Arboviral Diseases Branch, Centers for Disease Control and Prevention, Fort Collins, Colorado.
California Department of Public Health, Sacramento.
Clin Infect Dis. 2020 Jan 2;70(2):227-231. doi: 10.1093/cid/ciz195.
The clinical findings among children with postnatally acquired Zika virus disease are not well characterized. We describe and compare clinical signs and symptoms for children aged <18 years.
Zika virus disease cases were included if they met the national surveillance case definition, had illness onset in 2016 or 2017, resided in a participating state, and were reported to the Centers for Disease Control and Prevention. Pediatric cases were aged <18 years; congenital and perinatal infections were excluded. Pediatric cases were matched to adult cases (18‒49 years). Clinical information was compared between younger and older pediatric cases and between children and adults.
A total of 141 pediatric Zika virus disease cases were identified; none experienced neurologic disease. Overall, 28 (20%) were treated in an emergency department, 1 (<1%) was hospitalized; none died. Of the 4 primary clinical signs and symptoms associated with Zika virus disease, 133 (94%) children had rash, 104 (74%) fever, 67 (48%) arthralgia, and 51 (36%) conjunctivitis. Fever, arthralgia, and myalgia were more common in older children (12‒17 years) than younger children (1‒11 years). Arthralgia, arthritis, edema, and myalgia were more common in adults compared to children.
This report supports previous findings that Zika virus disease is generally mild in children. The most common symptoms are similar to other childhood infections, and clinical findings and outcomes are similar to those in adults. Healthcare providers should consider a diagnosis of Zika virus infection in children with fever, rash, arthralgia, or conjunctivitis, who reside in or have traveled to an area where Zika virus transmission is occurring.
患有后天获得性寨卡病毒病的儿童的临床发现尚不清楚。我们描述并比较了年龄<18 岁的儿童的临床症状和体征。
符合国家监测病例定义、2016 年或 2017 年发病、居住在参与州并向疾病控制和预防中心报告的寨卡病毒病病例被纳入研究。儿科病例年龄<18 岁；排除先天性和围产期感染。儿科病例与成年病例（18-49 岁）相匹配。比较年龄较小和较大的儿科病例以及儿童与成人之间的临床信息。
共发现 141 例儿科寨卡病毒病病例；无神经疾病。总体而言，28 例（20%）在急诊室接受治疗，1 例（<1%）住院；无死亡病例。在与寨卡病毒病相关的 4 个主要临床体征和症状中，133 例（94%）儿童出现皮疹，104 例（74%）发热，67 例（48%）关节痛，51 例（36%）结膜炎。发热、关节痛和肌痛在年龄较大的儿童（12-17 岁）中比年龄较小的儿童（1-11 岁）更常见。关节痛、关节炎、水肿和肌痛在成年人中比儿童更常见。
本报告支持先前的发现，即寨卡病毒病在儿童中通常较轻。最常见的症状与其他儿童感染相似，临床发现和结局与成人相似。在发烧、皮疹、关节痛或结膜炎且居住在或曾前往寨卡病毒传播地区的儿童中，应考虑寨卡病毒感染的诊断。
