Zika virus, an emerging flavivirus, as a cause of fever and rash in a traveller returning from Central America

Abstract

Fever in a returning traveller is a common clinical scenario for physicians in primary and acute care. Differential diagnoses for these patients are generated based on presenting clinical symptoms, travel destinations, potential exposure activities as well as the incubation period of common etiologic agents. In a case of fever and rash in a woman returning to Canada from El Salvador in November 2015, measles, dengue and chikungunya viral infections were queried as possible causes. Subsequent molecular testing using amplification of conserved regions of the flavivirus genome from nasopharyngeal and urine samples was positive, suggesting an active flavivirus infection. Sequencing was significant for the identification of Zika virus, a flavivirus that has only recently become endemic to Brazil and is now emerging throughout Central America. Zika virus should now be included in the differential diagnosis for travelers returning from Central and South America with a febrile illness and rash. To our knowledge this is the first reported case of Zika virus in Canada related to the most recent outbreak in Central America, South America and the Caribbean.