Arbo-Score: A Rapid Score for Early Identification of Patients with Imported Arbovirosis Caused by Dengue, Chikungunya and Zika Virus
Background: Chikungunya (CHIKV), Dengue (DENV), and Zika (ZIKV) viruses present significant clinical and epidemiological overlap, making an accurate and rapid diagnosis challenging. Timely activation of preventive vector control measures is crucial to avoid outbreaks in non-endemic settings. Diagnos...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-11-01
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| Series: | Microorganisms |
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| Online Access: | https://www.mdpi.com/2076-2607/8/11/1731 |
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| author | Iacopo Vellere Filippo Lagi Michele Spinicci Antonia Mantella Elisabetta Mantengoli Giampaolo Corti Maria Grazia Colao Federico Gobbi Gian Maria Rossolini Alessandro Bartoloni Lorenzo Zammarchi |
| author_facet | Iacopo Vellere Filippo Lagi Michele Spinicci Antonia Mantella Elisabetta Mantengoli Giampaolo Corti Maria Grazia Colao Federico Gobbi Gian Maria Rossolini Alessandro Bartoloni Lorenzo Zammarchi |
| author_sort | Iacopo Vellere |
| collection | DOAJ |
| description | Background: Chikungunya (CHIKV), Dengue (DENV), and Zika (ZIKV) viruses present significant clinical and epidemiological overlap, making an accurate and rapid diagnosis challenging. Timely activation of preventive vector control measures is crucial to avoid outbreaks in non-endemic settings. Diagnosis is based on combination of serological and molecular assays which could be time consuming and sometimes disappointing. Methods: We report the results of a retrospective case-control study carried out at a tertiary teaching hospital in Italy, including all febrile subjects returning from tropical countries during the period 2014–2019. Controls were travelers with other febrile illnesses who tested negative in laboratory analysis for CHIKV, DENV, ZIKV arbovirosis. A score weighted on the regression coefficients for the independent predictors was generated. Results: Ninety patients were identified: 34 cases (22 DENV, 4 CHIKV, and 8 ZIKV) and 56 controls. According to our results, myalgia, cutaneous rash, absence of respiratory symptoms, leukopenia, and hypertransaminasemia showed the strongest association with arbovirosis. Combining these variables, we generated a scoring model that showed an excellent performance (AUC 0.93). The best cut-off (>=2) presented a sensitivity of 82.35% and specificity of 96.43%. Conclusion: A handy and simple score, based on three clinical data (myalgia, cutaneous rash and absence of respiratory symptoms) and two laboratory results (leukopenia and hypertransaminasemia), provides a useful tool to help diagnose arboviral infections and appropriately activate vector control measures in order to avoid local transmission. |
| first_indexed | 2024-03-10T15:05:25Z |
| format | Article |
| id | doaj.art-b7941b3edeb547bbac88801e62af39df |
| institution | Directory Open Access Journal |
| issn | 2076-2607 |
| language | English |
| last_indexed | 2024-03-10T15:05:25Z |
| publishDate | 2020-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Microorganisms |
| spelling | doaj.art-b7941b3edeb547bbac88801e62af39df2023-11-20T19:48:55ZengMDPI AGMicroorganisms2076-26072020-11-01811173110.3390/microorganisms8111731Arbo-Score: A Rapid Score for Early Identification of Patients with Imported Arbovirosis Caused by Dengue, Chikungunya and Zika VirusIacopo Vellere0Filippo Lagi1Michele Spinicci2Antonia Mantella3Elisabetta Mantengoli4Giampaolo Corti5Maria Grazia Colao6Federico Gobbi7Gian Maria Rossolini8Alessandro Bartoloni9Lorenzo Zammarchi10Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, ItalyDepartment of Experimental and Clinical Medicine, University of Florence, 50134 Florence, ItalyDepartment of Experimental and Clinical Medicine, University of Florence, 50134 Florence, ItalyDepartment of