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We conducted a cohort study in Mexico to evaluate the natural history of Zika infection. We describe here the frequency of Zika, chikungunya and dengue virus infections immediately after Zika introduction in Mexico, and baseline characteristics of participants for each type of infection.\n<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Prospective, observational cohort evaluating the natural history of Zika virus infection in the Mexico-Guatemala border area. Patients with fever, rash or both, meeting the modified criteria of PAHO for probable Zika cases were enrolled (June 2016\u2013July 2018) and followed-up for 6\u00a0months. We collected data on sociodemographic, environmental exposure, clinical and laboratory characteristics. Diagnosis was established based on viral RNA identification in serum and urine samples using RT-PCR for Zika, chikungunya, and dengue. We describe the baseline sociodemographic and environmental exposure characteristics of participants according to diagnosis, and the frequency of these infections over a two-year period immediately after Zika introduction in Mexico.\n<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>We enrolled 427 participants. Most patients (n\u2009=\u2009307, 65.7%) had an acute illness episode with no identified pathogen (UIE), 37 (8%) Zika, 82 (17.6%) dengue, and 1 (0.2%) chikungunya. In 2016 Zika predominated, declined in 2017 and disappeared in 2018; while dengue increased after 2017. Patients with dengue were more likely to be men, younger, and with lower education than those with Zika and UIE. They also reported closer contact with water sources, and with other people diagnosed with dengue. Participants with Zika reported sexual exposure more frequently than people with dengue and UIE. Zika was more likely to be identified in urine while dengue was more likely found in blood in the first seven days of symptoms; but PCR results for both were similar at day 7\u201314 after symptom onset.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>During the first 2\u00a0years of Zika introduction to this dengue hyper-endemic region, frequency of Zika peaked and fell over a two-year period; while dengue progressively increased with a predominance in 2018. Different epidemiologic patterns between Zika, dengue and UIE were observed. <jats:italic>Trial registration<\/jats:italic> Clinical.Trials.gov (NCT02831699).<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12879-021-06520-x","type":"journal-article","created":{"date-parts":[[2021,8,28]],"date-time":"2021-08-28T10:02:37Z","timestamp":1630144957000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Different epidemiological profiles in patients with Zika and dengue infection in Tapachula, Chiapas in Mexico (2016\u20132018): an observational, prospective cohort study"],"prefix":"10.1186","volume":"21","clinical-trial-number":[{"clinical-trial-number":"nct02831699","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4775-4734","authenticated-orcid":false,"given":"Pablo 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Poster presented at: Society for Clinical Trials 34th Annual Meeting; 2013; Boston."}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-021-06520-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12879-021-06520-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-021-06520-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,28]],"date-time":"2021-08-28T10:03:50Z","timestamp":1630145030000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcinfectdis.biomedcentral.com\/articles\/10.1186\/s12879-021-06520-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,28]]},"references-count":33,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["6520"],"URL":"https:\/\/doi.org\/10.1186\/s12879-021-06520-x","relation":{},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,28]]},"assertion":[{"value":"26 February 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 August 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 August 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study protocol was approved by an Institution Review Board in all participating institutions in Mexico. Signed informed consent was obtained from all subjects. Participation of minors (<\u200918\u00a0year old) was consented by their legal guardians and their verbal (<\u20098\u00a0year old) or written (8\u201317\u00a0year old) assent was requested. If subjects were not able to sign the consent form because of the severity of the disease, a legal representative was asked to sign the consent form. The study was reviewed and approved by the Comit\u00e9 de \u00c9tica en Investigaci\u00f3n (Comittee on Ethics in Research) and the Comit\u00e9 de Investigaci\u00f3n (Research Comittee) at the Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n (INF-2636-18-19-1) for implementation at the General Hospital of Tapachula City, Hospital Regional de Alta Especialidad Ciudad Salud, and Cl\u00ednica Dr. Roberto Nettel Flores, ISSSTE. The protocol was reviewed and approved by the Comit\u00e9 de \u00c9tica en Investigaci\u00f3n (Comittee on Ethics in Research) and the Comit\u00e9 de Investigaci\u00f3n (Research Comittee) of the Instituto Mexicano del Seguro Social (Ref 09-B5-61-2800\/201600\/2378).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Pablo-Belaunzar\u00e1n Zamudio is an Associate Editor of BMC Infectious Diseases. The other authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"881"}}