Abstract
In 2016, Zika virus disease developed in a man (patient A) who had no known risk factors beyond caring for a relative who died of this disease (index patient). We investigated the source of infection for patient A by surveying other family contacts, healthcare personnel, and community members, and testing samples for Zika virus. We identified 19 family contacts who had similar exposures to the index patient; 86 healthcare personnel had contact with the index patient, including 57 (66%) who had contact with body fluids. Of 218 community members interviewed, 28 (13%) reported signs/symptoms and 132 (61%) provided a sample. Except for patient A, no other persons tested had laboratory evidence of recent Zika virus infection. Of 5,875 mosquitoes collected, none were known vectors of Zika virus and all were negative for Zika virus. The mechanism of transmission to patient A remains unknown but was likely person-to-person contact with the index patient.
Highlights
In 2016, Zika virus disease developed in a man who had no known risk factors beyond caring for a relative who died of this disease
Evaluation of Family Contacts and Mortuary Worker A total of 22 family members or friends potentially interacted with the index patient from his return to the United States until after his death; 19 (86%) met the definition of a contact
Our investigation of patient A did not identify the probable source of his infection and did not identify any additional persons recently infected with Zika virus among family contacts, healthcare workers, or community members
Summary
In 2016, Zika virus disease developed in a man (patient A) who had no known risk factors beyond caring for a relative who died of this disease (index patient). We investigated the source of infection for patient A by surveying other family contacts, healthcare personnel, and community members, and testing samples for Zika virus. Patient A had not traveled to an area with ongoing Zika virus transmission, had not had sexual contact with a person who recently traveled to such an area, and had not received a blood transfusion or organ transplant. Given the lack of travel or other risk factors for acquiring Zika virus for patient A, a public health investigation was launched to better define his exposures and determine a probable source of infection
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