Experimental and Clinical Medicine, University of Florence, 50134 Florence, ItalyInfectious and Tropical Diseases Unit, Careggi University Hospital, 50134 Florence, ItalyDepartment of Experimental and Clinical Medicine, University of Florence, 50134 Florence, ItalyClinical Microbiology and Virology Unit, Careggi University Hospital, 50134 Florence, ItalyDepartment of Infectious/Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, 37024 Negrar, Verona, ItalyDepartment of Experimental and Clinical Medicine, University of Florence, 50134 Florence, ItalyDepartment of Experimental and Clinical Medicine, University of Florence, 50134 Florence, ItalyDepartment of Experimental and Clinical Medicine, University of Florence, 50134 Florence, ItalyBackground: Chikungunya (CHIKV), Dengue (DENV), and Zika (ZIKV) viruses present significant clinical and epidemiological overlap, making an accurate and rapid diagnosis challenging. Timely activation of preventive vector control measures is crucial to avoid outbreaks in non-endemic settings. Diagnosis is based on combination of serological and molecular assays which could be time consuming and sometimes disappointing. Methods: We report the results of a retrospective case-control study carried out at a tertiary teaching hospital in Italy, including all febrile subjects returning from tropical countries during the period 2014–2019. Controls were travelers with other febrile illnesses who tested negative in laboratory analysis for CHIKV, DENV, ZIKV arbovirosis. A score weighted on the regression coefficients for the independent predictors was generated. Results: Ninety patients were identified: 34 cases (22 DENV, 4 CHIKV, and 8 ZIKV) and 56 controls. According to our results, myalgia, cutaneous rash, absence of respiratory symptoms, leukopenia, and hypertransaminasemia showed the strongest association with arbovirosis. Combining these variables, we generated a scoring model that showed an excellent performance (AUC 0.93). The best cut-off (>=2) presented a sensitivity of 82.35% and specificity of 96.43%. Conclusion: A handy and simple score, based on three clinical data (myalgia, cutaneous rash and absence of respiratory symptoms) and two laboratory results (leukopenia and hypertransaminasemia), provides a useful tool to help diagnose arboviral infections and appropriately activate vector control measures in order to avoid local transmission.https://www.mdpi.com/2076-2607/8/11/1731dengueZikachikungunyaimportedtimingdiagnosis |
| spellingShingle | Iacopo Vellere Filippo Lagi Michele Spinicci Antonia Mantella Elisabetta Mantengoli Giampaolo Corti Maria Grazia Colao Federico Gobbi Gian Maria Rossolini Alessandro Bartoloni Lorenzo Zammarchi Arbo-Score: A Rapid Score for Early Identification of Patients with Imported Arbovirosis Caused by Dengue, Chikungunya and Zika Virus Microorganisms dengue Zika chikungunya imported timing diagnosis |
| title | Arbo-Score: A Rapid Score for Early Identification of Patients with Imported Arbovirosis Caused by Dengue, Chikungunya and Zika Virus |
| title_full | Arbo-Score: A Rapid Score for Early Identification of Patients with Imported Arbovirosis Caused by Dengue, Chikungunya and Zika Virus |
| title_fullStr | Arbo-Score: A Rapid Score for Early Identification of Patients with Imported Arbovirosis Caused by Dengue, Chikungunya and Zika Virus |
| title_full_unstemmed | Arbo-Score: A Rapid Score for Early Identification of Patients with Imported Arbovirosis Caused by Dengue, Chikungunya and Zika Virus |
| title_short | Arbo-Score: A Rapid Score for Early Identification of Patients with Imported Arbovirosis Caused by Dengue, Chikungunya and Zika Virus |
| title_sort | arbo score a rapid score for early identification of patients with imported arbovirosis caused by dengue chikungunya and zika virus |
| topic | dengue Zika chikungunya imported timing diagnosis |
| url | https://www.mdpi.com/2076-2607/8/11/1731 |
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