Arthritis Associated with Alphavirus Infections: Dengue and Zika

  • Sergio Miguel Angel Toloza
  • Santiago Eduardo Agüero


Dengue virus (DENV) and Zika virus (ZIKV) are a cause of significant morbidity and mortality worldwide within specific regions of the world where they are endemic and susceptible to the occurrence of epidemics. The interaction between these viruses and other host factors (especially the immunocompetence) seems to influence the expression and severity of these conditions. The various clinical forms of both DENV and ZIKV are still being characterized phenotypically, serologically, and genetically together with the pathophysiological mechanisms leading to their protean clinical manifestations and complications. Arthralgias involving small and large joints occur frequently in DENV-affected patients, but typical arthritis is seldom found; accordingly, a physical exam of joints is often unremarkable. Joint pain may precede, appear simultaneously, or subsequently to the onset of fever, and might be masked by more prominent symptoms like backache, large-bone pain, and myalgias. The arthritic phenotype of DENV infection is still unknown, but it seems monoarticular, short-lived, and responsive to symptomatic treatment, whereas the articular manifestations of ZIKV infection are less severe. ZIKV is more likely to induce neurological complications and congenital abnormalities. Coinfection of DENV and ZIKV with chikungunya virus seems to lead to protracted arthritis manifestations and may be associated to a higher morbidity and mortality.


Dengue Zika virus Arthritis phenotype Autoimmune diseases Pathophysiology Diagnosis Pregnancy Management Prevention 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Sergio Miguel Angel Toloza
    • 1
  • Santiago Eduardo Agüero
    • 2
  1. 1.Health Statistics, Ministry of HealthProvince of CatamarcaArgentina
  2. 2.Centro de Rehabilitación Nivel II AmpliadoProvince of CatamarcaArgentina

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