Thread by @guerreroespejo

A 49-YO♀️: fever, myalgia, headache, blanching papular rash on her trunk & limbs, & conjunctivitis (1)
Neutropenia & mild hepatitis
The patient's husband accompanied the patient to the Cook Islands: a highly similar rash (2)
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doi.org/10.1093/cid/ci…
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Arboviral infection was suspected.
Pan-flavivirus PCR: ➕
PCR was sequenced, & a BLAST search: ➕ for Zika virus.

ZIKA VIRUS INFECTION

The wife (and her husband): recovery over 5 days with no specific treatment.
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doi.org/10.1093/cid/ci…
#virology #MedTwitter #MolBiol

Zika virus, endemic to Southeast Asia & Africa, is transmitted by Aedes species mosquitoes.

Clinical manifestations (fever, maculopapular rash, myalgias, and headache) are similar to other arboviral infections, such as dengue and chikungunya,
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Rash and conjunctivitis is more commonly reported in ZIKV than in dengue

Elevated liver enzymes, which are found in patients with acute dengue fever, are found in some, but not all, patients with Zika fever
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The illness is typically mild and self-limited with resolution over 1 week.

Neurological complications including Guillain-Barré syndrome have been described.
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Diagnosis most commonly relies on PCR of acute serum samples or ELISA for IgM antibodies against Zika virus

Serologic cross-reactivity with other flaviviruses is common, in particular dengue virus
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