Chikungunya and Dengue Fever among Hospitalized Febrile Patients in Northern Tanzania

Julian T. Hertz Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Durham, North Carolina; Kilimanjaro Christian Medical Centre, Moshi, Tanzania; Emerging Infectious Diseases Signature Research Program, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore; Duke Global Health Institute, Duke University, Durham, North Carolina; Kilimanjaro Christian Medical College, Tumaini University, Moshi, Tanzania; Mawenzi Regional Hospital, Moshi, Tanzania; Department of Pathology, Duke University Medical Center, Durham, North Carolina

Search for other papers by Julian T. Hertz in
Current site
Google Scholar
PubMed
Close
,
O. Michael Munishi Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Durham, North Carolina; Kilimanjaro Christian Medical Centre, Moshi, Tanzania; Emerging Infectious Diseases Signature Research Program, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore; Duke Global Health Institute, Duke University, Durham, North Carolina; Kilimanjaro Christian Medical College, Tumaini University, Moshi, Tanzania; Mawenzi Regional Hospital, Moshi, Tanzania; Department of Pathology, Duke University Medical Center, Durham, North Carolina

Search for other papers by O. Michael Munishi in
Current site
Google Scholar
PubMed
Close
,
Eng Eong Ooi Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Durham, North Carolina; Kilimanjaro Christian Medical Centre, Moshi, Tanzania; Emerging Infectious Diseases Signature Research Program, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore; Duke Global Health Institute, Duke University, Durham, North Carolina; Kilimanjaro Christian Medical College, Tumaini University, Moshi, Tanzania; Mawenzi Regional Hospital, Moshi, Tanzania; Department of Pathology, Duke University Medical Center, Durham, North Carolina

Search for other papers by Eng Eong Ooi in
Current site
Google Scholar
PubMed
Close
,
Shiqin Howe Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Durham, North Carolina; Kilimanjaro Christian Medical Centre, Moshi, Tanzania; Emerging Infectious Diseases Signature Research Program, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore; Duke Global Health Institute, Duke University, Durham, North Carolina; Kilimanjaro Christian Medical College, Tumaini University, Moshi, Tanzania; Mawenzi Regional Hospital, Moshi, Tanzania; Department of Pathology, Duke University Medical Center, Durham, North Carolina

Search for other papers by Shiqin Howe in
Current site
Google Scholar
PubMed
Close
,
Wen Yan Lim Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Durham, North Carolina; Kilimanjaro Christian Medical Centre, Moshi, Tanzania; Emerging Infectious Diseases Signature Research Program, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore; Duke Global Health Institute, Duke University, Durham, North Carolina; Kilimanjaro Christian Medical College, Tumaini University, Moshi, Tanzania; Mawenzi Regional Hospital, Moshi, Tanzania; Department of Pathology, Duke University Medical Center, Durham, North Carolina

Search for other papers by Wen Yan Lim in
Current site
Google Scholar
PubMed
Close
,
Angelia Chow Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Durham, North Carolina; Kilimanjaro Christian Medical Centre, Moshi, Tanzania; Emerging Infectious Diseases Signature Research Program, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore; Duke Global Health Institute, Duke University, Durham, North Carolina; Kilimanjaro Christian Medical College, Tumaini University, Moshi, Tanzania; Mawenzi Regional Hospital, Moshi, Tanzania; Department of Pathology, Duke University Medical Center, Durham, North Carolina

Search for other papers by Angelia Chow in
Current site
Google Scholar
PubMed
Close
,
Anne B. Morrissey Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Durham, North Carolina; Kilimanjaro Christian Medical Centre, Moshi, Tanzania; Emerging Infectious Diseases Signature Research Program, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore; Duke Global Health Institute, Duke University, Durham, North Carolina; Kilimanjaro Christian Medical College, Tumaini University, Moshi, Tanzania; Mawenzi Regional Hospital, Moshi, Tanzania; Department of Pathology, Duke University Medical Center, Durham, North Carolina

