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The patient&#39;s general condition was good&#44; and his temperature was 38&#46;3&#176;C&#46; He had a confluent erythematous maculopapular rash that predominantly affected the face &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41; and trunk &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; There were scattered lesions on the lower limbs&#46; The results of a complete blood count &#40;CBC&#41; and tests of liver function&#44; coagulation&#44; and acute phase reactants &#40;C-reactive protein and procalcitonin&#41; were normal&#46; We prescribed treatment for symptoms and ordered tests for cytomegalovirus &#40;CMV&#41;&#44; Epstein-Barr virus &#40;EBV&#41;&#44; hepatitis A virus &#40;HAV&#41;&#44; hepatitis B virus &#40;HBV&#41;&#44; hepatitis C virus &#40;HCV&#41;&#44; human immunodeficiency virus &#40;HIV&#41;&#44; dengue virus&#44; chikungunya virus&#44; Zika virus&#44; <span class="elsevierStyleItalic">Rickettsia conorii</span>&#44; and syphilis&#46; The results of all tests were negative&#44; except for PCR for Zika virus&#44; which was detected in both serum and urine samples&#46; The patient recovered fully within a week&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Case 2</span><p id="par0020" class="elsevierStylePara elsevierViewall">The patient was a 31-year-old Spanish woman who had returned 2 days earlier from Santo Domingo in the Dominican Republic&#46; She reported no clinically relevant events except for arthropod bites&#44; but consulted us for a centrifugally distributed generalized cutaneous rash that had appeared abruptly 24&#160;hours earlier together with self-limiting diarrhea and a mild frontal headache&#46; The patient&#39;s general condition was good&#44; and her temperature was 37&#46;7&#176;C&#46; An erythematous maculopapular rash was observed on the cheeks&#44; the anterior and posterior aspects of the trunk&#44; the limbs&#44; and the palms &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#46; Laboratory results &#40;CBC&#44; ionogram&#44; and tests of liver function&#44; coagulation&#44; and acute phase reactants&#41; were normal&#46; We prescribed treatment for symptoms&#46; The rash had resolved by a follow-up examination 24<span class="elsevierStyleHsp" style=""></span>hours later&#46; The results of microbiological tests for CMV&#44; EBV&#44; HAV&#44; HBV&#44; HCV&#44; HIV&#44; rubella and measles viruses&#44; dengue virus&#44; chikungunya virus&#44; Zika virus&#44; and syphilis were negative&#44; except for PCR detection of Zika virus in urine&#46; The patient recovered fully within 72<span class="elsevierStyleHsp" style=""></span>hours of onset&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Case 3</span><p id="par0025" class="elsevierStylePara elsevierViewall">The patient was a 46-year-old Venezuelan man who lives in Spain&#46; He reported no clinically relevant events during his most recent visit to Venezuela&#44; except for numerous arthropod bites&#46; Two days after returning to Spain he consulted us for skin lesions in the upper half of his body that had appeared several hours earlier&#46; The rash was accompanied by fever&#44; general malaise&#44; pain on swallowing&#44; myalgia&#44; and small joint pain&#46; The patient&#39;s general condition was good&#44; and his temperature was 39&#46;5&#176;C&#46; He had mucosal dryness and bilateral conjunctival hyperemia &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#41; together with a confluent erythematous maculopapular rash mainly on the face&#44; trunk&#44; and back and blanched when pressed with a glass slide&#46; The results of the CBC and liver function and coagulation tests were normal&#58; C-reactive protein&#44; 37&#46;0<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#59; procalcitonin&#44; 1&#46;27<span class="elsevierStyleHsp" style=""></span>ng&#47;mL&#46; Microbiology &#40;for CMV&#44; EBV&#44; HAV&#44; HBV&#44; HCV&#44; HIV&#44; chikungunya virus&#44; and syphilis&#41; results were negative but showed markers of a previous dengue virus infection&#46; The results of serology and blood PCR for Zika virus were negative&#46; Urine PCR produced a positive result for Zika virus&#46; The patient improved after 24<span class="elsevierStyleHsp" style=""></span>hours&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Discussion</span><p id="par0030" class="elsevierStylePara elsevierViewall">Zika virus is an arthropod-borne virus &#40;arbovirus&#41; &#40;genus <span class="elsevierStyleItalic">Flavivirus</span>&#44; family Flaviviridae&#41; that was first identified in Uganda in 1947&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">3</span></a> Transmission occurs via coexisting urban and sylvatic cycles and involves mosquito vectors of the genus <span class="elsevierStyleItalic">Aedes</span>&#46; Sexual&#44; vertical&#44; and blood-transfusion transmission have also been described&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">4&#44;5</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Zika virus was limited to specific regions of Africa and Asia until 2007&#46; Since then&#44; the virus has spread unrestrained throughout the world&#46; The cases reported to date in Spain have been the result of infections acquired in other countries&#59; congenital and sexual transmission has been described<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">6&#44;7</span></a> &#40;HYPERLINK &#8220;<a id="intr0010" class="elsevierStyleInterRef" href="http://www.msssi.gob.es/profesionales/saludPublica/zika/casosDiagnosticados/home.htm''">http&#58;&#47;&#47;www&#46;msssi&#46;gob&#46;es&#47;profesionales&#47;saludPublica&#47;zika&#47;casosDiagnosticados&#47;home&#46;htm&#8221;</a>&#41;&#46; Zika virus infection can potentially