Neurological infection by chikungunya and a triple Arbovirus co-infection in Mato Grosso, Central Western Brazil during 2019

• Published in: Journal of clinical virology 2022-01, Vol.146, p.105056-105056, Article 105056
• Main Authors: Pavon, Janeth Aracely Ramirez, Neves, Nilvanei Aparecido da Silva, Silva, Ludmilla Campos Fernandes, Azevedo, Francisco Kennedy de, Junior, José Alexander B.de Figueiredo, Nunes, Márcio Roberto Teixeira, Slhessarenko, Renata Dezengrini
• Format: Article
• Language: English
• Subjects: Arboviruses; Brazil - epidemiology; Chikungunya Fever - complications; Chikungunya Fever - epidemiology; Coinfection - epidemiology; Genotype; High throughput sequencing; Humans; Molecular epidemiology; Phylogeny; Viral encephalitis; Viral meningitis
• ISSN: 1386-6532; 1873-5967
• DOI: 10.1016/j.jcv.2021.105056

•Arboviruses are considered the third most common cause of viral neurological infections in brazil.•CHIKV, DENV and OROV are an important etiology for neurological infections in midwestern brazil.•Two mutations in CHIKV-ECSA genomes from the state of mato grosso were identified in 2019: nsP2:T31I and nsP3: A388V.•ECSA genotype of CHIKV is one of the most important arbovirus for public health in brazil.•Genome sequencing lead to the identification of microorganisms that may cause neurological infections. Neurological viral infection is frequently associated to enterovirus, herpesvirus and arboviruses. These infections may cause severe clinical outcomes, long lasting sequelae or death. Few studies have addressed viral neurological infections etiology in Brazil. Identification of viruses in the cerebral spinal fluid (CSF) of human neurological infections suspected of viral etiology during January and May 2019 in Midwestern Brazil. Clinical, laboratory and epidemiological information was gathered from medical records. In addition, an aliquot of the sampled CSF was subjected to viral RNA/DNA extraction, randomic dscDNA amplification by PCR, DNA purification and Ilumina HiSeq 2500 sequencing. Six viral genomes belonging to Chikungunya virus (CHIKV) East-Central-South African (ECSA) genotype (10.834–11.804 nt in length) confirmed lately by RT-PCR for CHIKV envelope were present in all six liquor samples. These genomes present two mutations, nsP2:T31I and nsP3:A388V, shared with other Mato Grosso State strains from 2019, not present in sequences of the virus from previous years obtained in the State. One case was a triple co-infection also confirmed through RT-PCR, with Dengue virus serotype 4 genotype II (NS5; 874 nt) and Oropouche virus genotype IA (segment S; 302 nt). CSF was clear and colorless (5/6 patients), with >10% of lymphomononuclear cells (6/6), 1–99 erythrocytes/mm3 (5/6), glucose levels >50 mg/dl (4/5) e > 10 mg/dl of proteins (4/4). One patient evolved to death, and another, a newborn, presented sequelae after recovery. Despite herpesviruses and enteroviruses are frequent etiologies of neurological infections, the casuistic here reported was associated to arboviruses already known to be responsible for acute febrile illness outbreaks in the state of Mato Grosso, Midwestern Brazil. [Display omitted]