Zika virus rash pattern, spots in vacationer could aid diagnosis, U.S. dermatologists say
Scientists may be determining new ways of recognizing Zika virus infections earlier
A vacationer with a confirmed Zika virus test developed a bumpy rash, spots and bloodshot eyes, say US. doctors, who add that the findings could help to recognize the infection early or rule it out.
Currently, the World Health Organization says a person can be suspected of being infected with Zika if they have a redness of the skin or mucous membranes and/or fever with at least one of: joint pain, arthritis or conjunctivitis (also called pink eye).
In Wednesday's online edition of JAMA Dermatology, doctors provide a detailed description of the case of an unidentified 44-year-old man who returned to New York from a six-day vacation in Puerto Rico.
Within three days of his return, he had a headache and lethargy. A day later, the redness erupted on his arms and hands. Over the next day, the eruption became more apparent and spread to his trunk. Itching wasn't a major feature, but he said his eyes were "bloodshot."
- Federal government announces $5M to help Zika virus fight
- Zika virus detection broadens to urine test
By the third day, the eruption faded on the upper body and darkened his knees and feet and he described burning in his feet.
The man said he felt joint pain in the wrist, knees and ankles on the fourth day. All symptoms improved on Day 5 and were gone by Day 8.
Symptoms match those elsewhere
When Dr. Amit Garg of the Hofstra Northwell School of Medicine in New York and his team examined the man, they observed many tiny pink and red papules scattered over the head, neck, trunk, and extremities, including the
palms and soles.
Petechiae, a small red or purple spot caused by bleeding into the skin, were found in the hard palate of the upper mouth.
A detailed awareness of the findings associated with Zika virus infection "will support its early recognition and will facilitate elimination of Zika infection from consideration for concerned patients who present with other, more common erythematous [redness] eruptions," the researchers said.
The team also describe high-power microscopic findings of the skin.
Tests detected Zika virus RNA in the urine but not the blood from samples taken three days after the eruption.
He did not experience cough, inflammation of the mucous membrane of the nose, sore throat, diarrhea, nausea, or vomiting.
Zika has spread across South and central America, as well as the Caribbean and South Pacific.
The man's symptoms match those of patients in Brazil, where the current outbreak began.
The WHO says people with Zika virus disease can have symptoms that can include mild fever, skin rash, conjunctivitis, muscle and joint pain, malaise or headache. These symptoms normally last for 2 to 7 days.
It's estimated about one in four people infected with Zika virus are believed to develop symptoms, federal health officials say.
There is no specific treatment or vaccine currently available.
Health officials in the U.S. and Canada expect more cases among people who've travelled to Zika-affected areas. As of May 5, the Public Health Agency of Canada reports 67 travel-related cases and 1 locally acquired case through sexual transmission in Canada.
Travellers are advised to protect themselves against mosquito bites.
While the illness is generally mild, April's risk assessment from the Public Health Agency of Canada's notes there is now scientific consensus that Zika virus causes infant microcephaly and other severe brain anomalies, as well as rare but severe outcomes such as Guillain Barré syndrome, a neurological disorder that can lead to paralysis.
Babies with microcephaly have abnormally small heads that can result in developmental problems.
The overall risk in Canada is very low, federal health officials say. Mosquitoes known to transmit the virus are not established in Canada and are not well-suited to our climate.