Skip to main content
SpringerLink
Log in
SpringerLink
Log in

Arthritis Associated with Alphavirus Infections: Dengue and Zika

  • Chapter
  • First Online:
Infections and the Rheumatic Diseases

  • 790 Accesses

Abstract

Dengue virus (DENV) and Zika virus (ZIKV) are a cause of significant morbidity and mortality worldwide within specific regions of the world where they are endemic and susceptible to the occurrence of epidemics. The interaction between these viruses and other host factors (especially the immunocompetence) seems to influence the expression and severity of these conditions. The various clinical forms of both DENV and ZIKV are still being characterized phenotypically, serologically, and genetically together with the pathophysiological mechanisms leading to their protean clinical manifestations and complications. Arthralgias involving small and large joints occur frequently in DENV-affected patients, but typical arthritis is seldom found; accordingly, a physical exam of joints is often unremarkable. Joint pain may precede, appear simultaneously, or subsequently to the onset of fever, and might be masked by more prominent symptoms like backache, large-bone pain, and myalgias. The arthritic phenotype of DENV infection is still unknown, but it seems monoarticular, short-lived, and responsive to symptomatic treatment, whereas the articular manifestations of ZIKV infection are less severe. ZIKV is more likely to induce neurological complications and congenital abnormalities. Coinfection of DENV and ZIKV with chikungunya virus seems to lead to protracted arthritis manifestations and may be associated to a higher morbidity and mortality.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Rigau-Pérez JG. The early use of break-bone fever (Quebranta huesos, 1771) and dengue (1801) in Spanish. Am J Trop Med Hyg. 1998;59(2):272–4.

    Article  Google Scholar 

  2. Gould E, Pettersson J, Higgs S, Charrel R, de Lamballerie X. Emerging arboviruses: why today? One Health. 2017;4:1–13. https://doi.org/10.1016/j.onehlt.2017.06.001. eCollection 2017 Dec. Review.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Leta S, Beyene TJ, De Clercq EM, Amenu K, Kraemer MUG, Revie CW. Global risk mapping for major diseases transmitted by Aedes aegypti and Aedes albopictus. Int J Infect Dis. 2018;67:25–35. https://doi.org/10.1016/j.ijid.2017.11.026. Epub 2017 Nov 28.

    Article  PubMed  Google Scholar 

  4. World Health Organization. Dengue and severe dengue; 13 September 2018. Accessed online at https://www.who.int/news-room/fact-sheets/detail/dengue-and-severe-dengue.

  5. World Health Organization. Situation Report Zika Virus Microcephaly Guillain-Barré Syndrome 10 March 2017 Data as of 9 March 2017. Accessed online at http://apps.who.int/iris/bitstream/handle/10665/254714/zikasitrep10Mar17-eng.pdf;jsessionid=BCE3098CD567B55EAAFDA1F9878FE731?sequence=1.

  6. Song BH, Yun SI, Woolley M, Lee YM. Zika virus: History, epidemiology, transmission, and clinical presentation. J Neuroimmunol. 2017;308:50–64.

    Article  CAS  Google Scholar 

  7. Ngono AE, Shresta S. Immune response to Dengue and Zika. Annu Rev Immunol. 2018;26(36):279–308.

    Article  Google Scholar 

  8. Lanciotti RS, Kosoy OL, Laven JJ, et al. Genetic and serologic properties of Zika virus associated with an epidemic, Yap State, Micronesia, 2007. Emerg Infect Dis. 2008;14:1232–9.

    Article  CAS  Google Scholar 

  9. Montoya M, Collins M, Dejnirattisai W, Katzelnick LC, et al. Longitudinal analysis of antibody cross-neutralization following Zika Virus and Dengue Virus Infection in Asia and the Americas. J Infect Dis. 2018;218(4):536–45.

    Article  CAS  Google Scholar 

  10. Andrade PE, Coloma J, Michlmayr D, Balmaseda AL, Harris E. Zika and dengue virus specific and cross-reactive memory B cell responses. J Immunol. 2017;98(1 Suppl):214.

    Google Scholar 

  11. Cordeiro MT, Pena LJ, Brito CA, et al. Positive IgM for Zika virus in the cerebrospinal fluid of 30 neonates with microcephaly in Brazil. Lancet. 2016;387:1811–2.

    Article  Google Scholar 

  12. Bhatt S, Gething PW, Brady OJ, Messina JP, et al. The global distribution and burden of dengue. Nature. 2013;496(7446):504.

    Article  CAS  Google Scholar 

  13. World Health Organization and the Special Programme for Research and Training in Tropical Diseases (TDR). Dengue guidelines for diagnosis, treatment, prevention and control: new edition. Publication date: 2009. Accessed online at http://www.who.int/rpc/guidelines/9789241547871/en/.

