Comparison of clinical characteristics of Zika and dengue symptomatic infections and other acute illnesses of unidentified origin in Mexico.

• Published in: PLOS Neglected Tropical Diseases
• Main Authors: Pablo F Belaunzarán-Zamudio, Allyson Mateja, Paola Del Carmen Guerra-de-Blas, Héctor A Rincón-León, Karla Navarro-Fuentes, Emilia Ruiz-Hernández, Sandra Caballero-Sosa, Francisco Camas-Durán, Zoila Priego-Smith, José G Nájera-Cancino, Alexander López-Roblero, Karina Del Carmen Trujillo-Murillo, John H Powers, Sally Hunsberger, Sophia Siddiqui, John H Beigel, Raydel Valdés-Salgado, Guillermo Ruiz-Palacios, Mexican Emerging Infectious Diseases Clinical Research Network (LaRed)
• Format: Article in Journal/Newspaper
• Language: English
• Published: Public Library of Science (PLoS) 2021
• Subjects: Arctic medicine. Tropical medicine; RC955-962; Public aspects of medicine; RA1-1270; Arctic
• Online Access: https://doi.org/10.1371/journal.pntd.0009133; https://doaj.org/article/2f15c9dcd5fb4ecc968b38fea6b1ced9

Background Our purpose was to provide a detailed clinical description, of symptoms and laboratory abnormalities, and temporality in patients with confirmed Zika and dengue infections, and other acute illnesses of unidentified origin (AIUO). Methods/ principal findings This was a two-year, multicenter, observational, prospective, cohort study. We collected data from patients meeting the Pan American Health Organization's modified case-definition criteria for probable Zika infection. We identified Zika, dengue chikungunya by RT-PCR in serum and urine. We compared characteristics between patients with confirmed Zika and dengue infections, Zika and AIUO, and Dengue and AIUO at baseline, Days 3,7,28 and 180 of follow-up. Most episodes (67%) consistent with the PAHO definition of probable Zika could not be confirmed as due to any flavivirus and classified as Acute Illnesses of Unidentified Origin (AIUO). Infections by Zika and dengue accounted for 8.4% and 16% of episodes. Dengue patients presented with fever, generalized non-macular rash, arthralgia, and petechiae more frequently than patients with Zika during the first 10 days of symptoms. Dengue patients presented with more laboratory abnormalities (lower neutrophils, lymphocytosis, thrombocytopenia and abnormal liver function tests), with thrombocytopenia lasting for 28 days. Zika patients had conjunctivitis, photophobia and localized macular rash more frequently than others. Few differences persisted longer than 10 days after symptoms initiation: conjunctivitis in Zika infections, and self-reported rash and petechia in dengue infections. Conclusions Our study helps characterize the variety and duration of clinical features in patients with Zika, dengue and AIUO. The lack of diagnosis in most patients points to need for better diagnostics to assist clinicians in making specific etiologic diagnoses.