Zika virus infection in the Veterans Health Administration (VHA), 2015-2016.
Zika virus (ZIKV) is an important flavivirus infection. Although ZIKV infection is rarely fatal, risk for severe disease in adults is not well described. Our objective was to describe the spectrum of illness in U.S. Veterans with ZIKV infection.Case series study including patients with laboratory-co...
Published in: | PLOS Neglected Tropical Diseases |
---|---|
Main Authors: | , , , , , , , , |
Format: | Article in Journal/Newspaper |
Language: | English |
Published: |
Public Library of Science (PLoS)
2018
|
Subjects: | |
Online Access: | https://doi.org/10.1371/journal.pntd.0006416 https://doaj.org/article/cbab8f02498341a2831ac97f4945b995 |
id |
ftdoajarticles:oai:doaj.org/article:cbab8f02498341a2831ac97f4945b995 |
---|---|
record_format |
openpolar |
spelling |
ftdoajarticles:oai:doaj.org/article:cbab8f02498341a2831ac97f4945b995 2023-05-15T15:13:19+02:00 Zika virus infection in the Veterans Health Administration (VHA), 2015-2016. Patricia L Schirmer Aaron Wendelboe Cynthia A Lucero-Obusan Russell A Ryono Mark A Winters Gina Oda Mirsonia Martinez Sonia Saavedra Mark Holodniy 2018-05-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0006416 https://doaj.org/article/cbab8f02498341a2831ac97f4945b995 EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC5967711?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0006416 https://doaj.org/article/cbab8f02498341a2831ac97f4945b995 PLoS Neglected Tropical Diseases, Vol 12, Iss 5, p e0006416 (2018) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2018 ftdoajarticles https://doi.org/10.1371/journal.pntd.0006416 2022-12-31T01:28:59Z Zika virus (ZIKV) is an important flavivirus infection. Although ZIKV infection is rarely fatal, risk for severe disease in adults is not well described. Our objective was to describe the spectrum of illness in U.S. Veterans with ZIKV infection.Case series study including patients with laboratory-confirmed or presumed positive ZIKV infection in all Veterans Health Administration (VHA) medical centers. Adjusted odds ratios of clinical variables associated with hospitalization and neurologic complications was performed.Of 1,538 patients tested between 12/2015-10/2016 and observed through 3/2017, 736 (48%) were RT-PCR or confirmed IgM positive; 655 (89%) were male, and 683 (93%) from VA Caribbean Healthcare System (VACHCS). Ninety-four (13%) were hospitalized, 91 (12%) in the VACHCS. Nineteen (3%) died after ZIKV infection. Hospitalization was associated with increased Charlson co-morbidity index (adjusted odds ratio [OR] 1.2; 95% confidence interval [CI], 1.1-1.3), underlying connective tissue disease (OR, 29.5; CI, 3.6-244.7), congestive heart failure (OR, 6; CI, 2-18.5), dementia (OR, 3.6; CI, 1.1-11.2), neurologic symptom presentation (OR, 3.9; CI, 1.7-9.2), leukocytosis (OR, 11.8; CI, 4.5-31), thrombocytopenia (OR, 7.8; CI, 3.3-18.6), acute kidney injury (OR, 28.9; CI, 5.8-145.1), or using glucocorticoids within 30 days of testing (OR, 13.3; CI 1.3-133). Patients presenting with rash were less likely to be hospitalized (OR, 0.29; CI, 0.13-0.66). Risk for neurologic complications increased with hospitalization (OR, 5.9; CI 2.9-12.2), cerebrovascular disease (OR 4.9; CI 1.7-14.4), and dementia (OR 2.8; CI 1.2-6.6).Older Veterans with multiple comorbidities or presenting with neurologic symptoms were at increased risk for hospitalization and neurological complications after ZIKV infection. