Zika Virus Infection Associated With Severe Thrombocytopenia

Sharp, Tyler M.; Muñoz‐Jordán, Jorge L.; Pérez-Padilla, Janice; Bello-Pagán, Melissa; Rivera, Aidsa; Pastula, Daniel M.; Salinas, Jorge; Mendez, Jose H. Martínez; Méndez, Mónica; Powers, Ann M.; Waterman, Stephen H.; Rivera-García, Brenda

doi:10.1093/cid/ciw476

Cited by 61 publications

(61 citation statements)

References 14 publications

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“…Zika virus infection during pregnancy has been associated with fetal loss and is a cause of microcephaly or other brain abnormalities (3,4). Guillain-Barré syndrome (an autoimmune disorder of the peripheral nervous system), other neurologic manifestations, and thrombocytopenia have been reported following Zika virus infections in adults (5,6). However, there are few published data on the clinical findings and outcomes of postnatally acquired Zika virus disease among children (7).…”

Section: On September 30 2016 This Report Was Posted As An Mmwr Earmentioning

confidence: 99%

Characteristics of Children Aged <18 Years with Zika Virus Disease Acquired Postnatally — U.S. States, January 2015–July 2016

Goodman¹,

Dziuban²,

Powell³

et al. 2016

MMWR Morb. Mortal. Wkly. Rep.

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Section: On September 30 2016 This Report Was Posted As An Mmwr Earmentioning

confidence: 99%

Characteristics of Children Aged <18 Years with Zika Virus Disease Acquired Postnatally — U.S. States, January 2015–July 2016

Goodman¹,

Dziuban²,

Powell³

et al. 2016

MMWR Morb. Mortal. Wkly. Rep.

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“…1 ZIKV is now recognized as a cause of congenital neurologic birth defects, notably microcephaly, 2 and has been associated with potentially fatal complications. 3,4 …”

mentioning

confidence: 99%

Persistence of Zika Virus in Body Fluids — Final Report

Paz–Bailey¹,

Rosenberg²,

et al. 2018

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BACKGROUND To estimate the frequency and duration of detectable Zika virus (ZIKV) RNA in human body fluids, we prospectively assessed a cohort of newly infected participants in Puerto Rico. METHODS We evaluated samples obtained from 150 participants (including 55 men) in whom ZIKV RNA was detected on reverse-transcriptase–polymerase-chain-reaction (RT-PCR) assay in urine or blood in an enhanced arboviral clinical surveillance site. We collected serum, urine, saliva, semen, and vaginal secretions weekly for the first month and then at 2, 4, and 6 months. All specimens were tested by means of RT-PCR, and serum was tested with the use of anti–ZIKV IgM enzyme-linked immunosorbent assay. Among the participants with ZIKV RNA in any specimen at week 4, biweekly collection continued until all specimens tested negative. We used parametric Weibull regression models to estimate the time until the loss of ZIKV RNA detection in each body fluid and reported the findings in medians and 95th percentiles. RESULTS The medians and 95th percentiles for the time until the loss of ZIKV RNA detection were 14 days (95% confidence interval [CI], 11 to 17) and 54 days (95% CI, 43 to 64), respectively, in serum; 8 days (95% CI, 6 to 10) and 39 days (95% CI, 31 to 47) in urine; and 34 days (95% CI, 28 to 41) and 81 days (95% CI, 64 to 98) in semen. Few participants had detectable ZIKV RNA in saliva or vaginal secretions. CONCLUSIONS The prolonged time until ZIKV RNA clearance in serum in this study may have implications for the diagnosis and prevention of ZIKV infection. Current sexual-prevention guidelines recommend that men use condoms or abstain from sex for 6 months after ZIKV exposure; in 95% of the men in this study, ZIKV RNA was cleared from semen after about 3 months. (Funded by the Centers for Disease Control and Prevention.)

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“…From the beginning of the current Zika outbreak in the Americas to November 2016, nine case-patients with severe Zika virus–associated thrombocytopenia have been reported, 1 in Suriname ( 10 ), 4 in Colombia ( 11 , 12 ), 2 in Puerto Rico ( 13 ), and 2 in Martinique ( 14 ). We report information for these 9 case-patients and the 7 patients we analyzed in Guadeloupe (Table).…”

Section: Resultsmentioning

confidence: 99%

“…Among the 4 patients who died, only 1 patient had isolated thrombocytopenia; this patient died of hemorrhagic complications ( 13 ). The other 3 patients had various systemic signs and symptoms and thrombocytopenia; thrombocytopenia was the direct cause of death for only 1 patient ( 11 ).…”

Section: Resultsmentioning

confidence: 99%