Zika virus (ZIKV) is transmitted primarily through mosquito vectors, including Aedes albopictus and Aedes aegypti, both of which are distributed across multiple provinces in China. Approximately 80% of ZIKV infections remain asymptomatic, while symptomatic cases typically manifest as mild, self-limiting illnesses lacking pathognomonic features. Common clinical presentations include maculopapular rash, low-grade fever, conjunctivitis, arthralgia, and myalgia. The clinical manifestations of ZIKV infection are nonspecific and may closely mimic other febrile illnesses, complicating differential diagnosis. This study documents the first laboratory-confirmed ZIKV infection case in Shandong Province. The patient exhibited fever accompanied by extensive subcutaneous petechiae, predominantly distributed across the chest and upper extremities. This investigation provides a comprehensive epidemiological analysis and phylogenetic characterization of a ZIKV infection case imported from Thailand. In accordance with China's Border Health and Quarantine Law, international port cities must strengthen surveillance and diagnostic testing for imported infectious diseases. For cases presenting with unclear diagnoses, healthcare providers should prioritize obtaining detailed 30-day travel histories to evaluate potential exposure risks of imported infectious diseases.
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