{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T05:55:15Z","timestamp":1791352515478,"version":"4.3.1"},"update-to":[{"DOI":"10.1371\/journal.pntd.0013260","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T00:00:00Z","timestamp":1757894400000}}],"reference-count":36,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T00:00:00Z","timestamp":1757289600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100020905","name":"Universidad Surcolombiana","doi-asserted-by":"publisher","award":["3660"],"award-info":[{"award-number":["3660"]}],"id":[{"id":"10.13039\/501100020905","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013409","name":"Sistema General de Regal\u00c3as de Colombia","doi-asserted-by":"publisher","award":["2020000100145"],"award-info":[{"award-number":["2020000100145"]}],"id":[{"id":"10.13039\/501100013409","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Dengue and chikungunya are arboviral diseases with overlapping clinical characteristics. Dengue virus (DENV) is endemic in Colombia, and in 2014\/2015, the chikungunya virus (CHIKV) caused an epidemic that resulted in over 350,000 cases. Since then, both viruses have been actively co-circulating. The early and accurate identification of pediatric infection caused by DENV or CHIKV is essential for proper medical management. Given that subsequent infections and co-infections with DENV and CHIKV have been reported, virological and immunological factors may influence their clinical outcomes. Here, we analyzed the viremia, antigenemia, and virus-specific antibody responses in hospitalized children suspected of having dengue during the peak of CHIKV infections in Colombia.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Ninety-one children with a clinical diagnosis of dengue were included in the peak of the CHIKV epidemic (December 2014 to May 2015) at a reference healthcare center in Huila, south of Colombia. Multiplexed RT-qPCR for DENV, CHIKV, and ZIKV was performed, and DENV antigenemia was evaluated using an ELISA for the NS1 antigen. Commercial capture or in-house indirect NS1-based ELISAs were used to assess circulating DENV and CHIKV-IgM and IgG. Clinical and laboratory characteristics were analyzed during hospitalization, and convalescent follow-up was conducted for a fraction of children.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>DENV and CHIKV monoinfections were confirmed in 54% and 12% of children, respectively, with the expected virus-specific seroconversion in recovery. Overlapping infections occurred in 22% of the children, while 12% showed no detectable DENV or CHIKV infections. Abdominal pain, vomiting, hepatomegaly, and thrombocytopenia were common findings associated with DENV, while arthralgia and rash characterized CHIKV monoinfections. One fatal secondary DENV-3 monoinfection was registered, and DENV infection dominated the symptoms of overlapping infections without producing different clinical outcomes compared to monoinfections. Thirty-eight percent of children were seropositive for CHIKV-IgG, indicating a significant burden of CHIKV infection in the pediatric population shortly after its introduction in Colombia. The previous virus-specific IgG serostatus did not impact the clinical outcome of the current heterotypic arboviral infection.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The pediatric population in southern Colombia was rapidly exposed to CHIKV infections during the first months following its arrival, with up to 12% of hospitalized children suspected of having dengue experiencing CHIKV monoinfection, supporting that complex and dynamic epidemiological patterns may lead to delayed or missed diagnoses. The overlapping infections of DENV and CHIKV were frequent and did not lead to worse clinical or fatal outcomes.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0013260","type":"journal-article","created":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T18:03:34Z","timestamp":1757354614000},"page":"e0013260","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":8,"title":["Clinical, virological, and antibody profiles of overlapping dengue and chikungunya virus infections in children from southern Colombia"],"prefix":"10.1371","volume":"19","author":[{"given":"Daniela","family":"Polan\u00eda-Espinosa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebasti\u00e1n","family":"Castro-Trujillo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0129-5210","authenticated-orcid":true,"given":"Carlos F.","family":"Narv\u00e1ez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,9,8]]},"reference":[{"issue":"4","key":"pntd.0013260.ref001","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1128\/CMR.00035-09","article-title":"Dengue virus pathogenesis: an integrated view","volume":"22","author":"BEE Martina","year":"2009","journal-title":"Clin Microbiol Rev"},{"issue":"6","key":"pntd.0013260.ref002","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1016\/S1473-3099(16)00026-8","article-title":"The global burden of dengue: an analysis from the Global Burden of Disease Study 2013","volume":"16","author":"JD Stanaway","year":"2016","journal-title":"Lancet Infect Dis"},{"key":"pntd.0013260.ref003","unstructured":"Instituto Nacional de Salud. Informe de evento y tableros de control. Available from: https:\/\/www.ins.gov.co\/buscador-eventos\/Paginas\/Info-Evento.aspx"},{"key":"pntd.0013260.ref004","unstructured":"Situaci\u00f3n epidemiol\u00f3gica del dengue en las Am\u00e9ricas. Available from: https:\/\/ais.paho.org\/ArboPortal\/AME_DENG_Situation_Report_SP_2024.asp?env=pri"},{"issue":"10427","key":"pntd.0013260.ref005","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1016\/S0140-6736(23)02576-X","article-title":"Dengue","volume":"403","author":"G Paz-Bailey","year":"2024","journal-title":"Lancet"},{"key":"pntd.0013260.ref006","doi-asserted-by":"crossref","DOI":"10.1093\/infdis\/jiw390","article-title":"Epidemiology of Chikungunya in the Americas","volume":"214","author":"S Yactayo","year":"2016","journal-title":"J Infect Dis"},{"key":"pntd.0013260.ref007","volume-title":"Comportamiento de los eventos de vigilancia en Salud P\u00fablica","author":"Instituto Nacional de Salud","year":"2024"},{"issue":"1","key":"pntd.0013260.ref008","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1038\/s41572-023-00429-2","article-title":"Chikungunya fever","volume":"9","author":"K Bartholomeeusen","year":"2023","journal-title":"Nat Rev Dis 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Krishnan","year":"2021","journal-title":"Pathogens"},{"key":"pntd.0013260.ref033","doi-asserted-by":"crossref","first-page":"821061","DOI":"10.3389\/fcimb.2022.821061","article-title":"Comodulation of Dengue and Chikungunya Virus Infection During a Coinfection Scenario in Human Cell Lines","volume":"12","author":"D Taraphdar","year":"2022","journal-title":"Front Cell Infect Microbiol"},{"issue":"6","key":"pntd.0013260.ref034","doi-asserted-by":"crossref","first-page":"1218","DOI":"10.4269\/ajtmh.22-0120","article-title":"Arbovirus Antibody Seroprevalence in the Human Population from Cauca, Colombia","volume":"107","author":"J Gil-Mora","year":"2022","journal-title":"Am J Trop Med Hyg"},{"issue":"4","key":"pntd.0013260.ref035","doi-asserted-by":"crossref","first-page":"56","DOI":"10.3390\/antib9040056","article-title":"High Seroprevalence of Antibodies against Arboviruses among Pregnant Women in Rural Caribbean Colombia in the Context of the Zika Virus Epidemic","volume":"9","author":"E 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