Serum samples were used for all diagnostic tests described below. For diagnosis of suspect dengue cases, DENV IgM Capture DxSelect™ (Focus Diagnostics, CA, USA) and Platelia™ Dengue NS1 Ag ELISA (BioRad Laboratories, CA, USA) were performed. Molecular detection and serotype typing were performed as previously described 28, by real‐time RT‐PCR protocol 29 and Simplexa™ Dengue Real Time RT‐PCR (Focus Diagnostics, Cypress, CA, USA) according to manufactureŕs protocol. We considered a positive diagnosis for DENV the samples positive for DENV qRT‐PCR or/and Dengue NS1 Ag, as stated above. Dengue patients were considered with primary infection provided being positive for IgM, whether negative for IgG or positive for IgG, provided the rate IgM/IgG was greater than 2.0. Dengue cases considered secondary infection presented IgM/IgG rate less than 2.0 18. We considered a positive diagnosis for Zika the samples positive for real‐time RT‐PCR for ZIKV, as described previously 19. DENV/ZIKV coinfected patients presented both criteria mentioned above for DENV and Zika positivity. For diagnosis of the suspected chikungunya cases, it was performed anti‐CHIKV IgM capture ELISA described by CDC 30 and Brazilian Ministry of Health 31, anti‐CHIKV ELISA IgM (Euroimmun, Lubeck, Germany) and molecular RT‐PCR protocol for CHIKV as described previously 32. Patient details are provided in Table 1.