Zika virus infection in pregnant women in Barcelona, Spain
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We describe here the first pregnant women described with Zika virus (ZIKV) infection in Europe. One of the cases was a probable coinfection with dengue virus (DENV) and the most prolonged viraemia ever reported. We communicate the protocol established in our setting as a response for the international emergency. The first patient was a Colombian woman in her 40s living in Spain who had travelled to Colombia in the months of December 2015 and January 2016. Three days after her return, at approximately 10 weeks’ gestation, she observed a maculopapular, nonconfluent rash affecting her trunk and limbs, with no fever or other concurrent symptoms. Fifteen days later, she contacted the outpatient service of the International Health Unit at Vall d’Hebron Hospital, Barcelona, where an arboviral infection was suspected and a serum sample was taken. To confirm ZIKV diagnosis, anti-ZIKV immunoglobulin (Ig) M and IgG antibodies (Arboviral Fever Mosaic, Euroimmun, Germany) and specific retrotranscriptase (RT) PCR, RealStar ZIKV RT-PCR Kit and a modification from Balm et al. []) were performed at the Spanish National Microbiology Center at Instituto Carlos III, Madrid. RT-PCR and ZIKV IgG were positive and ZIKV IgM was negative. Anti–chikungunya virus (CHKV) antibodies were negative. Anti-DENV IgM and IgG (Dengue VirClia Monotest, Vircell, Granada, Spain) showed positive results. It was considered a confirmed case of ZIKV infection according to approved diagnostic criteria.