Clinical relevance of Zika symptoms in the context of a Zika Dengue epidemic

J Infect Public Health. 2020 Feb;13(2):173-176. doi: 10.1016/j.jiph.2019.07.006. Epub 2019 Aug 6.

Abstract

Background: The clinical characteristics of the most frequent arbovirosis (Dengue, Zika, Chikungunya) are very similar, which is a diagnostic challenge for clinicians.

Objective: To identify the presence of clinical characteristics related to Zika virus infection confirmed by the laboratory in patients during an epidemic of co-infection with Zika and Dengue viruses.

Method: Cross-sectional descriptive study of patients with clinical - epidemiological suspicion of Zika virus infection, who were admitted in the Hospital "Joaquín Albarrán" (La Habana, Cuba), during June 1 to October 31 of 2017. Demographic and symptoms and signs were recorded. By PCR for Zika virus (in blood or urine) the disease was confirmed.

Results: 1541 patients were studied. The most frequent symptoms and signs were rash (93.8%), pruritus (77.9%), arthralgia (60.0%), headache (50.8%), myalgia (46.1%), fever (34.7%), asthenia (31.7%), and conjunctivitis (27.9%). Zika virus infection was confirmed in 279 patients (18.1%). Greater frequency of arthralgia, asthenia, and diarrhea was demonstrated in Zika confirmed patients.

Conclusion: Minor clinical relevance was observed in the symptoms or signs of arboviral disease to support the clinical diagnosis of Zika virus infections by clinician during a Zika-Dengue epidemic. The assessment of the temporality of the onset of Zika and Dengue symptoms of these infections is recommended to assist clinicians in the differential diagnosis.

Keywords: Clinical picture; Cuba; Infection; Non-specific febrile syndrome; Zika.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Arthralgia / epidemiology
  • Asthenia / epidemiology
  • Coinfection / epidemiology
  • Cross-Sectional Studies
  • Cuba / epidemiology
  • Dengue / epidemiology*
  • Dengue Virus / isolation & purification*
  • Diarrhea / epidemiology
  • Epidemics*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Polymerase Chain Reaction
  • Young Adult
  • Zika Virus / isolation & purification*
  • Zika Virus Infection / diagnosis
  • Zika Virus Infection / epidemiology*