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 Table of Contents  
Year : 2020  |  Volume : 8  |  Issue : 1  |  Page : 33-34

Co-infection of corona and dengue virus: A new challenge in dengue-endemic countries

1 Department of Entomology, Patuakhali Science and Technology University, Patuakhali, Bangladesh
2 Department of Entomology, Patuakhali Science and Technology University, Patuakhali, Bangladesh; Division of Pathology, School of Biological Sciences, University Sains Malaysia, Penang, Malaysia

Date of Submission23-Jun-2020
Date of Acceptance27-Jun-2020
Date of Web Publication4-Sep-2020

Correspondence Address:
Dr. Md Asaduzzaman Miah
Department of Entomology, Patuakhali Science and Technology University, Dumki, Patuakhali 8602
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jpsic.jpsic_14_20

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How to cite this article:
Miah MA, Husna A. Co-infection of corona and dengue virus: A new challenge in dengue-endemic countries. J Patient Saf Infect Control 2020;8:33-4

How to cite this URL:
Miah MA, Husna A. Co-infection of corona and dengue virus: A new challenge in dengue-endemic countries. J Patient Saf Infect Control [serial online] 2020 [cited 2021 Jan 21];8:33-4. Available from: https://www.jpsiconline.com/text.asp?2020/8/1/33/294370

COVID-19 has been declared as a global pandemic by the World Health Organization. Amidst the COVID-19 crisis, dengue cases have been increased in dengue-endemic countries. Consequently, the co-infection of corona and dengue viruses to the patients has been reported recently in different dengue-endemic countries such as Singapore, Thailand, India and Bangladesh. As an extremely unique occurrence, Singapore at first confirmed two patients who were co-infected with both corona and dengue viruses.[1] In Thailand, a man who also had dengue died from coronavirus infection.[2] Furthermore, an old patient with co-infection of dengue and corona died in India.[3] Moreover, two patients from Bangladesh were co-infected with both corona and dengue, and one of them died.[4] Hence, it is speculated that the cases may be increased as the dengue season has started. Currently, the dengue-endemic countries in Southeast Asia such as the Philippines, Malaysia and Singapore are suffering from concurrent outbreaks of dengue and COVID-19. Besides, several South American countries such as Brazil, Paraguay and Colombia are suffering for the same though there is no co-infection information. Therefore, there is a possibility to occur more co-infection in these dengue-endemic countries along with other Asian countries such as Thailand, Indonesia, Myanmar, India, Bangladesh and Pakistan where both dengue and COVID-19 diseases are already been co-existed.

Co-infection poses a challenge for accurate diagnosis and treatment, particularly when symptoms such as fever and aches are similar for several viral diseases such as COVID-19 and dengue. The distinction can be made with disease progresses. In fact, the symptoms of these viral diseases begin with fever. Guan et al. in their recent study reported that fever, cough and headache were observed as the most common symptoms for COVID-19 patients[5] whereas fever, headache and skin rash were observed for dengue patients. Besides, COVID-19 patients could present with a rash that was mistaken for dengue.[2] Moreover, the clinical and laboratory features of both dengue and COVID-19 are quite identical and therefore difficult to distinguish. In addition, Singapore-based studies reported that COVID-19 patients can produce false-positive results for dengue from a rapid serological test.[1] Thus, a new symptom of COVID-19 was discovered where the patient was suspected of suffering from dengue. The report warned that COVID-19 patients were misdiagnosed as dengue with failure to isolate such patients that ultimately assist to spread the virus.

We, in this letter, focused on the dengue-endemic countries where COVID-19 and dengue disease are co-existing. Therefore, the concurrent outbreaks of dengue and COVID-19 may happen due to repeated outbreaks of dengue in these countries that really pose new challenges. Co-infections may cause illness with overlapping signs and symptoms that make diagnosis and treatment difficult for physicians. We, therefore, emphasise that physicians should be aware of possible co-infection of corona and dengue through appropriate clinical management. Highly accurate and accessible diagnostic tests for COVID-19 and dengue along with continuous surveillance on the patients with clinical symptoms are recommended for early and proper recognition of infecting pathogens.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Yan G, Lee CK, Lam LTM, Yan B, Chua YX, Lim AYN, et al. Covert COVID-19 and false-positive dengue serology in Singapore. Lancet Infect Dis 2020;20:536.  Back to cited text no. 1
Joob B, Wiwanitkit V. COVID-19 can present with a rash and be mistaken for dengue. J Am Acad Dermatol 2020;82:e177.  Back to cited text no. 2
Ayub J. Stung by Dengue, Patient Dies of Coronavirus Co-infection in Bhopal. The Times of India; 2020.  Back to cited text no. 3
Report SO. A Double Struggle: Home Ministry PRO Battling COVID-19, Dengue. The Daily Star; 2020.  Back to cited text no. 4
Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020;382:1708-20.  Back to cited text no. 5


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