmen Guerra-de-Blas
Héctor A Rincón-León
Karla Navarro-Fuentes
Emilia Ruiz-Hernández
Sandra Caballero-Sosa
Francisco Camas-Durán
Zoila Priego-Smith
José G Nájera-Cancino
Alexander López-Roblero
Karina Del Carmen Trujillo-Murillo
John H Powers
Sally Hunsberger
Sophia Siddiqui
John H Beigel
Raydel Valdés-Salgado
Guillermo Ruiz-Palacios
Mexican Emerging Infectious Diseases Clinical Research Network (LaRed)
author_facet Pablo F Belaunzarán-Zamudio
Allyson Mateja
Paola Del Carmen Guerra-de-Blas
Héctor A Rincón-León
Karla Navarro-Fuentes
Emilia Ruiz-Hernández
Sandra Caballero-Sosa
Francisco Camas-Durán
Zoila Priego-Smith
José G Nájera-Cancino
Alexander López-Roblero
Karina Del Carmen Trujillo-Murillo
John H Powers
Sally Hunsberger
Sophia Siddiqui
John H Beigel
Raydel Valdés-Salgado
Guillermo Ruiz-Palacios
Mexican Emerging Infectious Diseases Clinical Research Network (LaRed)
author_sort Pablo F Belaunzarán-Zamudio
collection DOAJ
description <h4>Background</h4>Our purpose was to provide a detailed clinical description, of symptoms and laboratory abnormalities, and temporality in patients with confirmed Zika and dengue infections, and other acute illnesses of unidentified origin (AIUO).<h4>Methods/ principal findings</h4>This was a two-year, multicenter, observational, prospective, cohort study. We collected data from patients meeting the Pan American Health Organization's modified case-definition criteria for probable Zika infection. We identified Zika, dengue chikungunya by RT-PCR in serum and urine. We compared characteristics between patients with confirmed Zika and dengue infections, Zika and AIUO, and Dengue and AIUO at baseline, Days 3,7,28 and 180 of follow-up. Most episodes (67%) consistent with the PAHO definition of probable Zika could not be confirmed as due to any flavivirus and classified as Acute Illnesses of Unidentified Origin (AIUO). Infections by Zika and dengue accounted for 8.4% and 16% of episodes. Dengue patients presented with fever, generalized non-macular rash, arthralgia, and petechiae more frequently than patients with Zika during the first 10 days of symptoms. Dengue patients presented with more laboratory abnormalities (lower neutrophils, lymphocytosis, thrombocytopenia and abnormal liver function tests), with thrombocytopenia lasting for 28 days. Zika patients had conjunctivitis, photophobia and localized macular rash more frequently than others. Few differences persisted longer than 10 days after symptoms initiation: conjunctivitis in Zika infections, and self-reported rash and petechia in dengue infections.<h4>Conclusions</h4>Our study helps characterize the variety and duration of clinical features in patients with Zika, dengue and AIUO. The lack of diagnosis in most patients points to need for better diagnostics to assist clinicians in making specific etiologic diagnoses.
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spelling doaj-art-2f15c9dcd5fb4ecc968b38fea6b1ced92025-08-20T03:25:38ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352021-02-01152e000913310.1371/journal.pntd.0009133Comparison of clinical characteristics of Zika and dengue symptomatic infections and other acute illnesses of unidentified origin in Mexico.Pablo F Belaunzarán-ZamudioAllyson MatejaPaola Del Carmen Guerra-de-BlasHéctor A Rincón-LeónKarla Navarro-FuentesEmilia Ruiz-HernándezSandra Caballero-SosaFrancisco Camas-DuránZoila Priego-SmithJosé G Nájera-CancinoAlexander López-RobleroKarina Del Carmen Trujillo-MurilloJohn H PowersSally HunsbergerSophia SiddiquiJohn H BeigelRaydel Valdés-SalgadoGuillermo Ruiz-PalaciosMexican Emerging Infectious Diseases Clinical Research Network (LaRed)<h4>Background</h4>Our purpose was to provide a detailed clinical description, of symptoms and laboratory abnormalities, and temporality in patients with confirmed Zika and dengue infections, and other acute illnesses of unidentified origin (AIUO).<h4>Methods/ principal findings</h4>This was a two-year, multicenter, observational, prospective, cohort study. We collected data from patients meeting the Pan American Health Organization's modified case-definition criteria for probable Zika infection. We identified Zika, dengue chikungunya by RT-PCR in serum and urine. We compared characteristics between patients with confirmed Zika and dengue infections, Zika and AIUO, and Dengue and AIUO at baseline, Days 3,7,28 and 180 of follow-up. Most episodes (67%) consistent with the PAHO definition of probable Zika could not be confirmed as due to any flavivirus and classified as Acute Illnesses of Unidentified Origin (AIUO). Infections by Zika and dengue accounted for 8.4% and 16% of episodes. Dengue patients presented with fever, generalized non-macular rash, arthralgia, and petechiae more frequently than patients with Zika during the first 10 days of symptoms. Dengue patients presented with more laboratory abnormalities (lower neutrophils, lymphocytosis, thrombocytopenia and abnormal liver function tests), with thrombocytopenia lasting for 28 days. Zika patients had conjunctivitis, photophobia and localized macular rash more frequently than others. Few differences persisted longer than 10 days after symptoms initiation: conjunctivitis in Zika infections, and self-reported rash and petechia in dengue infections.<h4>Conclusions</h4>Our study helps characterize the variety and duration of clinical features in patients with Zika, dengue and AIUO. The lack of diagnosis in most patients points to need for better diagnostics to assist clinicians in making specific etiologic diagnoses.https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0009133&type=printable
spellingShingle Pablo F Belaunzarán-Zamudio
Allyson Mateja
Paola Del Carmen Guerra-de-Blas
Héctor A Rincón-León
Karla Navarro-Fuentes
Emilia Ruiz-Hernández
Sandra Caballero-Sosa
Francisco Camas-Durán
Zoila Priego-Smith
José G Nájera-Cancino
Alexander López-Roblero
Karina Del Carmen Trujillo-Murillo
John H Powers
Sally Hunsberger
Sophia Siddiqui
John H Beigel
Raydel Valdés-Salgado
Guillermo Ruiz-Palacios
Mexican Emerging Infectious Diseases Clinical Research Network (LaRed)
Comparison of clinical characteristics of Zika and dengue symptomatic infections and other acute illnesses of unidentified origin in Mexico.
PLoS Neglected Tropical Diseases
title Comparison of clinical characteristics of Zika and dengue symptomatic infections and other acute illnesses of unidentified origin in Mexico.
title_full Comparison of clinical characteristics of Zika and dengue symptomatic infections and other acute illnesses of unidentified origin in Mexico.
title_fullStr Comparison of clinical characteristics of Zika and dengue symptomatic infections and other acute illnesses of unidentified origin in Mexico.
title_full_unstemmed Comparison of clinical characteristics of Zika and dengue symptomatic infections and other acute illnesses of unidentified origin in Mexico.
title_short Comparison of clinical characteristics of Zika and dengue symptomatic infections and other acute illnesses of unidentified origin in Mexico.
title_sort comparison of clinical characteristics of zika and dengue symptomatic infections and other acute illnesses of unidentified origin in mexico
url https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0009133&type=printable
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