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Zika infections acquired by travellers to countries without recognized virus circulation

Updated: 06/28/2022
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Case number Year Country in which infection acquired Country to which infection imported Description References/notes
1-3 2008 Senegal USA
  • 36-yr-old American man (case 1)
  • working in Senegal on a mosquitosampling
  • project for malaria; after
  • his return to the USA, he became ill
  • with rash, fatigue, and headache;
  • tested positive for Zika antibodies
  • in serum
  • 27-yr-old American man (case 2)
  • working in Senegal on a mosquitosampling
  • project for malaria;
  • became ill with rash, fatigue,
  • headache, and joint pain; tested
  • positive for Zika antibodies in
  • serum
  • Wife of case 1 (see above), who
  • had not travelled outside the USA,
  • became ill with rash and joint pain
  • and tested positive for Zika
  • antibodies in serum, probably
  • through sexual transmission of
  • virus from case 1

Foy 20111

Authors note that:

"human sexual transmission of an arbovirus has not been documented” this may be the first report of sexual transmission of Zika virus (from case 1 to case 3) proven sexual transmission would have major implications for the epidemiology of Zika virus and possibly for other arthropodborne flaviviruses
4 2013* Indonesia Australia 52-yr-old Australian woman who returned from Indonesia; became ill with headache and rash; tested positive for Zika by PCR Kwong 20132
5 2013 Thailand Germany Early 50s German man who returned from Thailand, where he became ill with joint pain and swelling, rash, malaise, fever, and chills; tested positive for Zika-specific neutralising antibodies in serum

Tappe 20143

First case of Zika virus infection imported into Europe

 
6 2014† Thailand Canada 45-yr-old Canadian woman who returned from Thailand, where she recalled being bitten by mosquitoes; became ill with fever, chills, mouth blisters, rash, retroorbital headache, conjunctivitis, joint and muscle tenderness; tested positive for Zika by PCR (urine sample)

Fonseca 20144

First reported detection of Zika virus in Canada
7 2014 Malaysian Borneo Germany 45-yr-old German woman who returned from Malaysian Borneo; became ill with fever, rash, sore throat, conjunctivitis, swelling of the hands, arthralgia, and hearing difficulties; tested positive for Zika-specific neutralising antibodies in serum

Tappe 20155
8 2014 Thailand Japan Early 40s Japanese man who returned from Thailand; became ill with fever, headache, and rash; tested positive for Zika by RT-PCR in urine (after serum samples were equivocal). Shinohara 20166
9 2015 Maldives Finland 37-yr-old Finnish male returned from 6 months in the Maldives; became ill with flu-like symptoms, fever, rash, ocular pain, and arthralgia; first tested positive for dengue; amplification product detected in urine showed Zika virus identical to Asian lineage strains from Easter Island 2014, French Polynesia 2013, Brazil 2015, and Thailand 2013 Korhonen 20167
10 2015 Indonesia Australia Traveller returned to Australia after a monkey bite in Bali, Indonesia; became ill with fever, rash, and conjunctivitis

Leung 20158

Authors note that mosquito-borne transmission is possible, but suggest monkey bite as plausible route.
11 2016 Philippines United States An American woman returned from the Philippines in January 2016; became ill with fever, rash, arthralgia, myalgia, and conjunctivitis; tested positive for Zika antibodies

Case still being investigated; no further information available

* Case apparently detected in 2012; published in 2013

† Case detected in early 2013; published in 2014

1Foy BD, Kobylinski KC, Foy JLC, Blitvich BJJ, Travassos da Rosa A, Haddow AD, Lanciotti RS, Tesh RB. Probable non-vector-borne transmission of Zika virus, Colorado, USA. 2011 May. Accessed 28 April 2016. http://dx.doi.org/10.3201/eid1705.101939.
2Kwong JC, Druce JD, Leder K. Zika virus infection acquired during brief travel to Indonesia. Am J Trop Med Hyg 2013;89:516-17.
3Tappe D, Rissland J, Gabriel M, et al. First case of laboratory-confirmed Zika virus infection imported into Europe, November 2013. Euro Surveill 2014;19:pii=20685.
4Fonseca K, Meatherall DZ, Drebot M, MacDonald J, Pabbaraju D, Wong S, Webster P, Lindsay R, Tellier R. Case report: first case of Zika virus infection in a returning Canadian traveller. Am J Trop Med Hyg, 2014;91(5):1035-38.
5Tappe D, Nachtigall S, Kapaun A, Schnitzler P, Günther S, Schmid-Chanasit J. Acute Zika virus infection after travel to Malaysian Borneo, September 2014. Emerg Infect Dis 2015;21:911-13.
6 Shinohara K, Katsuna S, Takasaki T, Moi ML, Ikeda M, Kotaki A, Yamamoto K, Fujiya Y, Mawatari M, Takeshita N, Hayakawa M, Kanagawa S, Kato Y, Ohmagari N. Zika fever imported from Thailand to Japan, and diagnosed by PCR in the urine. J Trav Med 2016;Jan 18;23(1):1-3. Doi: 10.1093/jtm/tav011.
7Korhonen EM, Huhtamo E, Smura T, Kallio-Kokko H, Raassina M, Vapalahti O. Zika virus infection in a traveller returning from the Maldives, June 2015. Euro Surveill. 2016;21(2):pii=30107. DOI: http://dx.doi.org/10.2807/1560-7917.ES.2016.21.2.30107.
8Leung GH, Baird RW, Druce J, Anstey NM. Zika virus infection in Australia following a monkey bite in Indonesia. Southeast Asian J Trop Med Public Health. 2015;46(3):460-4. PMID:2652151933.