Evaluation of Patients for Zika Virus Infection in a Travel Clinic in the United States, 2016 Open Access

Abstract

Zika is an emerging infection that has challenged the U.S. public health system.
Characterization of patients with possible and confirmed infection is urgently needed to better
understand risks for infection in U.S. travelers and to inform evolving evaluation guidelines. To
address these needs, we performed a retrospective electronic health record (EHR) review of
patients evaluated for Zika virus (ZIKV) infection at an academic-affiliated travel clinic in Atlanta,
Georgia from January 1 through August 31, 2016. We evaluated 46 patients who presented to
the clinic during this period for evaluation of possible ZIKV infection, including patients with ZIKV
infection symptoms, asymptomatic patients with possible exposure to ZIKV, and referral visits
for ZIKV testing.

Among the 46 patients evaluated, 30 (65.2%) were tested for ZIKV, of which 8 patients
(17.4%) had laboratory evidence of infection (7 confirmed, 1 probable). Among those who were
tested for ZIKV, the three most frequent symptoms reported were headache (86.7%), Rash
(76.7%), and fever (66.7%). Among patients who were tested for ZIKV, rash and headache were
the most sensitive predictors of having laboratory evidence of infection (100% each). Having ≥3
positive ZIKV-related symptoms had a sensitivity of 88% (95% CI: 47%-100%) and a specificity of
50% (95% CI: 28%-72%) for having laboratory evidence of Zika (+LR: 1.75). Our findings may
assist clinicians and public health agencies in addressing timely clinical decision making for ZIKV
testing.

Table of Contents

1. Introduction: pp. 1-2
2. Methods: pp. 2-4
3. Results: pp. 4-7
4. Discussion: pp. 8-12
5. References: pp. 13-14
6. Figures and Tables: pp. 15-21

About this Master's Thesis

Rights statement

• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Epidemiology
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Medicine and Surgery Health Sciences, Epidemiology
Keyword	Zika Travel Case series
Committee Chair / Thesis Advisor	Wu, Henry M, Emory University Rosenberg, Eli S, Emory University
Partnering Agencies	Does not apply (no collaborating organization)

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