The Clinical Spectrum of Zika Virus in Returning Travelers

Abstract

Introduction: The clinical spectrum of Zika virus had, to date, been described in small series from endemic/epidemic countries and is not well established.

Methods: We describe the clinical manifestations of laboratory-proven Zika virus infection in Israeli travelers during December 2015-February 2016, and review all published cases of travel-related Zika virus.

Results: During the study period, 8 returning Israeli travelers were diagnosed with Zika virus infection. In addition, 41 published cases were included, mostly from Latin America to Europe and North America. Overall, 65.3% were diagnosed by polymerase chain reaction. Rash was the most frequent symptom, present in 95.7% of cases, followed by fever and arthralgia. Conjunctivitis was present in 53.1%; however, only 40.3% presented with a triad of conjunctivitis, fever, and rash. Less frequent symptoms included dysgeusia and nightmares, which, together with arthralgia, persisted for several weeks in some travelers.

Conclusions: Zika virus clinical picture in travelers is diverse. Prolonged symptoms may occur.

Keywords: Arboviruses; Israel; Travel; Zika virus.