  14. World Health Organization. Dengue haemorrhagic fever: diagnosis, treatment, prevention and control. 2nd ed. Geneva: WHO; 1997. Accessed online at http://apps.who.int/iris/bitstream/10665/41988/1/9241545003_eng.pdf.

    Google Scholar 

  15. Centers for Disease Control and Prevention. Zika Virus Disease Q & A. Accessed at: https://www.cdc.gov/zika/about/questions.html.

  16. Lozier MJ, Burke RM, Lopez J, Acevedo V, et al. Differences in prevalence of symptomatic Zika virus infection, by age and sex-Puerto Rico, 2016. J Infect Dis. 2018;217(11):1678–89.

    Article  Google Scholar 

  17. Adebajo AO. Dengue arthritis. Br J Rheumatol. 1996;35:909–10.

    Article  CAS  Google Scholar 

  18. Patil MM, Akki AS. Dengue arthritis in a child. Indian Pediatr. 2013;50(5):523–4.

    CAS  PubMed  Google Scholar 

  19. Jayamali WD, Herath HMMTB, Kulatunga A. A young female presenting with unilateral sacroiliitis following dengue virus infection: a case report. J Med Case Rep. 2017;11(1):307.

    Article  CAS  Google Scholar 

  20. Kularatne SA, Gihan MC, Weerasinghe SC, Gunasena S. Concurrent outbreaks of Chikungunya and Dengue fever in Kandy, Sri Lanka, 2006-07: a comparative analysis of clinical and laboratory features. Postgrad Med J. 2009;85(1005):342–6.

    Article  CAS  Google Scholar 

  21. Bhaskar E, Sowmya G, Moorthy S. Musculoskeletal manifestations of dengue fever: is there a changing pattern? J Clin Rheumatol. 2012;18(2):102–3.

    Article  Google Scholar 

  22. Londhey V, Agrawal S, Vaidya N, Kini S, Shastri JS, Sunil S. Dengue and Chikungunya virus co-infections: the inside story. J Assoc Physicians India. 2016;64(3):36–40.

    PubMed  Google Scholar 

  23. Halsey ES, Marks MA, Gotuzzo E, Fiestas V, Suarez L, Vargas J, Aguayo N, Madrid C, Vimos C, Kochel TJ, Laguna-Torres VA. Correlation of serotype-specific dengue virus infection with clinical manifestations. PLoS Negl Trop Dis. 2012;6(5):e1638.

    Article  Google Scholar 

  24. de Oliveira SA, Camacho LA, Bettini LR, Fernandes DG, Gouvea NA, Barros RA, Setúbal S, Siqueira MM. [The joint manifestations of exanthematous viroses]. Rev Soc Bras Med Trop. 1999;32:125–30.

    Google Scholar 

  25. Roimicher L, Ferreira OC Jr, Arruda MB, Tanuri A. Zika virus in the joint of a patient with rheumatoid arthritis. J Rheumatol. 2017;44(4):535.

    Article  Google Scholar 

  26. Duffy MR, Chen TH, Hancock WT, Powers AM, et al. Zika virus outbreak on Yap Island, Federated States of Micronesia. N Engl J Med. 2009;360:2536–43.

    Article  CAS  Google Scholar 

  27. Cherabuddi K, Iovine NM, Shah K, White SK, Paisie T, Salemi M, Morris JG Jr, Lednicky JA. Zika and Chikungunya virus co-infection in a traveller returning from Colombia, 2016: virus isolation and genetic analysis. JMM Case Rep. 2016;3(6):e005072.

    PubMed  PubMed Central  Google Scholar 

  28. Silva KR, Bica BERG, Pimenta ES, Serafim RB, et al. Fatal human case of Zika and Chikungunya virus co-infection with prolonged viremia and viruria. Diseases. 2018;6(3):53.

    Article  Google Scholar 

  29. Read JS, Torres-Velasquez B, Lorenzi O, Rivera Sanchez A, et al. Symptomatic Zika virus infection in infants, children, and adolescents living in Puerto Rico. JAMA Pediatr. 2018;172(7):686–93.

    Article  Google Scholar 

  30. Li HM, Huang YK, Su YC, Kao CH. Increased risk of autoimmune diseases in dengue patients: a population-based cohort study. J Infect. 2018;77(3):212–9. https://doi.org/10.1016/j.jinf.2018.03.014. Epub 2018 May 7.

    Article  PubMed  Google Scholar 

  31. Monsalve DM, Pacheco Y, Acosta-Ampudia Y, Rodríguez Y, Ramírez-Santana C, Anaya JM. Zika virus and autoimmunity. One-step forward. Autoimmun Rev. 2017;16(12):1237–45. https://doi.org/10.1016/j.autrev.2017.10.008. Epub 2017 Oct 14. Review.

