A 48-year-old male presented to his primary care physician with fever, pruritic rash, conjunctivitis, and joint pain for four days. Three days before the onset of symptoms, he returned with his wife (see Case 7 below) from a 12-day trip to Saint Martin and Saint Barthélemy: territories with known vector-borne ZIKV transmission []. The patient denied sexual contact with anybody who had “recently returned from a country where Zika has been spreading.” RT-PCR for ZIKV RNA in serum and urine as well as Zika IgM ELISA in serum were all positive. The patient was not tested for dengue or chikungunya virus.
A 56-year-old female presented to her primary care physician with fever, conjunctivitis, arthralgia, and a rash on her chest, arms, and neck. She reported recent travel to Jamaica. History regarding trip duration and timing relative to symptom onset is not available. Body fluid samples were collected, and RT-PCR for ZIKV RNA was positive in urine and negative in serum. Serum RT-PCR RNA for dengue virus was negative. Serology for dengue virus was negative for IgM and positive for IgG. Serum RT-PCR for chikungunya virus RNA was negative.