Conversely, we cannot rule out that some of the suspected cases, especially those without CPK measurement, had another cause of myalgia, such as infection by dengue, chikungunya, or Zika viruses, which have been concomitantly transmitted in Salvador since 2015,19, 20, 21 or epidemic myalgia22 caused by enteroviruses, such as echovirus 22 and 23, or by human parechoviruses (HPeV).23 Here, PIK3C2A is linked to infection.