Abstract: Zika virus disease is an acute viral infectious disease transmitted by Aedes mosquitoes, with clinical manifestations primarily including fever, rash, conjunctivitis, and arthralgia. In recent years, epidemics have remained active in Southeast Asia. Although sporadic imported cases have been reported in China, concurrent infection in a married couple is extremely rare. This article reports one pair of imported Zika virus disease cases in a married couple identified in Shenzhen. From September 27 to October 3, 2025, both patients traveled together to Semporna, Sabah, Malaysia, where they had a clear history of mosquito bites. On October 4, the male patient developed symptoms first, mainly presenting with chills, high fever, scattered red maculopapular rash over the body, and mild fatigue, accompanied by mild conjunctival congestion and joint pain. On October 5, the female patient subsequently became ill, with milder symptoms consisting only of low-grade fever, mild headache, and symmetrically distributed red maculopapular rash on the neck, trunk, and limbs. Laboratory testing showed positive Zika virus nucleic acid in both cases, while dengue virus and chikungunya virus nucleic acid tests were negative. After symptomatic and supportive treatment, the symptoms of both patients significantly improved within 3-5 days of hospitalization, with no neurological complications observed. Epidemiological investigation determined that the two cases were co-exposed imported infections. The community where the patients resided promptly implemented mosquito vector surveillance and control measures, and no secondary cases were identified. In summary, clinical manifestations of concurrent Zika virus infection in a married couple can show individual differences. Early recognition and intervention can alleviate the disease severity and effectively prevent local transmission, providing reference for the diagnosis, treatment, and prevention of imported Zika virus disease.

Key words: Zika virus, Imported infection, Couple co-infection, Vector control, Epidemiological characteristics, Shenzhen