have a substantial impact in Spain given the following factors&#58; 1&#41; Spain&#39;s thriving tourism industry&#59; 2&#41; the large number of Latin Americans resident here&#59; 3&#41; the presence along the Spanish Mediterranean coast of <span class="elsevierStyleItalic">Aedes albopictus</span>&#44; which could theoretically mediate autochthonous transmission after biting an individual infected abroad&#59; and 4&#41; the possibility of sexual transmission&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">2</span></a> Prompt diagnosis would allow optimization of clinical management&#44; improve the monitoring of severe cases&#44; and minimize the risk of potential autochthonous transmission&#46; Early detection in pregnant women is essential to detecting cases of congenital Zika virus infection&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Most patients &#40;75&#37;&#8211;80&#37;&#41; are asymptomatic&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">8</span></a> The remainder present with rash that is occasionally pruritic &#40;90&#37;&#41;&#44; fever &#40;65&#37;&#41;&#44; joint pain and inflammation &#40;65&#37;&#41;&#44; nonpurulent conjunctivitis &#40;55&#37;&#41;&#44; headache &#40;45&#37;&#41;&#44; and less frequently digestive symptoms &#40;10&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">5</span></a> In some cases Zika virus infection can be associated with neurological signs&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">9</span></a> The most important thing to remember about this disease is its ability to cause fetal malformations and miscarriage&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">10</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Although skin lesions are common in Zika infections&#44; they are not often illustrated in the literature&#46; The lesions are nonspecific and often difficult to distinguish from those caused by other arboviruses such as dengue and chikungunya viruses &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; Furthermore&#44; coinfections with other tropical viruses can complicate diagnosis&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">11</span></a> The rash caused by Zika virus consists of erythematous morbilliform or scarlatiniform macules and&#47;or papules that appear on the trunk or face 3 to 5 days after onset of the febrile phase&#46; In the cases we report the cutaneous manifestations resolved within 24<span class="elsevierStyleHsp" style=""></span>hours&#46; The differential diagnosis should include other infections such as rubella&#44; parvovirus&#44; measles&#44; dengue and chikungunya viruses&#44; leptospirosis&#44; and rickettsiosis&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">11</span></a> Zika virus infection can be distinguished from dengue and chikungunya infections by certain clinical signs&#46; Chikungunya virus causes characteristic polyarthralgia and joint pain and inflammation that can persist for months&#46; Auricular chondritis&#44; a highly characteristic symptom&#44; is sometimes present&#46; Dengue virus infections can be distinguished by the presence of intense myalgia and a purpuric rash predominantly affecting the lower limbs and dependent areas&#46; Zika virus infection usually causes low-grade fever and few systemic manifestations&#46; A definitive diagnosis is established by PCR detection of viral RNA in biological fluids during the acute phase of infection &#40;in blood for the first 5 days and in urine during 10 to 15 days&#41; and by the detection of immunoglobulin M antibodies by enzyme-linked immunosorbent assay or immunofluorescent antibody assay during the convalescent phase&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">11</span></a> Given the possibility of cross-reactions with other flaviviruses&#44; the results of these assays should be confirmed by virus neutralization testing&#46; Furthermore&#44; in patients who come from areas where other flaviviruses coexist with the Zika virus&#44; serum neutralization assays are required for a specific diagnosis&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">12</span></a></p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">Given the current lack of any specific treatment or prophylaxis for Zika virus infection&#44; symptomatic treatment and vigilance to detect complications are necessary&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">5</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">In conclusion&#44; early clinical suspicion of Zika virus infection can help minimize possible autochthonous transmission and optimize disease management&#46; Zika virus infection should therefore be included in the differential diagnosis in any case of nonspecific febrile rash and a compatible epidemiological history&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Ethical Disclosures</span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Protection of human and animal subjects</span><p id="par0060" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this investigation&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Data confidentiality</span><p id="par0065" class="elsevierStylePara elsevierViewall">The authors declare that they followed their hospital&#39;s regulations regarding the publication of patient information&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Right to privacy and informed consent</span><p id="par0070" class="elsevierStylePara elsevierViewall">The authors obtained the informed consent of the patients referred to in this article&#46; The signed forms are in the possession of the corresponding author&#46;</p></span></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Conflicts of Interest</span><p id="par0075" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
