Autor(es): Hearn P.T., Atkinson B., Hewson R., Brooks T.

Resumo: Zika virus (ZIKV) is a flavivirus related to Dengue, is transmitted by the Aedes mosquito and normally causes a self-limiting illness characterised by fever, rash, headache, conjunctival suffusion, myalgia and joint pains. It was discovered in 1947 at Zika Forest, near to Entebbe, Uganda. More recently it has been found outside Africa in outbreaks such as those of French Polynesia and the Cook Islands. We report the first case of imported Zika Fever to the UK, highlight novel samples for testing and a theoretical mode of non-vector-borne transmission. A couple travelled to the Cook Islands during what was thought to be a Dengue outbreak in February 2014. Within 6 days of exposure, both 'Patient 1' and his wife, 'Patient 2', had developed fatigue, followed 48 hours later by fever, headache, aching joints and a widespread maculopapular rash. Both reported symptoms resolving by day 5 of rash onset. In 2011, Foy et al described likely sexual transmission of ZIKV. A scientist from Colorado, travelling back from Senegal whilst incubating the virus, reportedly passed it to his wife, in whom clinical and serological evidence supported the diagnosis. On day 1 of rash onset, Patient 1 had serum sent to the Rare and Imported Pathogens Laboratory at Porton Down and a panel of serological tests based on stated travel was performed. Dengue testing revealed positive IgM, but negative IgG and PCR. This pattern has been reported previously due to cross-reactivity between the flaviviruses. The sample was then tested by PCR for ZIKV and found to be positive. Further samples were taken on day 28 after rash onset. Blood and urine from both patients were tested in parallel, along with a semen sample from Patient 1. The semen was the only sample found to be positive for ZIKV by PCR. The reasons for persistence in the semen are not yet clear, but this case is significant not only as the first case of Zika Fever imported to the UK, but also as support for the possibility of sexual transmission, though not in this case, and highlights an additional sample type for the confirmation of infection in the future.

Palavras-Chave: diagnosis, fever, hygiene, society, tropical medicine, United Kingdom

Imprenta: American Journal of Tropical Medicine and Hygiene, v. 91, n. 5, supl. 1, p. 62-63, nov. 2014

Descritores: Zika virus - Flaviviridae ; Zika virus - Pathogenesis ; Zika virus - Serology ; Zika virus - Serological diagnosis ; Zika virus - Sexual ; Zika virus - Transmission ; Zika virus - Public health ; Zika virus - Rash maculopapular ; Zika virus - Zika fever

Data de publicação: 2014

INDICADORES

ACESSO