title: Preliminary Findings from an Investigation of Zika Virus Infection in a Patient with No Known Risk Factors - Utah, 2016.
abstract: On July 12, 2016, the Utah Department of Health (UDOH) was notified by a clinician caring for an adult (patient A) who was evaluated for fever, rash, and conjunctivitis that began on July 1. Patient A had not traveled to an area with ongoing Zika virus transmission; had not had sexual contact with a person who recently traveled; and had not received a blood transfusion, organ transplant, or mosquito bites (1). Patient A provided care over several days to an elderly male family contact (the index patient) who contracted Zika virus abroad. The index patient developed septic shock with multiple organ failure and died in the hospital on June 25, 2016. The index patient's blood specimen obtained 2 days before his death had a level of viremia approximately 100,000 times higher than the average level reported in persons infected with Zika virus (2). Zika virus infection was diagnosed in patient A by real-time reverse transcription-polymerase chain reaction (rRT-PCR) testing on a urine specimen collected 7 days after symptom onset. In addition, a serum specimen collected 11 days after symptom onset, after patient A's symptoms had resolved, was positive for antibodies to Zika virus by Zika immunoglobulin M (IgM) capture enzyme-linked immunosorbent assay (MAC-ELISA) and had neutralizing antibodies detected by plaque-reduction neutralization testing (PRNT). Working with Salt Lake and Davis County Health Departments, UDOH requested assistance from CDC with an investigation to determine patient A's exposures and determine a probable source of infection.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Brent
authors.forename: Angela
authors.initials: A
authors.lastname: Dunn
authors.forename: Harry
authors.initials: H
authors.lastname: Savage
authors.forename: Ary
authors.initials: A
authors.lastname: Faraji
authors.forename: Mike
authors.initials: M
authors.lastname: Rubin
authors.forename: Ilene
authors.initials: I
authors.lastname: Risk
authors.forename: Wendy
authors.initials: W
authors.lastname: Garcia
authors.forename: Margaret
authors.initials: M
authors.lastname: Cortese
authors.forename: Shannon
authors.initials: S
authors.lastname: Novosad
authors.forename: Elisabeth Raquel
authors.initials: ER
authors.lastname: Krow-Lucal
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Crain
authors.forename: Mary
authors.initials: M
authors.lastname: Hill
authors.forename: Annette
authors.initials: A
authors.lastname: Atkinson
authors.forename: Dallin
authors.initials: D
authors.lastname: Peterson
authors.forename: Kimberly
authors.initials: K
authors.lastname: Christensen
authors.forename: Melissa
authors.initials: M
authors.lastname: Dimond
authors.forename: J Erin
authors.initials: JE
authors.lastname: Staples
authors.forename: Allyn
authors.initials: A
authors.lastname: Nakashima
mesh_terms: D000368:Aged; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D012307:Risk Factors; D014589:Utah; D000071244:Zika Virus / Q000302:isolation & purification*; D000071243:Zika Virus Infection / Q000175:diagnosis*