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            0 => "Virus Zika"
            1 => "Piel"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Zika virus infection should be suspected in travelers or immigrants with the signs or symptoms of a viral infection &#40;rash&#44; fever&#44; joint pains&#44; conjunctivitis&#44; headache&#44; etc&#46;&#41; and a compatible epidemiological history&#46; Although cutaneous manifestations are among the most common clinical signs of Zika&#44; they are not specific and very few images are available&#46; We present 3 patients &#40;2 travelers and 1 immigrant&#41; in whom a rash was the presenting manifestation of Zika virus infection&#46; Prompt diagnosis optimizes outcomes in these patients&#44; improves the management of severe disease&#44; and minimizes the risk of local transmission by <span class="elsevierStyleItalic">Aedes albopictus</span>&#44; now a potential local vector for the virus due to its presence in areas along Spain&#39;s Mediterranean coast&#46;</p></span>"
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        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">La infecci&#243;n por el virus Zika debe sospecharse en viajeros o inmigrantes con cl&#237;nica de viriasis &#40;exantema&#44; fiebre&#44; artralgias&#44; artritis&#44; conjuntivitis&#44; cefalea&#44; etc&#46;&#41; y una historia epidemiol&#243;gica compatible&#46; Aunque las manifestaciones cut&#225;neas se encuentran entre las m&#225;s frecuentes no son espec&#237;ficas y su iconograf&#237;a es escasa&#46; Presentamos 3 casos&#44; 2 viajeros y un inmigrante que comienzan con un exantema por virus Zika&#46; Alcanzar el diagn&#243;stico de forma r&#225;pida optimiza el manejo de estos pacientes&#44; mejora el control de los casos graves y permite minimizar una posible transmisi&#243;n aut&#243;ctona dado el riesgo que supone la presencia del <span class="elsevierStyleItalic">Aedes albopictus</span> como potencial vector transmisor de esta enfermedad en el litoral mediterr&#225;neo espa&#241;ol&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Cosano-Quero A&#44; Velasco-Tirado V&#44; Seco MPS&#44; Manzanedo-Bueno L&#44; Belhassen-Garc&#237;a M&#46; Virus Zika&#58; manifestaciones cut&#225;neas en 3 pacientes&#46; Actas Dermosifiliogr&#46; 2018&#59;109&#58;e13&#8211;e16&#46;</p>"
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          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Confluent erythematous papules on the forehead&#44; the dorsum of the nose&#44; and both cheeks 24<span class="elsevierStyleHsp" style=""></span>hours after initial appearance&#46;</p>"
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          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A&#44; Papular erythematous rash on the chest&#46; B&#44; Papular erythematous rash on the back&#46;</p>"
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                  \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Edema and erythema of the malar region of the face</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Submandibular and cervical lymphadenitis</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Gingival bleeding&nbsp;\t\t\t\t\t\t\n
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                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Assessing the global threat from Zika virus"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Lessler"
                            1 => "L&#46;H&#46; Chaisson"
                            2 => "L&#46;M&#46; Kucirka"
                            3 => "Q&#46; Bi"
                            4 => "K&#46; Grantz"
                            5 => "H&#46; SAlje"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1126/science.12.297.353"
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                        "tituloSerie" => "Science"
                        "fecha" => "2016"
                        "volumen" => "12"
                        "paginaInicial" => "353"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17776275"
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                          ]
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                ]
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            1 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Review of ten-years presence of Aedes albopictus in Spain 2004-2014&#58; Known distribution and public health concerns"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46; Collantes"
                            1 => "S&#46; Delacour"
                            2 => "P&#46;M&#46; Alarc&#243;n-Elbal"
                            3 => "I&#46; Ruiz-Arrondo"
                            4 => "J&#46;A&#46; Delgado"
                            5 => "A&#46; Torrell-Sorio"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Parasit Vectors"
                        "fecha" => "2015"
                        "volumen" => "1"
                        "paginaInicial" => "655"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Zika virus&#46; I&#46; Isolations and serological specificity"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "G&#46; Dick"
                            1 => "S&#46;F&#46; Kitchen"
                            2 => "A&#46;J&#46; Haddow"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Trans R Soc Trop Med Hyg"
                        "fecha" => "1952"
                        "volumen" => "5"
                        "paginaInicial" => "509"
                        "paginaFinal" => "520"
                        "itemHostRev" => array:3 [
                          "pii" => "S0165587612005459"
                          "estado" => "S300"