Search for other papers by Anne B. Morrissey in
Current site
Google Scholar
PubMed
Close
,
John A. Bartlett Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Durham, North Carolina; Kilimanjaro Christian Medical Centre, Moshi, Tanzania; Emerging Infectious Diseases Signature Research Program, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore; Duke Global Health Institute, Duke University, Durham, North Carolina; Kilimanjaro Christian Medical College, Tumaini University, Moshi, Tanzania; Mawenzi Regional Hospital, Moshi, Tanzania; Department of Pathology, Duke University Medical Center, Durham, North Carolina

Search for other papers by John A. Bartlett in
Current site
Google Scholar
PubMed
Close
,
Jecinta J. Onyango Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Durham, North Carolina; Kilimanjaro Christian Medical Centre, Moshi, Tanzania; Emerging Infectious Diseases Signature Research Program, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore; Duke Global Health Institute, Duke University, Durham, North Carolina; Kilimanjaro Christian Medical College, Tumaini University, Moshi, Tanzania; Mawenzi Regional Hospital, Moshi, Tanzania; Department of Pathology, Duke University Medical Center, Durham, North Carolina

Search for other papers by Jecinta J. Onyango in
Current site
Google Scholar
PubMed
Close
,
Venance P. Maro Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Durham, North Carolina; Kilimanjaro Christian Medical Centre, Moshi, Tanzania; Emerging Infectious Diseases Signature Research Program, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore; Duke Global Health Institute, Duke University, Durham, North Carolina; Kilimanjaro Christian Medical College, Tumaini University, Moshi, Tanzania; Mawenzi Regional Hospital, Moshi, Tanzania; Department of Pathology, Duke University Medical Center, Durham, North Carolina

Search for other papers by Venance P. Maro in
Current site
Google Scholar
PubMed
Close
,
Grace D. Kinabo Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Durham, North Carolina; Kilimanjaro Christian Medical Centre, Moshi, Tanzania; Emerging Infectious Diseases Signature Research Program, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore; Duke Global Health Institute, Duke University, Durham, North Carolina; Kilimanjaro Christian Medical College, Tumaini University, Moshi, Tanzania; Mawenzi Regional Hospital, Moshi, Tanzania; Department of Pathology, Duke University Medical Center, Durham, North Carolina

Search for other papers by Grace D. Kinabo in
Current site
Google Scholar
PubMed
Close
,
Wilbrod Saganda Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Durham, North Carolina; Kilimanjaro Christian Medical Centre, Moshi, Tanzania; Emerging Infectious Diseases Signature Research Program, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore; Duke Global Health Institute, Duke University, Durham, North Carolina; Kilimanjaro Christian Medical College, Tumaini University, Moshi, Tanzania; Mawenzi Regional Hospital, Moshi, Tanzania; Department of Pathology, Duke University Medical Center, Durham, North Carolina

Search for other papers by Wilbrod Saganda in
Current site
Google Scholar
PubMed
Close
,
Duane J. Gubler Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Durham, North Carolina; Kilimanjaro Christian Medical Centre, Moshi, Tanzania; Emerging Infectious Diseases Signature Research Program, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore; Duke Global Health Institute, Duke University, Durham, North Carolina; Kilimanjaro Christian Medical College, Tumaini University, Moshi, Tanzania; Mawenzi Regional Hospital, Moshi, Tanzania; Department of Pathology, Duke University Medical Center, Durham, North Carolina

Search for other papers by Duane J. Gubler in
Current site
Google Scholar
PubMed
Close
, and
John A. Crump Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Durham, North Carolina; Kilimanjaro Christian Medical Centre, Moshi, Tanzania; Emerging Infectious Diseases Signature Research Program, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore; Duke Global Health Institute, Duke University, Durham, North Carolina; Kilimanjaro Christian Medical College, Tumaini University, Moshi, Tanzania; Mawenzi Regional Hospital, Moshi, Tanzania; Department of Pathology, Duke University Medical Center, Durham, North Carolina

