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. Author manuscript; available in PMC: 2019 May 1.
Published in final edited form as: J Autoimmun. 2018 Jan 17;89:11–20. doi: 10.1016/j.jaut.2018.01.002

Fig. 1. ZIKV co-circulation and co-infection with DENV and CHIKV.

Fig. 1

Aedes aegypti and Aedes Albopictus are the primary vector for ZIKV, DENV, and CHIKV, and it can infect humans with all combinations of these viruses simultaneously. These mosquitoes co-circulate ZIKV, DENV, and CHIKV creating significant practical difficulties in controlling and diagnosing these arbovirus infections. Previous infection or vaccination of DENV that trigger strong T cell responses can offer protection against ZIKV infection. However, poor T-cell immunity response against DENV or ZIKV infection could increase the possibility of antibody-dependent enhancement (ADE) that worsen ZIKV infection by facilitating virus uptake by host cell. The pre-existing of ZIKV infection followed by CHIKV infection or ZIKV-CHIKV co-infection increase the incidence Guillain-Barré Syndrome and other neurological complications.