                          "issn" => "01655876"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evidence of sexual transmission of Zika Virus"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46; D&#8217;Ortenzio"
                            1 => "S&#46; Matheron"
                            2 => "Y&#46; Yazdanpanah"
                            3 => "X&#46; de Lamballerie"
                            4 => "B&#46; Hubert"
                            5 => "G&#46; Piorkowski"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "N Engl J of Med"
                        "fecha" => "2016"
                        "volumen" => "22"
                        "paginaInicial" => "2195"
                        "paginaFinal" => "2198"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Zika Virus"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "L&#46;R&#46; Petersen"
                            1 => "D&#46;J&#46; Jamieson"
                            2 => "A&#46;M&#46; Powers"
                            3 => "M&#46;A&#46; Honein"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2016"
                        "volumen" => "16"
                        "paginaInicial" => "1552"
                        "paginaFinal" => "1563"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "First case of imported Zika virus infection in Spain"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "P&#46; Bachiller-Luque"
                            1 => "M&#46; Dom&#237;nguez-Gil Gonz&#225;lez"
                            2 => "J&#46; &#193;lvarez-Manzanares"
                            3 => "A&#46; V&#225;zquez"
                            4 => "F&#46; de Ory"
                            5 => "M&#46;P&#46; S&#225;nchez-Seco Fari&#241;as"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Enferm Infecc Microbiol Clin"
                        "fecha" => "2016"
                        "volumen" => "4"
                        "paginaInicial" => "243"
                        "paginaFinal" => "246"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Confirmed case of Zika virus congenital infection&#44; Spain"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Perez"
                            1 => "R&#46; Tato"
                            2 => "J&#46;J&#46; Cabrera"
                            3 => "A&#46; Lopez"
                            4 => "O&#46; Robles"
                            5 => "E&#46; Paz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Euro Surveill"
                        "fecha" => "2016"
                        "volumen" => "24"
                        "paginaInicial" => "30261"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Zika virus outbreak on Yap Island&#44; Federated States of Micronesia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;R&#46; Duffy"
                            1 => "T-H&#46; Chen"
                            2 => "W&#46;T&#46; Hancock"
                            3 => "A&#46;M&#46; Powers"
                            4 => "J&#46;L&#46; Kool"
                            5 => "R&#46;S&#46; Lanciotti"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2009"
                        "volumen" => "24"
                        "paginaInicial" => "2536"
                        "paginaFinal" => "2543"
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0105"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Zika virus as a cause of neurologic disorders"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "N&#46; Broutet"
                            1 => "F&#46; Krauer"
                            2 => "M&#46; Riesen"
                            3 => "A&#46; Khalakdina"
                            4 => "M&#46; Almiron"
                            5 => "S&#46; Aldighieri"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2016"
                        "volumen" => "16"
                        "paginaInicial" => "1506"
                        "paginaFinal" => "1509"
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0110"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Modeling Zika virus infection in pregnancy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "I&#46;U&#46; Mysorekar"
                            1 => "M&#46;S&#46; Diamond"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2016"
                        "volumen" => "5"
                        "paginaInicial" => "481"
                        "paginaFinal" => "484"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Emerging infectious diseases with cutaneous manifestations&#58; Viral and bacterial infections"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "Z&#46;Y&#46; Nawas"
                            1 => "Y&#46; Tong"
                            2 => "R&#46; Kollipara"
                            3 => "A&#46;J&#46; Peranteau"
                            4 => "L&#46; Woc-Colbum"
                            5 => "A&#46;C&#46; Yan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "2016"
                        "volumen" => "1"
                        "paginaInicial" => "1"
                        "paginaFinal" => "16"
                      ]
                    ]
                  ]
                ]
              ]
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Guidelines for plaque-reduction neutralization testing of human antibodies to Dengue viruses"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;T&#46; Roehrig"
                            1 => "J&#46; Hombach"
                            2 => "A&#46;D&#46;T&#46; Barrett"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Viral Immunol"
                        "fecha" => "2008"
                        "volumen" => "2"
                        "paginaInicial" => "123"
                        "paginaFinal" => "132"
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
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