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First report of Zika virus infection in a returned traveller from the Solomon Islands

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A 33-year-old man returning from the Solomon Islands presented to an emergency department in Brisbane after 4 days of retro-orbital headache, fever, and myalgias, which had started 10 days into his journey. On examination, he was afebrile and had a diffuse erythematous rash. A full blood count revealed mild neutropenia and thrombocytopenia. IgG seroconversion for flavivirus was shown by parallel testing, 15 days apart. Zika virus (ZIKV) RNA was also found in blood, urine and throat samples by polymerase chain reaction (PCR) testing. The patient received supportive medical care and recovered fully.

ZIKV is a mosquito-borne flavivirus, first identified in the Zika forest of Uganda during yellow fever research in 1947; the first evidence for infection in humans was reported in 1952. Serosurveys during the 1950s suggested widespread ZIKV transmission in Africa and South-East Asia.1

ZIKV infection occurs in a geographical distribution, and causes a clinical syndrome similar to mild infection with dengue virus (DENV), also a flavivirus. Infection is characterised by fever, arthralgia, myalgia, headache and rash. Other features include peripheral oedema and non-purulent conjunctivitis. Symptoms abate within 3–12 days. Asymptomatic infection is common. ZIKV infection is not typically associated with blood film abnormalities, in contrast to infection with DENV or Chikungunya virus.2

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