Encephalitis' clinical and laboratory characteristics during a triple epidemic of Dengue, Zika and Chikungunya 

Our pilot study aims to investigate clinical and laboratory aspects of 18 patients who developed encephalitis during a triple epidemics of Dengue, Zika and Chikungunya in Brazilian northeast from June 2015 to December 2017. Those people were assisted in a single tertiary center.

By that time, we asked the patients to donate blood and cerebral spinal fluid (CSF) for further virological study. As we had no funding to laboratory tests by that time, the samples were stored in an adequate facility and the patients’ clinical history was carefully noted in medical records. This initiative was approved by local ethical committee.

With funding available, first we will conduct a search for viral genetic material in those samples, though a technique called real-time polymerase chain reaction (RT-PCR).

We are also going to look into the samples for antibodies against Dengue, Zika and Chikungunya. Antibodies are specific structures from the human defense system that show us if defense was activated against an invader. They usually last from weeks to months in the host blood and CSF.

Latter, we are going to measure a CSF biomarker to measure degeneration of brain cells.

Finally, we are going to compare clinical and laboratory data, to find out which virus was able to cause a larger damage and if the encephalitis was more severe when vestiges of more than one virus are present in the same patient.

If our biomarkers proof to be useful we will pursue a larger project in which we are going it during patients’ one-year follow-up to evaluate if the damage caused by the viruses is only punctual or if they are able to generate a chronic and sustained brain damage.

Lead project-Aline de Moura Brasil Matos, Instituto de Medicina Tropical, Medicine School, University of São Paulo, Brazil