Cutaneous Manifestations and Associated Systemic Findings of Patients with Zika Infections

Charussri  Leeyaphan; Ploypailin  Tantrapornpong

doi:10.33192/Smj.2020.44

Authors

Charussri Leeyaphan Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700 http://orcid.org/0000-0001-8430-376X
Ploypailin Tantrapornpong Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700 http://orcid.org/0000-0002-6632-7706

DOI:

https://doi.org/10.33192/Smj.2020.44

Keywords:

Zika virus, viral exanthema, maculopapular rash

Abstract

Objective: This retrospective study explored the clinical characteristics and laboratory results of ZIKV infections, and compared them with those of other viral exanthems.
Methods: The medical records of patients presenting with maculopapular viral exanthems between January 2017 and December 2018 were reviewed. The patients were divided into 2 two groups: ZIKV infections (confirmed by urine RT-PCR testing for ZIKV), and other viral exanthems. The clinical characteristics and laboratory results of complete blood counts of the two groups were compared.
Results: In all, 104 viral-exanthem patients were reviewed, with 35 patients diagnosed with a ZIKV infection (33.7%) and 69 with other viral exanthems (66.3%). The mean age of the ZIKV-infected patients was significantly higher than that of the other-viral-exanthem group (43.6 vs 36.2 years; p-value = 0.005). A multivariate analysis revealed that the incidences of a family/close contact cluster, conjunctivitis, and myalgia were significantly associated with ZIKV infections. However, there were no significant associations between the laboratory results of the ZIKV and other-viral-exanthem groups.
Conclusion: The ZIKV infection exhibits a prominent pattern recognition, including a family/close contact cluster, conjunctivitis, and myalgia, that can be used to distinguish it from other exanthematous viral diseases.

References

1. Tabak F, Murtezaoglu A, Tabak O, Ozaras R, Mete B, Kutlubay Z, et al. Clinical features and etiology of adult patients with Fever and rash. Ann Dermatol 2012;24:420-5.
2. Keighley CL, Saunderson RB, Kok J, Dwyer DE. Viral exanthems. Curr Opin Infect Dis 2015;28:139-50.
3. Biesbroeck L, Sidbury R. Viral exanthems: an update. Dermatol Ther 2013;26:433-8.
4. MacDonald PDM, Holden EW. Zika and Public Health: Understanding the Epidemiology and Information Environment. Pediatrics 2018;141(Supplement 2):S137.
5. Baud D, Gubler DJ, Schaub B, Lanteri MC, Musso D. An update on Zika virus infection. Lancet (London, England) 2017;390:2099-109.
6. Chang C, Ortiz K, Ansari A, Gershwin ME. The Zika outbreak of the 21st century. J Autoimmun 2016;68:1-13.
7. Hussain A, Ali F, Latiwesh OB, Hussain S. A Comprehensive Review of the Manifestations and Pathogenesis of Zika Virus in Neonates and Adults. Cureus 2018;10:e3290.
8. Armstrong N, Hou W, Tang Q. Biological and historical overview of Zika virus. World J Virol 2017;6:1-8.
9. Aziz H, Zia A, Anwer A, Aziz M, Fatima S, Faheem M. Zika virus: Global health challenge, threat and current situation. J Med Virol 2017;89:943-51.
10. Haby MM, Pinart M, Elias V, Reveiz L. Prevalence of asymptomatic Zika virus infection: a systematic review. B World Health Organ 2018;96:402-13d.
11. Agumadu VC, Ramphul K. Zika Virus: A Review of Literature. Cureus 2018;10:e3025.
12. Adams L, Bello-Pagan M, Lozier M, Ryff KR, Espinet C, Torres J, et al. Update: Ongoing Zika Virus Transmission - Puerto Rico, November 1, 2015-July 7, 2016. MMWR 2016;65:774-9.
13. Sun J, Fu T, Mao H, Wang Z, Pan J, Rutherford S, et al. A cluster of Zika virus infection in a Chinese tour group returning from Fiji and Samoa: Sci Rep 2017;7:43527.
14. Wang G, Zheng W, Wu Z, Qi R, Zhu S, Tong Y, et al. A cluster of Zika virus infection among travellers returning to China from Samoa: a case tracing study. J Travel Med. 2018;25(1). doi: 10.1093/jtm/tay022.
15. Wu D, Sun J, Zhong H, Guan D, Zhang H, Tan Q, et al. A family cluster of imported ZIKV cases: Viremia period may be longer than previously reported. J Infection 2016;73:300-3.
16. Buathong R, Hermann L, Thaisomboonsuk B, Rutvisuttinunt W, Klungthong C, Chinnawirotpisan P, et al. Detection of Zika Virus Infection in Thailand, 2012-2014. Am J Trop Med Hyg 2015;93:380-3.
17. Basarab M, Bowman C, Aarons EJ, Cropley I. Zika virus. BMJ (Clinical research ed) 2016;352:i1049.
18. Ng DHL, Ho HJ, Chow A, Wong J, Kyaw WM, Tan A, et al. Correlation of clinical illness with viremia in Zika virus disease during an outbreak in Singapore. BMC Infect Dis 2018;18:301.
19. Benzekri R, Belfort R, Jr., Ventura CV, de Paula Freitas B, Maia M, Leite M, et al. [Ocular manifestations of Zika virus: What we do and do not know]. J. Fr. Ophtalmol 2017;40:138-45.
20. Woon YL, Lim MF, Tg Abd Rashid TR, Thayan R, Chidambaram SK, Syed Abdul Rahim SS, et al. Zika virus infection in Malaysia: an epidemiological, clinical and virological analysis. BMC Infect Dis 2019;19:152.
21. Vieira M, Costa CHN, Linhares ADC, Borba AS, Henriques DF, Silva E, et al. Potential role of dengue virus, chikungunya virus and Zika virus in neurological diseases. Mem Inst Oswaldo Cruz 2018;113:e170538.