Surveillance report of Zika virus among Canadian travellers returning from the Americas

Andrea K. Boggild; Jennifer Geduld; Michael Libman; Cedric P. Yansouni; Anne E. McCarthy; Jan Hajek; Wayne Ghesquiere; Yazdan Mirzanejad; Jean Vincelette; Susan Kuhn; Pierre J. Plourde; Sumontra Chakrabarti; David O. Freedman; Kevin C. Kain

doi:10.1503/cmaj.161241

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Figure 1:
Distribution of 41 cases of Zika virus infection by month of acquisition among ill travellers presenting for care at a CanTravNet site from October 2015 to September 2016.

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Table 1:

Demographic characteristics of 41 ill travellers presenting to a CanTravNet site for care of Zika virus acquired in the Americas, October 2015 to September 2016^*

Characteristic	Acquisition period; no. (%) of travellers with Zika virus infection^†			p value^‡
Characteristic	Total n = 41	October 2015 to March 2016 n = 13	April to September 2016 n = 28	p value^‡
Sex				0.7
Male	17 (41)	6 (46)	11 (39)
Female	24 (59)	7 (54)	17 (61)
Age, yr, median (range)	36 (13–70)	36 (18–54)	35 (13–70)	0.8
Reason for travel
Tourism	17 (41)	4 (31)	13 (46)	0.5
Visiting friends and relatives	15 (37)	7 (54)	8 (29)	0.2
Business	4 (10)	0 (0)	4 (14)	0.3
Missionary/aid work	4 (10)	2 (15)	2 (7)	0.6
Education	1 (2)	0 (0)	1 (4)	1.0
Region of acquisition
Caribbean	22 (54)	4 (31)	18 (64)	0.09
Central America	10 (24)	2 (15)	8 (29)	0.5
South America	8 (20)	7 (54)	1 (4)	< 0.001
North America	1 (2)	0 (0)	1 (4)	1.0

↵* The total cohort comprised 1118 travellers returning from the Americas between Oct. 1, 2015, and Sept. 30, 2016.
↵† Unless stated otherwise.
↵‡ Comparison between first half of study period (October 2015 to March 2016) and latter half (April to September 2016). Categorical variables were compared by means of Fisher exact test, and continuous variables were compared by means of Mann–Whitney Rank sum test.

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Table 2:

Presenting symptoms of ill travellers with Zika virus infection or dengue who presented to a CanTravNet site, October 2015 to September 2016

Symptom	Diagnosis; no. (%) of travellers
Symptom	Zika virus n = 41	Dengue n = 41
Any rash	36 (88)	15 (37)
Fever	33 (80)	36 (88)
Diffuse rash	29 (71)	12 (29)
Arthralgia	22 (54)	12 (29)
Myalgia	19 (46)	20 (49)
Fatigue	19 (46)	9 (22)
Headache	17 (41)	18 (44)
Focal rash	7 (17)	3 (7)
Conjunctivitis	5 (12)	0 (0)
Diarrhea	5 (12)	7 (17)
Cough	4 (10)	4 (10)
Arthritis	3 (7)	2 (5)
Paresthesia	2 (5)	0 (0)
Dyspnea	1 (2)	1 (2)
Epididymitis	1 (2)	0 (0)
Sore throat	1 (2)	0 (0)
Nausea	1 (2)	4 (10)