Zika virus rash pattern, spots in vacationer could aid diagnosis, U.S. dermatologists say

A vacationer with a confirmed Zika virus test developed a bumpy rash, spots and bloodshot eyes, say US. doctors, who add that the findings could help to recognize the infection early or rule it out.

Currently, the World Health Organization says a person can besuspected of being infected with Zika if they have a redness of the skin or mucous membranes and/or fever with at least one of: joint pain, arthritis or conjunctivitis (also called pink eye).

In Wednesday's online edition of JAMA Dermatology, doctors provide a detailed description of the case of an unidentified 44-year-old man who returned to New York from a six-day vacation in Puerto Rico.

Within three days of his return, he had a headache and lethargy. A day later, the redness erupted on his arms and hands. Over the next day, the eruption became more apparent and spread to his trunk. Itching wasn't a major feature, but he said his eyes were "bloodshot."

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By the third day, the eruption faded on the upper body and darkened his knees and feet and he described burning in his feet.

The man said he felt joint pain in the wrist, knees and ankles on the fourth day. All symptoms improved on Day 5 and were gone by Day 8.

Symptoms match those elsewhere

When Dr.Amit Gargof the Hofstra Northwell School of Medicine inNew York and his team examined the man, they observed many tiny pink and redpapules scattered over the head, neck, trunk, and extremities, including the
palms and soles.

Petechiae,a small red or purple spot caused by bleeding into the skin, were found in the hard palate of the upper mouth.

A detailed awareness of the findings associated with Zika virus infection "will support its early recognition and will facilitate elimination of Zika infection from consideration for concerned patients who present with other, more common erythematous [redness] eruptions," the researchers said.

The team also describe high-power microscopic findings of the skin.

Tests detectedZika virus RNA in the urine but not the blood from samples taken three days after the eruption.

He did not experiencecough, inflammation of the mucous membrane of the nose,sore throat, diarrhea, nausea, or vomiting.

Zika has spread across South and central America, as well as the Caribbean and South Pacific.

The man's symptomsmatch those of patients in Brazil, where the current outbreak began.

The WHO says people with Zika virus disease can have symptoms that can include mild fever, skin rash, conjunctivitis, muscle and joint pain, malaise or headache. These symptoms normally last for 2 to7 days.

It's estimated about one in fourpeople infected with Zika virus are believed to develop symptoms, federal health officials say.

There is no specific treatment or vaccine currently available.

Health officials in the U.S. and Canada expect more cases among people who've travelled to Zika-affected areas.As of May 5, the Public Health Agency of Canada reports67 travel-related cases and 1 locally acquired case through sexual transmission in Canada.

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Travellers are advised to protect themselves againstmosquito bites.

While the illness is generally mild,April'srisk assessment from the Public Health Agency of Canada's notes there is now scientific consensus that Zika virus causesinfant microcephaly and other severe brain anomalies, as well as rare but severeoutcomes such asGuillain Barrsyndrome, aneurological disorder that can lead to paralysis.

Babies with microcephalyhaveabnormally small heads that can result in developmental problems.

The overall risk in Canada is very low, federal health officials say.Mosquitoes known to transmit the virus are not established in Canada and are not well-suited to our climate.