Search for other papers by John A. Crump in
Current site
Google Scholar
PubMed
Close
Restricted access

Consecutive febrile admissions were enrolled at two hospitals in Moshi, Tanzania. Confirmed acute Chikungunya virus (CHIKV), Dengue virus (DENV), and flavivirus infection were defined as a positive polymerase chain reaction (PCR) result. Presumptive acute DENV infection was defined as a positive anti-DENV immunoglobulin M (IgM) enzyme-linked immunsorbent assay (ELISA) result, and prior flavivirus exposure was defined as a positive anti-DENV IgG ELISA result. Among 870 participants, PCR testing was performed on 700 (80.5%). Of these, 55 (7.9%) had confirmed acute CHIKV infection, whereas no participants had confirmed acute DENV or flavivirus infection. Anti-DENV IgM serologic testing was performed for 747 (85.9%) participants, and of these 71 (9.5%) had presumptive acute DENV infection. Anti-DENV IgG serologic testing was performed for 751 (86.3%) participants, and of these 80 (10.7%) had prior flavivirus exposure. CHIKV infection was more common among infants and children than adults and adolescents (odds ratio [OR] 1.9, P = 0.026) and among HIV-infected patients with severe immunosuppression (OR 10.5, P = 0.007). CHIKV infection is an important but unrecognized cause of febrile illness in northern Tanzania. DENV or other closely related flaviviruses are likely also circulating.

Author Notes

*Address correspondence to John A. Crump, Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Box 102359, Durham, NC 27710. E-mail: john.crump@duke.edu
†These two authors contributed equally to this work.

Financial support: This work was supported by an International Studies on AIDS Associated Co-infections (ISAAC) award, a United States National Institutes of Health (NIH) funded program (U01 AI062563). Authors received support from the NIH Fogarty International Center through the International Clinical Research Fellows Program at Vanderbilt University (R24 TW007988 to JTH, OMM), AIDS International Training and Research Program (D43 PA-03-018 to OMM, JAB, JJO, VPM, GDK, JAC), the Duke Clinical Trials Unit and Clinical Research Sites (U01 AI069484 to JAB, VPM, JAC), and the Center for AIDS Research (2P30 AI064518 to JAB, JAC).

Disclosure: Presented in part at the 60th American Society of Tropical Medicine and Hygiene Annual Meeting, Philadelphia, PA, December 4–8, 2011, Abstracts 435 and 828.

Authors' addresses: Julian T. Hertz, Anne B. Morrissey, John A. Bartlett, and John A. Crump, Department of Medicine, Duke University Medical Center, Durham, NC, E-mails: julian.hertz@gmail.com, amorr1023@gmail.com, john.bartlett@duke.edu, and john.crump@duke.edu. O. Michael Munishi, Jecinta J. Onyango, Venance P. Maro, Grace D. Kinabo, Kilimanjaro Christian Medical Centre, Moshi, Tanzania, E-mails: godhappyus@yahoo.com, jeccy_onyango@yahoo.com, venmaro@yahoo.co.uk, and gkinabo@hotmail.com. Eng Eong Ooi, Shiqin Howe, Wen Yan Lim, Angelia Chow, and Duane J. Gubler, Emerging Infectious Diseases Signature Research Program, Duke-National University of Singapore Graduate Medical School, Singapore, Singapore, E-mails: engeong.ooi@duke-nus.edu.sg, shiqin.howe@duke-nus.edu.sg, wenyan.lim@duke-nus.edu.sg, angelia.chow@duke-nus.edu.sg, and duane.gubler@duke-nus.edu.sg. Wilbrod Saganda, Mawenzi Regional Hospital, Moshi, Tanzania.

  • 1.

