Symptomatology of Zika Virus Infection During Pregnancy [20C

Abstract

INTRODUCTION: This study describes symptoms reported by patients with confirmed Zika virus (ZIKV) infection during pregnancy. METHODS: Data were obtained from patients attending our institution with a diagnosis confirmed either by positive real-time reverse transcription–polymerase chain reaction or immunoglobulin M enzyme-linked immunosorbent assay. RESULTS: A total of 273 patients with a diagnosis of Zika virus infection were identified with 222 (81.3%) reporting symptoms while 51 (18.7%) were asymptomatic. The average maternal age at diagnosis was 24 y/o (range 17-38) and average pre-pregnancy BMI was 26.48 kg/m2 (range 15.8–48.2) similar to our general low risk population. Reported symptoms included: maculopapular rash in 210 (94.6%), arthralgia 85 (38.3%), fever 46 (20.7%), general malaise 19 (8.6%), headache 29 (13.1%), conjunctivitis 36 (16.2%), hand and/or feet swelling 11 (5.0%), retro-orbital pain 12 (5.4%), itching 18 (8.1%) and vomiting 6 (2.7%). Less common symptoms were myalgia (7), back pain (6), bone pain (2), chills (1), cough (1), nausea (1), hand numbness (1), mild thrombocytopenia (1), ocular itching (1), dizziness (2), pancytopenia (1), and symptoms of upper respiratory tract infection (1). Eight two patients (36.9%) reported only one symptom. Rash was the most common isolated symptom in 79/82 patients (96%). CONCLUSION: Symptoms of ZIKV infection are varied. The characteristic rash is not present in 5% of symptomatic patients and conjunctivitis is much less frequent than previously reported. Physician bias may lead to testing patients with certain classic symptoms. Since clinical symptoms may be absent, vague, or varied, physicians must be alert at any sign that could suggest infection.