Evaluation of Patients for Zika Virus Infection in a Travel Clinic in the Southeast United States, 2016

South Med J. 2019 Jan;112(1):45-51. doi: 10.14423/SMJ.0000000000000917.

Abstract

Objectives: Zika virus is an emerging infection that has posed vexing challenges to the US public health system. Improved characterization of patients with possible and confirmed infection is needed to better understand risks for infection in US travelers and to inform evolving evaluation guidelines.

Methods: We performed a retrospective electronic health record review of patients evaluated for Zika virus infection at an academic travel clinic in Atlanta, Georgia, from January 1 through August 31, 2016. We evaluated 46 patients who presented to the clinic during this period for evaluation of possible Zika virus infection, including patients with Zika virus symptoms, asymptomatic patients with possible exposure to Zika virus, and referral visits for Zika virus testing.

Results: Among the 46 patients evaluated, 30 (65.2%) were tested for Zika virus, 8 of whom (17.4%) had laboratory evidence of infection (7 confirmed, 1 probable). Cases, including confirmed and probable infections, most commonly had fever, rash, conjunctivitis, headache, and myalgia, although differences compared with noncases were not statistically significant. Many patients evaluated were not tested because of stringent testing criteria.

Conclusions: Our findings may help inform improvements in timely clinical decision making for Zika virus testing. This may assist clinicians and public health agencies. Wider access to accurate screening modalities will help providers evaluate and advise patients.

MeSH terms

  • Adult
  • Ambulatory Care Facilities
  • Asymptomatic Infections
  • Conjunctivitis / etiology
  • Conjunctivitis / physiopathology
  • Exanthema / etiology
  • Exanthema / physiopathology
  • Female
  • Fever / etiology
  • Fever / physiopathology
  • Georgia / epidemiology
  • Headache / etiology
  • Headache / physiopathology
  • Humans
  • Male
  • Middle Aged
  • Myalgia / etiology
  • Myalgia / physiopathology
  • Referral and Consultation
  • Retrospective Studies
  • Travel*
  • Zika Virus Infection / complications
  • Zika Virus Infection / diagnosis*
  • Zika Virus Infection / physiopathology