    Jupp P, McIntosh B, 1988. Chikungunya virus disease. Monath T, ed. The Arboviruses: Epidemiology and Ecology. Boca Raton, FL: CRC Press, 137157.

    • Search Google Scholar
    • Export Citation
  • 2.

    Gubler DJ, 1988. Dengue. Monath T, ed. The Arboviruses: Ecology and Epidemiology. Boca Raton, FL: CRC Press, 223260.

  • 3.

    Leroy EM, Nkoghe D, Ollomo B, Nze-Nkogue C, Becquart P, Grard G, Pourrut X, Charrel R, Moureau G, Ndjoyi-Mbiguino A, De-Lamballerie X, 2009. Concurrent Chikungunya and dengue virus infections during simultaneous outbreaks, Gabon, 2007. Emerg Infect Dis 15: 591593.

    • Search Google Scholar
    • Export Citation
  • 4.

    Diallo M, Sall AA, Moncayo AC, Ba Y, Fernandez Z, Ortiz D, Coffey LL, Mathiot C, Tesh RB, Weaver SC, 2005. Potential role of sylvatic and domestic African mosquito species in dengue emergence. Am J Trop Med Hyg 73: 445449.

    • Search Google Scholar
    • Export Citation
  • 5.

    McCrae AW, Henderson BE, Kirya BG, Sampala SD, 1971. Chikungunya virus in the Entebbe area of Uganda: isolations and epidemiology. Trans R Soc Trop Med Hyg 65: 152168.

    • Search Google Scholar
    • Export Citation
  • 6.

    Vasilakis N, Cardosa J, Hanley KA, Holmes EC, Weaver SC, 2011. Fever from the forest: prospects for the continued emergence of sylvatic dengue virus and its impact on public health. Nat Rev Microbiol 9: 532541.

    • Search Google Scholar
    • Export Citation
  • 7.

    Ross RW, 1956. The Newala epidemic. III. The virus: isolation, pathogenic properties, and relationship to the epidemic. J Hyg (Lond) 54: 177191.

    • Search Google Scholar
    • Export Citation
  • 8.

    Pastorino B, Muyembe-Tamfum JJ, Bessaud M, Tock F, Tolou H, Durand JP, Peyrefitte CN, 2004. Epidemic resurgence of Chikungunya virus in Democratic Republic of the Congo: identification of a new central African strain. J Med Virol 74: 277282.

    • Search Google Scholar
    • Export Citation
  • 9.

    Gear J, Reid F, 1957. The occurrence of dengue-like fever in north-eastern Transvaal. S Afr Med J 31: 253257.

  • 10.

    Jentes ES, Robinson J, Johnson BW, Conde I, Sakouvougui Y, Iverson J, Beecher S, Bah MA, Diakite F, Coulibaly M, Bausch DG, 2010. Acute arboviral infections in Guinea, West Africa, 2006. Am J Trop Med Hyg 83: 388394.

    • Search Google Scholar
    • Export Citation
  • 11.

    Kanesa-thasan N, Chang GJ, Smoak BL, Magill A, Burrous MJ, Hoke CH, 1998. Molecular and epidemiologic analysis of dengue virus isolates from Somalia. Emerg Infect Dis 4: 299303.

    • Search Google Scholar
    • Export Citation
  • 12.

    Gubler DJ, Sather GE, Kuno G, Cabral JR, 1986. Dengue 3 virus transmission in Africa. Am J Trop Med Hyg 35: 12801284.

  • 13.

    World Health Organization, 2009. Dengue in Africa: emergency of DENV-3, Cote d'Ivoire, 2008. Wkly Epidemiol Rec 84: 8596.

  • 14.

    Gubler DJ, 1998. Dengue and dengue hemorrhagic fever. Clin Microbiol Rev 11: 480496.

  • 15.

