National Centre for Infectious Diseases, Moulmein Road, Singapore, 308433, Singapore.
Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore.
BMC Infect Dis. 2018 Jul 4;18(1):301. doi: 10.1186/s12879-018-3211-9.
The first autochthonous Zika virus (ZIKV) outbreak in Singapore was detected in August 2016. We report an analysis of the correlation of clinical illness with viremia and laboratory parameters in this Asian cohort.
We conducted a prospective longitudinal cohort study of patients with a positive blood ZIKV polymerase chain reaction (PCR) result who were admitted to Tan Tock Seng Hospital, Singapore, for isolation and management.
We included 40 patients in our study. Rash was present in all patients, while 80% (32/40) had fever, 62.5% (25/40) myalgia, 60% (24/40) conjunctivitis and 38% (15/40) arthralgia. The median duration of viremia was 3.5 days (IQR: 3-5 days). Patients with viremia of ≥4 days were more likely to have prolonged fever compared to those with viremia of less than 4 days (95% versus 63%, p = 0.01), but had no significant correlation with other clinical signs and symptoms, or laboratory investigations. However, 21 patients (53%) had hypokalemia despite the absence of gastrointestinal symptoms.
Although fever correlated with duration of viremia, 30% of patients remained viremic despite defervescence. Laboratory abnormalities such as leukopenia or thrombocytopenia were not prominent in this cohort but about half the patients were noted to have hypokalemia.
2016 年 8 月，新加坡首次发现本地的 Zika 病毒（ZIKV）爆发。我们报告了对该亚洲队列中病毒血症与临床疾病之间相关性的分析。
我们对因确诊 Zika 病毒聚合酶链反应（PCR）阳性而被送往新加坡陈笃生医院进行隔离和管理的患者进行了前瞻性纵向队列研究。
我们纳入了 40 名患者。所有患者均出现皮疹，而 80%（32/40）有发热，62.5%（25/40）有肌痛，60%（24/40）有结膜炎，38%（15/40）有关节炎。病毒血症的中位持续时间为 3.5 天（IQR：3-5 天）。病毒血症持续时间≥4 天的患者与病毒血症持续时间<4 天的患者相比，发热时间延长的可能性更高（95%对 63%，p=0.01），但与其他临床体征和症状或实验室检查均无显著相关性。然而，尽管没有胃肠道症状，仍有 21 名患者（53%）出现低钾血症。
尽管发热与病毒血症持续时间相关，但仍有 30%的患者在退热后仍有病毒血症。本队列中白细胞减少或血小板减少等实验室异常并不明显，但约一半患者出现低钾血症。
