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Characteristics of Zika virus infection among international travelers: A prospective study from a Spanish referral unit

Publicado en:Travel Medicine and Infectious Disease. 33 (101543): 101543- - 2020-01-01 33(101543), DOI: 10.1016/j.tmaid.2019.101543

Autores: Crespillo-Andujar, Clara; Diaz-Menendez, Marta; Trigo, Elena; Arsuaga, Marta; De la Calle, Fernando; Lago, Mar; Ladron de Guevara, Maria Concepcion; Barreiro, Pablo; Montero, Dolores; Garcia-Bujalance, Silvia; Antolin Alvarado, Eugenia; de la Calle, Maria; Paz Sanchez-Seco, Maria; de Ory, Fernando; Vazquez, Ana; Arribas, Jose R; Garcia, Julio; Martin-Boado, Elena; Martinez-Sanchez, Nuria; Rodriguez, Roberto; Herrero, Beatriz; Lopez, Francisco; Luis Bartha, Jose; Dolores Elorza, Maria; Cabrera Lafuente, Marta; Garcia Hortelano, Milagros

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© 2019 Elsevier Ltd Background: From the first Zika virus (ZIKV) description, it has progressively widespread worldwide. We analyzed demographic, clinical, microbiologic and travel-related characteristic from returned patients from a ZIKV endemic country in a referral Tropical Medicine Unit. Method: A prospective cohort study performed in a Spanish referral center with the aim of determining the significant factors associated with confirmed Zika virus (ZIKV) infection. Results: 817 patients, (56% women, median age 36 [IQR, Interquartile Range: 32–42]) were enrolled. Most had returned from Latin America (n = 486; 59.4%), travelled for tourism (n = 404; 49.4%) and stayed a median of 18 days (IQR: 10–30). 602 (73.6%) presented symptoms, but only 25 (4%) were finally diagnosed with confirmed ZIKV infection (including two pregnant women, without adverse fetal outcomes), 88% (n:22) presented with fever and 92% (n:23) with rash. 56% (n:14) arthralgia and/or myalgia and 28% (n:7) conjunctivitis. The presence of conjunctivitis, fever and rash were associated with an 8.9 (95% CI: 2.2–34.9), 6.4 (95% CI: 1.2–33.3) and 72.3 (95% CI: 9.2–563.5) times greater probability of confirmed ZIKV infection, respectively. Conclusion: Travel characteristics and clinical presentation may help clinicians to optimize requests for microbiological testing. Diagnosis of arboviriasis in travellers arriving form endemic areas remains a challenge for clinicians, but must be detected for the possible transmission outside endemic areas, where the vector is present.

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