    Moi ML, Takasaki T, Kotaki A, Tajima S, Lim CK, Sakamoto M, Iwagoe H, Kobayashi K, Kurane I, 2010. Importation of dengue virus type 3 to Japan from Tanzania and Cote d'Ivoire. Emerg Infect Dis 16: 17701772.

    • Search Google Scholar
    • Export Citation
  • 16.

    Gautret P, Simon F, Hervius Askling H, Bouchaud O, Leparc-Goffart I, Ninove L, Parola P, EuroTravNet, 2010. Dengue type 3 infections in European travellers returning from the Comoros and Zanzibar, February–April 2010. Euro Surveill 15: 19541.

    • Search Google Scholar
    • Export Citation
  • 17.

    Crump JA, Ramadhani HO, Morrissey AB, Msuya LJ, Yang L-Y, Chow S-C, Morpeth SC, Reyburn H, Njau BN, Shaw AV, Diefenthal HC, Bartlett JA, Shao JF, Schimana W, Cunningham CK, Kinabo GD, 2011. Invasive bacterial and fungal infections among hospitalized HIV-infected and HIV-uninfected children and infants in northern Tanzania. Trop Med Int Health 16: 830837.

    • Search Google Scholar
    • Export Citation
  • 18.

    Crump JA, Ramadhani HO, Morrissey AB, Saganda W, Mwako MS, Yang L-Y, Chow S-C, Morpeth SC, Reyburn H, Njau BN, Shaw AV, Diefenthal HC, Shao JF, Bartlett JA, Maro VP, 2011. Invasive bacterial and fungal infections among hospitalized HIV-infected and HIV-uninfected adults and adolescents in northern Tanzania. Clin Infect Dis 52: 341348.

    • Search Google Scholar
    • Export Citation
  • 19.

    Mayhood MK, Afwamba IA, Odhiambo CO, Ndanu E, Thielman NM, Morrissey AB, Shao JF, Pence BW, Crump JA, 2008. Validation, performance under field conditions, and cost-effectiveness of Capillus HIV-1/HIV-2 and Determine HIV-1/2 rapid human immunodeficiency virus antibody assays using sequential and parallel testing algorithms in Tanzania. J Clin Microbiol 46: 39463951.

    • Search Google Scholar
    • Export Citation
  • 20.

    Scott LE, Crump JA, Msuya E, Morrissey AB, Venter WF, Stevens WS, 2011. Abbott RealTime HIV-1 m2000rt viral load testing: manual extraction versus the automated m2000sp extraction. J Virol Methods 172: 7880.

    • Search Google Scholar
    • Export Citation
  • 21.

    Crump JA, Scott LE, Msuya E, Morrissey AB, Kimaro EE, Shao JF, Stevens WS, 2009. Evaluation of the Abbott m2000rt RealTime HIV-1 assay with manual sample preparation compared with the ROCHE COBAS AmpliPrep/AMPLICOR HIV-1 MONITOR 1.5 using specimens from East Africa. J Virol Methods 162: 218222.

    • Search Google Scholar
    • Export Citation
  • 22.

    Lai YL, Chung YK, Tan HC, Yap HF, Yap G, Ooi EE, Ng LC, 2007. Cost-effective real-time reverse transcriptase PCR (RT-PCR) to screen for dengue virus followed by rapid single-tube multiplex RT-PCT for serotyping the virus. J Clin Microbiol 45: 935941.

    • Search Google Scholar
    • Export Citation
  • 23.

    Pastorino B, Bessaud M, Grandadam M, Murri S, Tolou HJ, Peyrefitte CN, 2005. Development of a TaqMan RT-PCR assay without RNA extraction for the detection and quantification of African Chikungunya viruses. J Virol Methods 124: 6571.

    • Search Google Scholar
    • Export Citation
  • 24.

    Scaramozzino N, Crance JM, Jouan A, DeBriel DA, Stoll F, Garin D, 2001. Comparison of flavivirus universal primer pairs and development of a rapid, highly sensitive heminested reverse transcriptase-PCR assay for detection of flaviviruses targeting to a conserved region of the NS5 gene sequences. J Clin Microbiol 39: 19221927.

