Travel-Associated Zika Virus Infection — An Update

Summary and Comment |
December 1, 2016

Travel-Associated Zika Virus Infection — An Update

  1. Stephen G. Baum, MD

A summary of the epidemiology, clinical findings, and sequelae of travel-associated Zika virus infections in the Americas

  1. Stephen G. Baum, MD

Zika virus infection (ZVI) in the Americas was first identified in Brazil in 2015. Many studies have been published since then, but these authors concentrate on travel-associated infection (TAI) transmitted by mosquito.

Ninety-three cases (median age, 41; 63% female) met the interim case definition established by the U.S. Council of State and Territorial Epidemiologists: 64 confirmed, 13 probable, and 16 clinically suspect (in patients with travel to a Zika virus–prevalent area and a compatible clinical presentation). Zones of exposure were South America (59%), the Caribbean (25%), and Central America (16%). The median stay in the country of exposure was 22 days; median time from symptom onset to clinic presentation was 6 days. Most diagnoses were made in Europe and North America.

Polymerase chain reaction was performed in 72 cases, yielding 57 confirmed cases. Blood was positive in 30 cases; urine, 10; blood and urine, 12; saliva and urine, 2; semen, 2; and urine and semen, 1. Plaque reduction neutralization assays were positive in an additional 7 cases. The most common signs and symptoms were exanthema (88%), fever (76%), arthralgia (72%), headache (61%), myalgia (60%), fatigue (47%), conjunctivitis (40%), and pruritus (23%). Laboratory results were variable and not pathognomonic.

Disease was generally mild. Three of four pregnant women had severe fetal complications, and two patients developed Guillain-Barré syndrome — both now accepted as ZVI-related sequelae.


As with all “new infections,” additional clinical presentations, modes of transmission, and sequelae will be revealed with time. For now, efforts should emphasize curtailing modes of transmission, some of which are only passingly described in the article.

Editor Disclosures at Time of Publication

  • Disclosures for Stephen G. Baum, MD at time of publication Consultant / Advisory board Clinical Infectious Diseases (Editorial Advisory Board) Speaker’s bureau UpToDate (author) Editorial boards Medical Letter (Board of Directors, Chairman)


Reader Comments (1)


I have found information update on Zika Virus infection very rewarding as the epidemiology of the disease continues to evolve

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