{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T06:15:50Z","timestamp":1793254550155,"version":"4.5.0"},"reference-count":14,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,10,5]]},"abstract":"<jats:p>Zika virus (ZIKV) and chikungunya virus (CHIKV) cocirculate throughout much of the tropical Western Hemisphere; however, few cases of coinfection with these two pathogens have been reported. Herein, we describe three cases of ZIKV\u2013CHIKV coinfection detected at a single center in Ecuador: a patient who developed symptoms on postoperative day 5 from an orthopedic procedure, a woman who had traveled to Ecuador for fertility treatment, and a woman who was admitted for Guillain\u2013Barr\u00e9 syndrome and had ZIKV and CHIKV detected in serum and cerebrospinal fluid. All cases were diagnosed using a multiplex real-time reverse transcription polymerase chain reaction, and ZIKV viremia was detected as late as 16 days after symptom onset. These cases demonstrate the varied clinical presentation of ZIKV\u2013CHIKV coinfections as well as the importance of multiplexed arboviral testing for these pathogens.<\/jats:p>","DOI":"10.4269\/ajtmh.16-0323","type":"journal-article","created":{"date-parts":[[2016,7,12]],"date-time":"2016-07-12T02:25:38Z","timestamp":1468290338000},"page":"894-896","source":"Crossref","is-referenced-by-count":79,"title":["Zika Virus and Chikungunya Virus CoInfections: A Series of Three Cases from a Single Center in Ecuador"],"prefix":"10.4269","volume":"95","author":[{"given":"Hector","family":"Zambrano","sequence":"first","affiliation":[{"name":"1Laboratorio de Biolog\u00eda Molecular, Hospital Luis Vernaza, Guayaquil, Ecuador."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse J.","family":"Waggoner","sequence":"additional","affiliation":[{"name":"2Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Almeida","sequence":"additional","affiliation":[{"name":"1Laboratorio de Biolog\u00eda Molecular, Hospital Luis Vernaza, Guayaquil, Ecuador."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisette","family":"Rivera","sequence":"additional","affiliation":[{"name":"1Laboratorio de Biolog\u00eda Molecular, Hospital Luis Vernaza, Guayaquil, Ecuador."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Quintana","family":"Benjamin","sequence":"additional","affiliation":[{"name":"3Departamento de Neurolog\u00eda, Hospital Luis Vernaza, Guayaquil, Ecuador."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin A.","family":"Pinsky","sequence":"additional","affiliation":[{"name":"2Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California."},{"name":"4Department of Pathology, Stanford University School of Medicine, Stanford, California."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"ref1","series-title":"N Engl J Med","first-page":"2536","article-title":"Zika virus outbreak on Yap Island, Federated States of Micronesia","volume":"360","author":"Duffy","year":"2009"},{"key":"ref2","series-title":"J Clin Microbiol","first-page":"860","article-title":"Zika virus: diagnostics for an emerging pandemic threat","volume":"54","author":"Waggoner","year":"2016"},{"key":"ref3","series-title":"Mem Inst Oswaldo Cruz","first-page":"569","article-title":"First report of autochthonous transmission of Zika virus in Brazil","volume":"110","author":"Zanluca","year":"2015"},{"key":"ref4","series-title":"Lancet","first-page":"1531","article-title":"Guillain-Barre syndrome outbreak associated with Zika virus infection in French Polynesia: a case-control study","volume":"387","author":"Cao-Lormeau","year":"2016"},{"key":"ref5","series-title":"Lancet Infect Dis","first-page":"653","article-title":"Detection and sequencing of Zika virus from amniotic fluid of fetuses with microcephaly in Brazil: a case study","volume":"16","author":"Calvet","year":"2016"},{"key":"ref6","series-title":"N Engl J Med","first-page":"1981","article-title":"Zika virus and birth defects: reviewing the evidence for causality","volume":"374","author":"Rasmussen","year":"2016"},{"key":"ref7","series-title":"Emerg Infect Dis","first-page":"381","article-title":"Co-infection with Zika and dengue viruses in 2 patients, New Caledonia, 2014","volume":"21","author":"Dupont-Rouzeyrol","year":"2015"},{"key":"ref8","series-title":"J Infect Public Health","article-title":"Dengue, chikungunya and Zika co-infection in a patient from Colombia","author":"Villamil-Gomez","year":"2016"},{"key":"ref9","series-title":"Emerg Infect Dis","first-page":"1295","article-title":"Single-reaction multiplex reverse transcription PCR for detection of Zika, chikungunya, and dengue viruses","volume":"22","author":"Waggoner","year":"2016"},{"key":"ref10","series-title":"Euro Surveill","first-page":"30159","article-title":"Isolation of infectious Zika virus from saliva and prolonged viral RNA shedding in a traveller returning from the Dominican Republic to Italy, January 2016","volume":"21","author":"Barzon","year":"2016"},{"key":"ref11","series-title":"N Engl J Med","first-page":"2142","article-title":"Zika virus infection with prolonged maternal viremia and fetal brain abnormalities","volume":"374","author":"Driggers","year":"2016"},{"key":"ref12","series-title":"J Clin Virol","first-page":"53","article-title":"Detection of Zika virus in saliva","volume":"68","author":"Musso","year":"2015"},{"key":"ref13","series-title":"Emerg Infect Dis","first-page":"1232","article-title":"Genetic and serologic properties of Zika virus associated with an epidemic, Yap State, Micronesia, 2007","volume":"14","author":"Lanciotti","year":"2008"},{"key":"ref14","series-title":"Euro Surveill","first-page":"30205","article-title":"Zika virus detection in cerebrospinal fluid from two patients with encephalopathy, Martinique, February 2016","volume":"21","author":"Roze","year":"2016"}],"container-title":["The American Society of Tropical Medicine and 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