Valle Javier, Eick Stephanie M, Fairley Jessica K, Waggoner Jesse J, Goodman Richard A, Rosenberg Eli, Wu Henry M
From the Department of Family and Preventive Medicine and the Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, the Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, Georgia, and the School of Public Health, State University of New York, Albany.
South Med J. 2019 Jan;112(1):45-51. doi: 10.14423/SMJ.0000000000000917.
Zika virus is an emerging infection that has posed vexing challenges to the US public health system. Improved characterization of patients with possible and confirmed infection is needed to better understand risks for infection in US travelers and to inform evolving evaluation guidelines.
We performed a retrospective electronic health record review of patients evaluated for Zika virus infection at an academic travel clinic in Atlanta, Georgia, from January 1 through August 31, 2016. We evaluated 46 patients who presented to the clinic during this period for evaluation of possible Zika virus infection, including patients with Zika virus symptoms, asymptomatic patients with possible exposure to Zika virus, and referral visits for Zika virus testing.
Among the 46 patients evaluated, 30 (65.2%) were tested for Zika virus, 8 of whom (17.4%) had laboratory evidence of infection (7 confirmed, 1 probable). Cases, including confirmed and probable infections, most commonly had fever, rash, conjunctivitis, headache, and myalgia, although differences compared with noncases were not statistically significant. Many patients evaluated were not tested because of stringent testing criteria.
Our findings may help inform improvements in timely clinical decision making for Zika virus testing. This may assist clinicians and public health agencies. Wider access to accurate screening modalities will help providers evaluate and advise patients.
寨卡病毒是一种新出现的感染源，给美国公共卫生系统带来了棘手的挑战。需要对可能感染和确诊感染的患者进行更全面的特征描述，以便更好地了解美国旅行者的感染风险，并为不断发展的评估指南提供依据。
我们对2016年1月1日至8月31日期间在佐治亚州亚特兰大一家学术旅行诊所接受寨卡病毒感染评估的患者进行了回顾性电子健康记录审查。我们评估了在此期间到诊所就诊以评估可能感染寨卡病毒的46名患者，包括有寨卡病毒症状的患者、可能接触过寨卡病毒的无症状患者以及因寨卡病毒检测而进行的转诊就诊患者。
在接受评估的46名患者中，30名（65.2%）接受了寨卡病毒检测，其中8名（17.4%）有感染的实验室证据（7例确诊，1例可能感染）。包括确诊和可能感染在内的病例最常见的症状是发热、皮疹、结膜炎、头痛和肌痛，尽管与非病例相比差异无统计学意义。由于严格的检测标准，许多接受评估的患者未进行检测。
我们的研究结果可能有助于为寨卡病毒检测的及时临床决策改进提供参考。这可能有助于临床医生和公共卫生机构。更广泛地使用准确的筛查方式将有助于医疗服务提供者评估患者并提供建议。
