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Case Reports
. 2014 Nov;91(5):1035-8.
doi: 10.4269/ajtmh.14-0151. Epub 2014 Oct 6.

First case of Zika virus infection in a returning Canadian traveler

Affiliations
Case Reports

First case of Zika virus infection in a returning Canadian traveler

Kevin Fonseca et al. Am J Trop Med Hyg. 2014 Nov.

Abstract

A woman who recently traveled to Thailand came to a local emergency department with a fever and papular rash. She was tested for measles, malaria, and dengue. Positive finding for IgM antibody against dengue and a failure to seroconvert for IgG against dengue for multiple blood samples suggested an alternate flavivirus etiology. Amplification of a conserved region of the non-structural protein 5 gene of the genus Flavivirus yielded a polymerase chain reaction product with a matching sequence of 99% identity with Zika virus. A urine sample and a nasopharygeal swab specimen obtained for the measles investigation were also positive for this virus by reverse transcription polymerase chain reaction. Subsequently, the urine sample yielded a Zika virus isolate in cell culture. This case report describes a number of novel clinical and laboratory findings, the first documentation of this virus in Canada, and the second documentation from this region in Thailand.

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Figures

Figure 1.
Figure 1.
Reverse transcription polymerase chain reaction assay showing location of genus Flavivirus bands. Lane 1, 1 kb ladder; lane 2, urine sample collected on day 6 of illness; lane 3, nasopharyngeal swab specimen collected on day 6 of illness; lane 4, serum sample collected on day 6 of illness; lane 5, serum sample collected on day 9 of illness; lane 6, positive control (Calbertado virus in vitro RNA; lane 7, negative control (RNase- free water).
Figure 2.
Figure 2.
Phylogenetic analyses of Zika virus from the patient with representative sequences deposited in Genbank. Scale bar indicates nucleotide substitutions per site.

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