    • Search Google Scholar
    • Export Citation
  • 25.

    Figueiredo LT, Simoes MC, Cavalcante SM, 1989. Enzyme immunoassay for the detection of dengue IgG and IgM antibodies using infected mosquito cells as antigen. Trans R Soc Trop Med Hyg 83: 702707.

    • Search Google Scholar
    • Export Citation
  • 26.

    World Health Organization, 2006. Antiretroviral Therapy of HIV Infection in Infants and Children: Towards Universal Access. World Health Organization, ed. Geneva: WHO, 144.

    • Search Google Scholar
    • Export Citation
  • 27.

    Tanzania National Bureau of Statistics, 2002. Village Statistics, 2002 Population and Housing Census. Dar es Salaam, Tanzania. Available from https://www.nbs.go.tz. Accessed March 25, 2010.

    • Search Google Scholar
    • Export Citation
  • 28.

    Saathoff E, Schneider P, Kleinfeldt V, Geis S, Haule D, Maboko L, Samky E, de Souza M, Robb M, Hoelscher M, 2008. Laboratory reference values for health adults from southern Tanzania. Trop Med Int Health 13: 612625.

    • Search Google Scholar
    • Export Citation
  • 29.

    Buchanan AM, Muro FJ, Gratz J, Crump JA, Musyoka AM, Sichangi MW, Morrissey AB, M'rimberia JK, Njau BN, Msuya LJ, Bartlett JA, Cunningham CK, 2010. Establishment of hematological and immunological reference values for healthy Tanzanian children in the Kilimanjaro Region. Trop Med Int Health 15: 10111021.

    • Search Google Scholar
    • Export Citation
  • 30.

    Kam YW, Ong EK, Renia L, Tong JC, Ng LF, 2009. Immuno-biology of Chikungunya and implications for disease intervention. Microbes Infect 11: 11861196.

    • Search Google Scholar
    • Export Citation
  • 31.

    Rianthavorn P, Prianantathavorn K, Wuttirattanakowit N, Theamboonlers A, Poovoravorn P, 2010. An outbreak of Chikungunya in southern Thailand from 2008 to 2009 caused by African strains with A226V mutation. Int J Infect Dis 14 (Suppl 3): e161e165.

    • Search Google Scholar
    • Export Citation
  • 32.

    Staikowsky F, Talarim F, Grivard P, Souab A, Schuffenecker I, Le Roux K, Lecuit M, Michault A, 2009. Prospective study of chikungunya virus acute infection in the Island of La Reunion during the 2005–2006 outbreak. PLoS ONE 4: e7603.

    • Search Google Scholar
    • Export Citation
  • 33.

    Schwartz O, Albert ML, 2010. Biology and pathogenesis of Chikungunya virus. Nat Rev Microbiol 8: 491500.

  • 34.

    Labadie K, Larcher T, Joubert C, Mannioui A, Delache B, Brochard P, Guigand L, Dubreil L, Lebon P, Verrier B, de Lamballerie X, Suhrbier A, Cherel Y, Le Grand R, Roques P, 2010. Chikungunya disease in nonhuman primates involves long-term viral persistence in macrophages. J Clin Invest 120: 894906.

    • Search Google Scholar
    • Export Citation
  • 35.

    Rajapakse S, Rodrigo C, Rajapakse A, 2010. Atypical manifestations of Chikungunya infection. Trans R Soc Trop Med Hyg 104: 8996.

  • 36.

    Das T, Jaffar-Bandjee MC, Hoarau JJ, Krejbich Trotot P, Denizot M, Lee-Pat-Yuen G, Sahoo R, Guirand P, Ramful D, Robin S, Alessandri JL, Gauzere BA, Gasque P, 2010. Chikungunya fever: CNS infection and pathologies of a re-emerging arbovirus. Prog Neurobiol 91: 121129.

