Volume 23, Number 4—April 2017
Dispatch
Assessing Sensitivity and Specificity of Surveillance Case Definitions for Zika Virus Disease
, Hanley J. Ho, Mar-Kyaw Win, and Yee-Sin Leo
Table 1
Clinical characteristics of an adult cohort with suspected Zika virus disease, Singapore, August 26–September 5, 2016*
| Characteristic | Zika virus positive, n = 149 | Zika virus negative, n = 210 |
|---|---|---|
| Demographic data | ||
| Mean age, y (SD) | 38.1 (14.2) | 34.2 (12.1) |
| Sex | ||
| M | 92 (61.7) | 129 (61.4) |
| F | 57 (38.3) | 81 (38.6) |
| Ethnicity | ||
| Chinese | 109 (73.2) | 122 (58.1) |
| Malay | 15 (10.1) | 17 (8.1) |
| Indian | 9 (6.0) | 24 (11.4) |
| Other | 16 (10.7) | 47 (22.4) |
| Singapore residents |
113 (75.8) |
131 (62.4) |
| Signs and symptoms at presentation | ||
| Rash | 139 (93.3) | 94 (44.8) |
| Fever | 118 (79.2) | 181 (86.2) |
| Myalgia | 63 (42.3) | 124 (59.1) |
| Headache | 35 (23.5) | 75 (35.7) |
| Conjunctivitis | 35 (23.5) | 32 (15.2) |
| Arthralgia | 34 (22.8) | 50 (23.8) |
| Pruritis | 17 (11.4) | 17 (8.1) |
| Any gastrointestinal symptom† |
10 (6.7) |
25 (11.9) |
| Fulfilled case definition | ||
| United States‡ | 149 (100.0) | 206 (98.1) |
| World Health Organization§ | 57 (38.3) | 64 (30.5) |
| PAHO¶ | 73 (49.0) | 50 (23.8) |
| ECDC# | 83 (55.7) | 55 (26.2) |
| Singapore Ministry of Health** | 81 (54.4) | 51 (24.3) |
*Values are no. (%) except as indicated. ECDC, European Centre for Disease Prevention and Control; PAHO, Pan American Health Organization.
†Nausea, vomiting, diarrhea, or abdominal pain.
‡Definition used in the United States (interim, February 2016; confirmed, June 2016) states that clinical criteria for noncongenital Zika virus disease are defined as >1 of the following: acute onset of fever, maculopapular rash, arthralgia, and conjunctivitis.
§Interim case definition (February 12, 2016) includes rash or fever and >1 of the following signs or symptoms: arthralgia or arthritis, or conjunctivitis (nonpurulent/hyperemic).
¶Interim case definition (April 1, 2016) includes rash with >2 of the following signs or symptoms: fever, conjunctivitis (nonpurulent/hyperemic), arthralgia, myalgia, or periarticular edema.
#Interim case definition (March 17, 2016) includes rash with or without fever and >1 of the following signs or symptoms: arthralgia, myalgia, or conjunctivitis (nonpurulent/hyperemic).
**Case definition (August 2016) includes fever and rash and >1 of the following symptoms: headache, myalgia, arthralgia, or nonpurulent conjunctivitis.