    Article  CAS  PubMed  Google Scholar 

  32. Zea-Vera AF, Parra B. Zika virus (ZIKV) infection related with immune thrombocytopenic purpura (ITP) exacerbation and antinuclear antibody positivity. Lupus. 2017;26:890–2.

    Article  CAS  Google Scholar 

  33. Talib SH, Bhattu S, Bhattu R, Deshpande S, Dahiphale D. Dengue fever triggering systemic lupus erythematosus and lupus nephritis: a case report. Int Med Case Rep J. 2013;6:71–5.

    Article  Google Scholar 

  34. Rajadhyaksha A, Mehra S. Dengue fever evolving into systemic lupus erythematosus and lupus nephritis: a case report. Lupus. 2012;21(9):999–1002.

    Article  CAS  Google Scholar 

  35. Verdolin LD, Borner AR, Mussi H, Gismondi RA, Schau B, Ramos RC. Rhabdomyolysis associated with dengue fever in a lupic patient. Rev Bras Reumatol. 2014;54(4):318–21.

    Article  Google Scholar 

  36. Harris VK, Danda D, Murali NS, Das PK, Abraham M, Cherian AM, Chandy M. Unusual association of Kikuchi’s disease and dengue virus infection evolving into systemic lupus erythematosus. J Indian Med Assoc. 2000;98(7):391–3.

    CAS  PubMed  Google Scholar 

  37. Kumar S, Iuga A, Jean R. Cardiac tamponade in a patient with dengue fever and lupus nephritis: a case report. J Intensive Care Med. 2010;25(3):175–8.

    Article  Google Scholar 

  38. de Souza SP, de Moura CG. Dengue mimicking a lupus flare. J Clin Rheumatol. 2010;16(1):47–8.

    Article  Google Scholar 

  39. Chen WH. An unusual transitory increase of lupus anticoagulant in dengue virus infection complicated with cerebral ischaemia. J Infect. 2006;52(3):e87–91.

    Article  Google Scholar 

  40. Santosa A, Poh Z, Teng GG. Delayed diagnosis of systemic lupus erythematosus due to misinterpretation of dengue serology. Scand J Rheumatol. 2012;41(1):77–9.

    Article  CAS  Google Scholar 

  41. Wiwanitkit V. Delayed diagnosis of systemic lupus erythematosus due to misinterpretation of dengue serology: comments on the article by Santosa et al. Scand J Rheumatol. 2012;41(5):410–1.

    Article  CAS  Google Scholar 

  42. Zainal N, Tan KK, Johari J, Hussein H, Wan Musa WR, Hassan J, Lin YS, AbuBakar S. Sera of patients with systemic lupus erythematosus cross-neutralizes dengue viruses. Microbiol Immunol. 2018;62(10):659–72.

    Article  CAS  Google Scholar 

  43. Morel Z, Ramírez A. Autoimmune response in children with dengue. Case reports. Reumatol Clin. 2014;10(4):257–9.

    Article  Google Scholar 

  44. Palacios-Cuervo F, Calderón-Rivera A, Espinal-Reyes F, Canelo-Aybar C. Autoimmunity in dengue: literature review. Reumatol Clin. 2016;12(3):173–4.

    Article  Google Scholar 

  45. Colman N, Ojeda A, Yinde Y, Aquino A, Duarte M. Impacto de la infeccion por Dengue en pacientes con enfermedades autoinmunes. Revisión de casos. Rev Par Reumatol. 2017;3(1):20–4.

    Google Scholar 

  46. Agüero S, Toloza S, Lejtman N, Orellana Barrera S, Guaraz G. Manifestaciones clínicas y bioquímicas asociadas a infección por virus del dengue en pacientes con enfermedades reumáticas durante un brote epidémico en la provincia de Catamarca, República Argentina. Rev Arg Reumatol. 2011;22(3):14–28.

    Google Scholar 

  47. de Abreu MM, Maiorano AC, Tedeschi SK, Yoshida K, Lin TC, Solomon DH. Outcomes of lupus and rheumatoid arthritis patients with primary dengue infection: a seven-year report from Brazil. Semin Arthritis Rheum. 2018;47(5):749–55.

    Article  Google Scholar 

  48. Deligny C, de Bandt M, Dehlinger V, Numéric P, Cabié A, Lombard F, Polomat K, JeanBaptiste G, Arfi S. Dengue fever in patients under biologics. J Clin Virol. 2014;61(3):442–3.

    Article  Google Scholar 

  49. Wu WL, Ho LJ, Chen PC, Tsai YT, Hsu ST, Chang DM, Lai JH. Immunosuppressive effects and mechanisms of leflunomide in dengue virus infection of human dendritic cells. J Clin Immunol. 2011;31(6):1065–78.

