Experience with a triplex arbovirus nucleic acid test (NAT) at a Canadian Public Health Laboratory

dc.contributor.authorChoudhury, Saugata
dc.contributor.authorTellier, Raymond
dc.contributor.authorFonseca, Kevin
dc.contributor.authorBerenger, Byron M.
dc.date.accessioned2021-11-14T01:02:18Z
dc.date.available2021-11-14T01:02:18Z
dc.date.issued2021-11-10
dc.date.updated2021-11-14T01:02:17Z
dc.description.abstractAbstract Background Dengue, chikungunya and zika infections occur in tropical and subtropical regions of the world. We describe the utilization of an in-house nucleic acid test (NAT) targeting all three viruses for febrile returning travelers in Alberta, Canada. Methods NAT was performed until 40 days from symptom onset or exposure due to the prolonged duration of zika virus RNA detection. From Sept 1, 2017 to August 31, 2019, 2552 specimens from 1932 patients were tested. Results Approximately 2% of patients tested were NAT positive for dengue virus (n = 42), chikungunya virus (n = 4), and zika virus (n = 1). The majority presented with fever, myalgia and rash. Regions with the most frequent travel included SouthEast Asia (68.5%), South America (25%) and the Caribbean (6.5%). Ct values were stronger (~ 1.5 logs) for patients within 1–3 days following onset of clinical symptoms than those presenting later. Nineteen patients had urine and plasma submitted; 5 were positive for both specimens and 2 were positive only for dengue virus in the urine. Also, Ct values were lower for plasma when compared to the corresponding urine. RNA was detected until 10 days and 5 days post-exposure in plasma and urine respectively for dengue virus. Conclusions Owing to dengue viremia detected beyond the conventional 7 days and low levels of circulating zika virus globally, a cutoff of 14 days from symptom onset to NAT is sufficient to diagnose acute cases. Inclusion of a zoonotic history form that collects appropriate clinical history results in improved test utilization.
dc.identifier.citationBMC Infectious Diseases. 2021 Nov 10;21(1):1147
dc.identifier.doihttps://doi.org/10.1186/s12879-021-06842-w
dc.identifier.urihttp://hdl.handle.net/1880/114111
dc.identifier.urihttps://doi.org/10.11575/PRISM/45804
dc.language.rfc3066en
dc.rights.holderThe Author(s)
dc.titleExperience with a triplex arbovirus nucleic acid test (NAT) at a Canadian Public Health Laboratory
dc.typeJournal Article
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