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.

中文翻译：

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国际旅行者中寨卡病毒感染的特征：西班牙转诊单位的前瞻性研究

背景

从第一个Zika病毒（ZIKV）描述开始，它已在全球范围内逐步传播。我们分析了热带医学科转诊的ZIKV流行国家归国患者的人口统计学，临床，微生物学和与旅行相关的特征。

方法

在西班牙转诊中心进行的一项前瞻性队列研究旨在确定与确诊的寨卡病毒（ZIKV）感染相关的重要因素。

结果

纳入817例患者（56％的女性，中位年龄36 [IQR，四分位间距：32-42]）。大多数人从拉丁美洲返回（n = 486； 59.4％），旅游（n = 404； 49.4％），平均停留时间为18天（IQR：10–30）。602（73.6％）出现症状，但最终只有25（4％）被诊断出确诊ZIKV感染（包括两名孕妇，无不良胎儿结局），88％（n：22）出现发烧，92％（n： 23）有皮疹。56％（n：14）的关节痛和/或肌痛和28％（n：7）的结膜炎。结膜炎，发烧和皮疹的存在与被确认的ZIKV机率高8.9（95％CI：2.2–34.9），6.4（95％CI：1.2–33.3）和72.3（95％CI：9.2–563.5）相关分别感染。

结论

出行特征和临床表现可帮助临床医生优化微生物检测要求。对于从流行地区到达的旅行者来说，虫媒病毒的诊断仍然是临床医生面临的挑战，但必须检测到存在这种媒介的流行地区外可能传播。