title: Initial experience with imported Zika virus infection in Spain.
abstract: A considerable increase of imported Zika virus (ZIKV) infection has been reported in Europe in the last year. This is the result of the large outbreak of the disease in the Americas, along with the increase in the numbers of travellers and immigrants arriving from ZIKV endemic areas.
  
  
  
  A descriptive study was conducted in the Tropical Medicine Unit of Hospital La Paz-Carlos III in Madrid on travellers returning from an endemic area for ZIKV from January to April 2016. Demographic, clinical and microbiological data were analyzed.
  
  
  
  A total of 185 patients were screened for ZIKV (59.9% women, median age of 37.7±10.3 years). Main purpose of the travel was tourism to Colombia, Brazil, and México. Just under three-quarters (73%) were symptomatic, mostly with fever and headache. A total of 13 patients (7% of those screened) were diagnosed with ZIKV infections, of which four of them were pregnant. All of them were symptomatic patients, the majority immigrants, and mainly from Colombia. Diagnostic tests were based on positive neutralization antibodies (8 cases, 61.6%) and a positive RT-PCR in different organic fluids (7 cases, 53.8%) The four infected pregnant women underwent a neurosonography every 3 weeks, and no alterations were detected. RT-PCR in amniotic fluid was performed in three of them, with negative results. One of the children has already been born healthy.
  
  
  
  Our cases series represents the largest cohort of imported ZIKV to Spain described until now. Clinicians must increase awareness about the progression of the ZIKV outbreak and the affected areas so that they can include Zika virus infection in their differential diagnosis for travellers from those areas.
authors.affiliation: Unidad de Medicina Tropical y del Viajero, Hospital Universitario La Paz-Carlos III, Madrid, Spain. Electronic address: marta.diaz@salud.madrid.org.
authors.forename: Marta
authors.initials: M
authors.lastname: Díaz-Menéndez
authors.affiliation: Unidad de Medicina Tropical y del Viajero, Hospital Universitario La Paz-Carlos III, Madrid, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: de la Calle-Prieto
authors.affiliation: Servicio de Microbiología y Parasitología, Hospital Universitario La Paz-Carlos III, Madrid, Spain.
authors.forename: Dolores
authors.initials: D
authors.lastname: Montero
authors.affiliation: Sección de Ecografía y Medicina Fetal, Servicio de Obstetricia y Ginecología, Hospital Universitario La Paz-Carlos III, Madrid, Spain.
authors.forename: Eugenia
authors.initials: E
authors.lastname: Antolín
authors.affiliation: Centro Nacional de Microbiología, Unidad de Virología, Arbovirus y Enfermedades Víricas Importadas, Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Vazquez
authors.affiliation: Unidad de Medicina Tropical y del Viajero, Hospital Universitario La Paz-Carlos III, Madrid, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Arsuaga
authors.affiliation: Unidad de Medicina Tropical y del Viajero, Hospital Universitario La Paz-Carlos III, Madrid, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Trigo
authors.affiliation: Servicio de Microbiología, Hospital Universitario La Paz-Carlos III, Madrid, Spain.
authors.forename: Silvia
authors.initials: S
authors.lastname: García-Bujalance
authors.affiliation: Unidad de Medicina Materno-fetal, Servicio de Obstetricia y Ginecología, Hospital Universitario La Paz-Carlos III, Madrid, Spain.
authors.forename: María
authors.initials: M
authors.lastname: de la Calle
authors.affiliation: Centro Nacional de Microbiología, Unidad de Virología, Arbovirus y Enfermedades Víricas Importadas, Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Paz
authors.initials: P
authors.lastname: Sánchez Seco
authors.affiliation: Centro Nacional de Microbiología, Laboratorio de Serología, Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: de Ory
authors.affiliation: Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital La Paz-Carlos III, Madrid, Spain.
authors.forename: Jose Ramón
authors.initials: JR
authors.lastname: Arribas
mesh_terms: D000328:Adult; D000569:Americas; D000076263:Communicable Diseases, Imported / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D014195:Travel; D000071243:Zika Virus Infection / Q000175:diagnosis / Q000453:epidemiology
keywords: Arbovirus; Epidemia; Epidemic; Infección por virus Zika; Medicina del viajero; Travel medicine; Zika virus infection