A 49-year-old female presented to her primary care physician with fever and pruritic rash for four days. She denied symptoms of conjunctivitis and joint pain. Three days before the onset of symptoms, she returned with her husband (see Case 6 above) 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 was positive in urine. Serum was not tested for ZIKV (RNA or IgM) nor was serologic testing done for chikungunya or dengue viruses. ZIKV test results for all cases can be seen in Table .
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.