Zika disease generally mild in children

  • Lindsey NP & al.
  • Clin Infect Dis
  • 11 Mar 2019

  • International Clinical Digest
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Takeaway

  • Neurological manifestations appear to be uncommon in postnatally acquired Zika virus (ZIKV) infections in children.
  • Most common clinical manifestations that are generally mild include rash, fever, arthralgia, and conjunctivitis, in that order.

Why this matters

  • Include ZIKV among differentials in children presenting with acute onset fever, rash, arthralgia, or conjunctivitis who also reside in/have traveled to an area with active ZIKV transmission.

Key results

  • 141 cases, 64% 12-17 years, 30% 5-11 years, 5% 1-4 years, 1%
  • 99% (139) had travel-related ZIKV acquisition.
  • 89% (125) had laboratory-confirmed ZIKV (87% [109] by RT-PCR; 13% [16] by IgM).
  • Among 4 primary clinical signs/symptoms, 94% (133) had rash, 74% (104) fever, 48% (67) arthralgia, 36% (51) conjunctivitis.
  • 82% (116) had ≥2 signs/symptoms.
  • Fever, arthralgia, myalgia reported more frequently in older vs younger children (P=.02, P<.01 p=".04," respectively vs younger children>
  • Arthralgia (OR, 0.43; 95% CI, 0.27-0.71; P<.01 arthritis ci myalgia reported more frequently in adults vs children of all age groups.>

Study design

  • Case-cohort study describing clinical manifestations/outcomes among children
  • Funding: CDC.

Limitations

  • Nongeneralizable.

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