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. 2018 May 5;217(11):1678-1689.
doi: 10.1093/infdis/jix630.

Differences in Prevalence of Symptomatic Zika Virus Infection, by Age and Sex-Puerto Rico, 2016

Matthew J Lozier  1 , Rachel M Burke  2 , Juan Lopez  1   3 , Veronica Acevedo  1 , Manuel Amador  1 , Jennifer S Read  1 , Amanda Jara  1   4 , Stephen H Waterman  1 , Roberto Barrera  1 , Jorge Muñoz-Jordan  1 , Brenda Rivera-Garcia  5 , Tyler M Sharp  1
Affiliations

Differences in Prevalence of Symptomatic Zika Virus Infection, by Age and Sex-Puerto Rico, 2016

Matthew J Lozier et al. J Infect Dis. .

Abstract

Background: During the outbreak of Zika virus (ZIKV) disease in Puerto Rico in 2016, nonpregnant women aged 20-39 years were disproportionately identified with ZIKV disease. We used household-based cluster investigations to determine whether this disparity was associated with age- or sex-dependent differences in the rate of ZIKV infection or reported symptoms.

Methods: Participation was offered to residents of households within a 100-m radius of the residences of a convenience sample of 19 laboratory-confirmed ZIKV disease cases. Participants answered a questionnaire and provided specimens for diagnostic testing by reverse transcription-polymerase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay (ELISA).

Results: Among 367 study participants, 114 (31.1%) were laboratory positive for ZIKV infection, of whom 30% reported a recent illness (defined as self-reported rash or arthralgia) attributable to ZIKV infection. Age and sex were not associated with ZIKV infection. Female sex (adjusted prevalence ratio [aPR], 2.28; 95% confidence interval [CI], 1.40, 3.67), age <40 years (aPR, 2.39; 95% CI, 1.55, 3.70), and asthma (aPR, 1.63; 95% CI, 1.12, 2.37) were independently associated with symptomatic infection.

Conclusions: Although neither female sex nor age were associated with an increased prevalence of ZIKV infection, both were associated with symptomatic infection. Further investigation to identify a potential mechanism of age- and sex-dependent differences in reporting symptomatic ZIKV infection is warranted.

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Conflict of interest statement

Potential conflicts of interest. All authors: No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

Figure 1.
Figure 1.
Flow diagram of households and participants enrolled in household-based cluster investigations—Puerto Rico, 16 September-27 October 2016.
Figure 2.
Figure 2.
Cluster-specific rate of Zika virus infection among participants enrolled in household-based cluster investigations—Puerto Rico, 16 September-27 October 2016. (Note: One cluster had three participants, of whom one was an index case and the other two did not provide adequate specimens for analysis: hence, this cluster was not included on the map.)
Figure 3.
Figure 3.
Hierarchical clustering for symptoms among Zika virus-positive participants of household-based cluster investigations—Puerto Rico, 16 September-27 October 2016 (n = 114).
See this image and copyright information in PMC

Comment in

  • Age and Sex in the Zika Pandemic Era.
    Rossi SL, Estofolete CF, Nogueira ML, Vasilakis N. Rossi SL, et al. J Infect Dis. 2018 May 5;217(11):1675-1677. doi: 10.1093/infdis/jix631. J Infect Dis. 2018. PMID: 29216367 Free PMC article. No abstract available.

References

    1. Faria NR, Azevedo RDSDS, Kraemer MUG, et al. Zika virus in the Americas: Early epidemiological and genetic findings. Science 2016; 352:345–9. - PMC - PubMed
    1. Pan American Health Organization. Zika Epidemiological Update, 17 November. Washington, D.C.: Pan American Health Organization / World Health Organization, 2016.
    1. Aubry M, Teissier A, Huart M, et al. Zika virus seroprevalence, French Polynesia, 2014–2015. Emerg Infect Dis 2017; 23. - PMC - PubMed
    1. Duffy MR, Chen TH, Hancock WT, et al. Zika virus outbreak on Yap Island, Federated States of Micronesia. N Engl J Med 2009; 360:2536–43. - PubMed
    1. World Health Organization. Zika Strategic Response Plan, Revised for July 2016 - December 2017. Geneva, Switzerland: World Health Organization, 2016.

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