List: Fatal Sickle Cell Disease and Zika Virus Infection in Girl from Colombia

Abstract

Zika virus, a mosquito-borne flavivirus, causes, a usually self-limiting febrile and exanthematic arthralgia syndrome that resembles dengue and chikungunya (1). This arboviral disease has emerged in tropical areas of Latin America, particularly in Brazil and Colombia (2), as a public health threat in 2015 and has spread into areas to which dengue virus (DENV) and chikungunya virus (CHIKV) are endemic (1–4).

Cases of severe and fatal Zika virus infection have not been described (5), and the spectrum of clinical disease remains uncertain in the setting of rapidly evolving epidemics of this arbovirus in Latin America (1). We report a person with sickle cell disease who acquired a Zika virus infection and died.

The patient was a 15-year-old girl who in October 2015 came to the outpatient clinic of the Hospital of Malambo (a primary-level public hospital) in Malambo (Atlántico Department) in northern Colombia. In this region, during September 22, 2015–January 2, 2016, a total of 468 suspected cases of Zika virus infection and 4 reverse transcription PCR (RT-PCR)–confirmed cases have been reported. This patient had a high fever (temperature >40°C), arthralgias, retro-ocular pain, abdominal pain, myalgias, and jaundice for the previous 4 days. She had sickle cell disease for 5 years (hemoglobin genotype SC identified by DNA analysis), but no previous hospitalizations or episodes of vaso-occlusive crises. She had never had dengue, chikungunya, or acute chest syndrome.