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 12 5 e0006416 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Patricia L Schirmer Aaron Wendelboe Cynthia A Lucero-Obusan Russell A Ryono Mark A Winters Gina Oda Mirsonia Martinez Sonia Saavedra Mark Holodniy Zika virus infection in the Veterans Health Administration (VHA), 2015-2016. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Zika virus (ZIKV) is an important flavivirus infection. Although ZIKV infection is rarely fatal, risk for severe disease in adults is not well described. Our objective was to describe the spectrum of illness in U.S. Veterans with ZIKV infection.Case series study including patients with laboratory-confirmed or presumed positive ZIKV infection in all Veterans Health Administration (VHA) medical centers. Adjusted odds ratios of clinical variables associated with hospitalization and neurologic complications was performed.Of 1,538 patients tested between 12/2015-10/2016 and observed through 3/2017, 736 (48%) were RT-PCR or confirmed IgM positive; 655 (89%) were male, and 683 (93%) from VA Caribbean Healthcare System (VACHCS). Ninety-four (13%) were hospitalized, 91 (12%) in the VACHCS. Nineteen (3%) died after ZIKV infection. Hospitalization was associated with increased Charlson co-morbidity index (adjusted odds ratio [OR] 1.2; 95% confidence interval [CI], 1.1-1.3), underlying connective tissue disease (OR, 29.5; CI, 3.6-244.7), congestive heart failure (OR, 6; CI, 2-18.5), dementia (OR, 3.6; CI, 1.1-11.2), neurologic symptom presentation (OR, 3.9; CI, 1.7-9.2), leukocytosis (OR, 11.8; CI, 4.5-31), thrombocytopenia (OR, 7.8; CI, 3.3-18.6), acute kidney injury (OR, 28.9; CI, 5.8-145.1), or using glucocorticoids within 30 days of testing (OR, 13.3; CI 1.3-133). Patients presenting with rash were less likely to be hospitalized (OR, 0.29; CI, 0.13-0.66). Risk for neurologic complications increased with hospitalization (OR, 5.9; CI 2.9-12.2), cerebrovascular disease (OR 4.9; CI 1.7-14.4), and dementia (OR 2.8; CI 1.2-6.6).Older Veterans with multiple comorbidities or presenting with neurologic symptoms were at increased risk for hospitalization and neurological complications after ZIKV infection. |
format |
Article in Journal/Newspaper |
author |
Patricia L Schirmer Aaron Wendelboe Cynthia A Lucero-Obusan Russell A Ryono Mark A Winters Gina Oda Mirsonia Martinez Sonia Saavedra Mark Holodniy |
author_facet |
Patricia L Schirmer Aaron Wendelboe Cynthia A Lucero-Obusan Russell A Ryono Mark A Winters Gina Oda Mirsonia Martinez Sonia Saavedra Mark Holodniy |
author_sort |
Patricia L Schirmer |
title |
Zika virus infection in the Veterans Health Administration (VHA), 2015-2016. |
title_short |
Zika virus infection in the Veterans Health Administration (VHA), 2015-2016. |
title_full |
Zika virus infection in the Veterans Health Administration (VHA), 2015-2016. |
title_fullStr |
Zika virus infection in the Veterans Health Administration (VHA), 2015-2016. |
title_full_unstemmed |
Zika virus infection in the Veterans Health Administration (VHA), 2015-2016. |
title_sort |
zika virus infection in the veterans health administration (vha), 2015-2016. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2018 |
url |
https://doi.org/10.1371/journal.pntd.0006416 https://doaj.org/article/cbab8f02498341a2831ac97f4945b995 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 12, Iss 5, p e0006416 (2018) |
op_relation |
http://europepmc.org/articles/PMC5967711?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0006416 https://doaj.org/article/cbab8f02498341a2831ac97f4945b995 |
op_doi |
https://doi.org/10.1371/journal.pntd.0006416 |
container_title |
PLOS Neglected Tropical Diseases |
container_volume |
12 |
container_issue |
5 |
container_start_page |
e0006416 |
_version_ |
1766343877938118656 |