    Article  CAS  Google Scholar 

  50. Mancera-Páez O, Román GC, Pardo-Turriago R, Rodríguez Y, Anaya JM. Concurrent Guillain-Barré syndrome, transverse myelitis and encephalitis post-Zika: a case report and review of the pathogenic role of multiple arboviral immunity. J Neurol Sci. 2018;395:47–53.

    Article  Google Scholar 

  51. Li GH, Ning ZJ, Liu YM, Li XH. Neurological manifestations of dengue infection. Front Cell Infect Microbiol. 2017;7:449.

    Article  Google Scholar 

  52. Dalugama C, Shelton J, Ekanayake M, Gawarammana IB. Dengue fever complicated with Guillain-Barré syndrome: a case report and review of the literature. J Med Case Rep. 2018;12(1):137.

    Article  Google Scholar 

  53. Malik S, Saran S, Dubey A, Punj A. Longitudinally extensive transverse myelitis following dengue virus infection: a rare entity. Ann Afr Med. 2018;17(2):86–9.

    Article  Google Scholar 

  54. Herath HMM, Hewavithana JS, De Silva CM, Kularathna OAR, Weerasinghe NP. Cerebral vasculitis and lateral rectus palsy - two rare central nervous system complications of dengue fever: two case reports and review of the literature. J Med Case Rep. 2018;12(1):100.

    Article  CAS  Google Scholar 

  55. Kamoi K, Mochizuki M, Ohno-Matsui K. Dengue fever-associated necrotizing scleritis: a case report with long-term follow-up. Medicine (Baltimore). 2018;97(32):e11875.

    Article  Google Scholar 

  56. Vouga M, Baud D. Imaging of congenital Zika virus infection: the route to identification of prognostic factors. Prenat Diagn. 2016;36(9):799–811.

    Article  Google Scholar 

  57. Olafuyi O, Badhan RKS. Dose optimisation of chloroquine by pharmacokinetic modelling during pregnancy for the treatment of Zika virus infection. J Pharm Sci. 2019;108(1):661–73. pii: S0022-3549(18)30689-0.

    Article  CAS  Google Scholar 

  58. Stanaway JD, Shepard DS, Undurraga EA, Halasa YA, et al. The global burden of dengue: a analysis from the Global Burden of Disease Study 2013. Lancet Infect Dis. 2016;16(6):712–23.

    Article  Google Scholar 

  59. Shepard DS, Undurraga EA, Halasa YA, Stanaway JD. The global economic burden of dengue: a systematic analysis. Lancet Infect Dis. 2016 Aug;16(8):935–41.

    Article  Google Scholar 

  60. World Health Organization. Emergencies: one year into the Zika outbreak: how an obscure disease became a global health emergency. Accessed at: http://www.who.int/emergencies/zika-virus/articles/one-year-outbreak/en/index5.html.

  61. Plourde AR, Bloch EM. A literature review of Zika virus. Emerg Infect Dis. 2016;22(7):1185–92.

    Article  CAS  Google Scholar 

  62. Tebas P, Roberts CC, Muthumani K, Reuschel EL, et al. Safety and immunogenicity of an anti-Zika virus DNA vaccine - preliminary report. N Engl J Med. 2017; https://doi.org/10.1056/NEJMoa1708120.

  63. World Health Organization. Dengue vaccine: WHO position paper, July 2016 - recommendations. Vaccine. 2017;35(9):1200–1.

    Article  CAS  Google Scholar 

  64. World Health Organization. Questions and answers on dengue vaccines; 20 April 2018. Accessed at: https://www.who.int/immunization/research/development/dengue_q_and_a/en/.

  65. Eppes C, Rac M, Dunn J, Versalovic J, et al. Testing for Zika virus infection in pregnancy: key concepts to deal with an emerging epidemic. Am J Obstet Gynecol. 2017;216(3):209–25.

    Article  Google Scholar 

  66. Jentes ES, et al. Evidence-based risk assessment and communication: a new global dengue-risk map for travellers and clinicians. J Travel Med. 2016;23(6)

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Health Statistics, Ministry of Health, Province of Catamarca, Argentina

    Sergio Miguel Angel Toloza

  2. Centro de Rehabilitación Nivel II Ampliado, Province of Catamarca, Argentina

    Santiago Eduardo Agüero

Authors
  1. Sergio Miguel Angel Toloza
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Santiago Eduardo Agüero
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. LSU Health Sciences at New Orleans, Louisiana State University, New Orleans, LA, USA

    Luis R. Espinoza

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Toloza, S.M.A., Agüero, S.E. (2019). Arthritis Associated with Alphavirus Infections: Dengue and Zika. In: Espinoza, L. (eds) Infections and the Rheumatic Diseases. Springer, Cham. https://doi.org/10.1007/978-3-030-23311-2_12

Download citation

Publish with us

Policies and ethics

Search

Navigation