    • Search Google Scholar
    • Export Citation
  • 37.

    Chretien J-P, Anyamba AA, Bedno SA, Breiman RF, Sang R, Sergon K, Powers AM, Onyango CO, Small J, Tucker CJ, Linthicum KJ, 2007. Drought-associated Chikungunya emergence along coastal East Africa. Am J Trop Med Hyg 76: 405407.

    • Search Google Scholar
    • Export Citation
  • 38.

    Westbrook CJ, Reiskind MH, Pesko KN, Greene KE, Lounibos LP, 2010. Larval environmental temperature and the susceptibility of Aedes albopictus Skuse (Diptera: Culicidae) to Chikungunya virus. Vector Borne Zoonotic Dis 10: 241247.

    • Search Google Scholar
    • Export Citation
  • 39.

    Lindegren G, Vene S, Lundkvist A, Falk KI, 2005. Optimized diagnosis of acute dengue fever in Swedish travelers by a combination of reverse transcription-PCR and immunoglobulin M detection. J Clin Microbiol 43: 28502855.

    • Search Google Scholar
    • Export Citation
  • 40.

    Raengsakulrach B, Nisalak A, Maneekarn N, Yenchitsomanus PT, Limsomwong C, Jairungsri A, Thirawuth V, Green S, Kalayanarooj S, Suntayakorn S, Sittisombut N, Malasit P, Vaughn D, 2002. Comparison of four reverse transcription-polymerase chain reaction procedures for the detection of dengue virus in clinical specimens. J Virol Methods 105: 219232.

    • Search Google Scholar
    • Export Citation
  • 41.

    Gubler DJ, 1997. Laboratory diagnosis of dengue virus infections. Gubler DJ, Kuno G, eds. Dengue and Dengue Hemorrhagic Fever. Oxford: CABI, 31333.

    • Search Google Scholar
    • Export Citation
  • 42.

    Blacksell SD, Mammen MP, Thongpaseuth S, Gibbons RV, Jarman RG, Jenjaroen K, Nisalak A, Phetsouvanh R, Newton PN, Day NPJ, 2008. Evaluation of the Panbio dengue virus nonstructural 1 antigen detection and immunoglobulin M antibody enzyme-linked immunosorbent assays for the diagnosis of acute dengue infections in Laos. Diagn Microbiol Infect Dis 60: 4349.

    • Search Google Scholar
    • Export Citation
  • 43.

    Vazquez S, Hafner G, Ruiz D, Calzada N, Guzman MG, 2007. Evaluation of immunoglobulin M and G capture enzyme-linked immunosorbent assay Panbio kits for diagnostic dengue infections. J Clin Virol 39: 194198.

    • Search Google Scholar
    • Export Citation
  • 44.

    Watthanaworawit W, Turner P, Turner CL, Tanganuchitcharnchai A, Jarman RG, Blacksell SD, Nosten FH, 2011. A prospective evaluation of diagnostic methodologies for the acute diagnosis of dengue virus infection on the Thailand-Myanmar border. Trans R Soc Trop Med Hyg 105: 3237.

    • Search Google Scholar
    • Export Citation
  • 45.

    McBride WJ, Mullner H, LaBrooy JT, Wronski I, 1998. The 1993 dengue 2 epidemic in north Queensland: a serosurvey and comparison of hemagglutination inhibition with ELISA. Am J Trop Med Hyg 59: 457461.

    • Search Google Scholar
    • Export Citation
Past two years Past Year Past 30 Days
Abstract Views 65 65 18
Full Text Views 693 147 0
PDF Downloads 246 50 0
 
Membership Banner
 
 
 
Affiliate Membership Banner
 
 
Research for Health Information Banner
 
 
CLOCKSS
 
 
 
Society Publishers Coalition Banner
Save