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Travel-Associated Zika Virus Disease Acquired in the Americas Through February 2016: A GeoSentinel Analysis.

Abstract：

Background:Zika virus has spread rapidly in the Americas and has been imported into many nonendemic countries by travelers. Objective:To describe clinical manifestations and epidemiology of Zika virus disease in travelers exposed in the Americas. Design:Descriptive, using GeoSentinel records. Setting:63 travel and tropical medicine clinics in 30 countries. Patients:Ill returned travelers with a confirmed, probable, or clinically suspected diagnosis of Zika virus disease seen between January 2013 and 29 February 2016. Measurements:Frequencies of demographic, trip, and clinical characteristics and complications. Results:Starting in May 2015, 93 cases of Zika virus disease were reported. Common symptoms included exanthema (88%), fever (76%), and arthralgia (72%). Fifty-nine percent of patients were exposed in South America; 71% were diagnosed in Europe. Case status was established most commonly by polymerase chain reaction (PCR) testing of blood and less often by PCR testing of other body fluids or serology and plaque-reduction neutralization testing. Two patients developed Guillain-Barré syndrome, and 3 of 4 pregnancies had adverse outcomes (microcephaly, major fetal neurologic abnormalities, and intrauterine fetal death). Limitation:Surveillance data collected by specialized clinics may not be representative of all ill returned travelers, and denominator data are unavailable. Conclusion:These surveillance data help characterize the clinical manifestations and adverse outcomes of Zika virus disease among travelers infected in the Americas and show a need for global standardization of diagnostic testing. The serious fetal complications observed in this study highlight the importance of travel advisories and prevention measures for pregnant women and their partners. Travelers are sentinels for global Zika virus circulation and may facilitate further transmission. Primary Funding Source:Centers for Disease Control and Prevention, International Society of Travel Medicine, and Public Health Agency of Canada.

journal_name

Ann Intern Med

journal_title

Annals of internal medicine

authors

Hamer DH,Barbre KA,Chen LH,Grobusch MP,Schlagenhauf P,Goorhuis A,van Genderen PJ,Molina I,Asgeirsson H,Kozarsky PE,Caumes E,Hagmann SH,Mockenhaupt FP,Eperon G,Barnett ED,Bottieau E,Boggild AK,Gautret P,Hynes NA,Kuhn

doi

10.7326/M16-1842

subject

Has Abstract

pub_date

2017-01-17 00:00:00

pages

99-108

issue

eissn

0003-4819

issn

1539-3704

pii

2587368

journal_volume

166

pub_type

杂志文章

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Travel-Associated Zika Virus Disease Acquired in the Americas Through February 2016: A GeoSentinel Analysis.