Severe thrombocytopenia is a rare outcome of Zika virus (ZIKV) infection, although patients with thrombocytopenia and ZIKV experience prominent acute morbidity, according to a new study that examined the incidence and outcome of severe and non-severe thrombocytopenia and ZIKV in Puerto Rico during 2016. Severe thrombocytopenia was defined as platelet county <20 x 109/L, or platelet count <50 x 109/L and treatment for immune thrombocytopenia (ITP). Researchers found:
- Of 37,878 patients with ZIKV infection, 47 (0.1%) had thrombocytopenia in the absence of an alternative etiology, including 12 with severe thrombocytopenia.
- Most patients with thrombocytopenia were adult (77%) and male (53%).
- Among patients with severe thrombocytopenia, all had bleeding, 33% were admitted to the ICU, and 8% died; 50% were treated for ITP.
- Administration of ITP treatments in this patient population may be more efficacious than platelet transfusion in resolving thrombocytopenia.
Van Dyne EA, Neaterour P, Rivera A, et al. Incidence and outcome of severe and non-severe thrombocytopenia associated with Zika virus infection—Puerto Rico, 2016. [Published online ahead of print December 3, 2018]. Open Forum Infect Dis. doi:10.1093/ofid/ofy325.
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Clinical & Virologic & Characteristics of Zika Virus Infection, Open Forum Infect Dis; ePub 2018 Dec 19; El Sahly, et al
Zika Virus Infection and Thrombocytopenia Incidence, Open Forum Infect Dis; ePub 2018 Dec 3; Van Dyne, et al
Testing for Zika Virus Among US Blood Donors, N Engl J Med; 2018 May 10; Saá, Proctor, et al
CDC Updates Zika Guidance for Infants, MMWR; 2017 Oct 20; Adebanjo, Godfred-Cato, et al
FDA Approves Zika Virus Screening Test , FDA news release; 2017 Oct 5