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Zika Virus Infection

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Riddhi Patel, MD | Image – Vitma/Shutterstock |

If you’ve turned on the news recently chances are you’ve heard about the infamous Zika Virus. The virus has come into the spotlight due to recent outbreaks and its link with birth defects. Healthcare professionals should know about this virus, it’s clinical presentation, and the resulting neurologic defects.

What is the Zika Virus?

The virus was first discovered in the Zika forest in Africa in 1947. It had remained confined to Africa and Asia until 2015 when it began to spread to the Americas. As of February 2016 Zika virus has been identified in 31 countries including the United States. The virus is part of the Flavivirus genus and is spread through Aedes mosquitoes. These mosquitoes usually bite during the daytime hours, particularly early and late afternoon. It is related to other well known flaviviruses including West Nile Virus and dengue.

Transmission

The virus is primarily transmitted through mosquitoes however there are several other forms of transmission. The virus has been shown to remain in the blood of an infected individual for days to a week and in semen for 62 days after onset of symptoms. It has been seen in pregnancy for 10 weeks after symptoms begin and can result in intrauterine or intrapartum infection.

Signs & Symptoms

Clinical manifestations occur in only 1 out of 5 people infected with Zika virus. Patients may present with fever, maculopapular rash, conjunctivitis, fatigue, headaches, muscle and joint pain. Asking patients with any of these symptoms about their travel history is important. The symptoms are usually mild, lasting a few days before resolving.

Complications

Although the clinical picture of Zika virus is mild, it can result in grave complications. The CDC has recently announced that there is enough evidence to state that Zika virus infection during pregnancy is the cause of birth defects. It can also cause fetal death, placental insufficiency, and central nervous system injury during pregnancy. Eye defects and hearing loss have also been identified in infants infected with Zika. The greatest risk of malformations is infection during the first trimester.

Zika virus has also been shown to cause Guillan-Barre Syndrome, a disorder in which the body’s immune system damages the peripheral nervous system resulting in rapid onset ascending muscle weakness.

What to do?

The treatment of Zika virus symptoms is similar to treatment for any other virus. Rest, hydration, and symptomatic management. There is no vaccine available for prevention of the virus but several personal preventive measures can be taken such as wearing long-sleeves and pants, staying indoors as much as possible, and using insect repellants. Pregnant women should avoid traveling to areas where Zika transmission is high. Women of childbearing age with Zika infection or exposure should wait at least 8 weeks before trying to conceive.

Staying up to date

This topic is being heavily researched and it is important for healthcare providers to stay up to date on information and recommendation. Online updates can be viewed at the World Health Organization and Centers for Disease Control websites.

References:

  1. Fauci, Anthony. Zika Virus in the Americas. The New England Journal of Medicine. 2016; 374:601-604
  2. Centers for Disease Control and Prevention. Zika virus: Transmission. http://www.cdc.gov/zika/transmission/index.html
  3. World Health Organization. Zika virus. http://www.who.int/mediacentre/factsheets/zika/en/
  4. Sexton, Daniel. Zika virus infection. Up to date. 2016.

2 COMMENTS

  1. Just came across one article here. Researchers have found the evidence of Zika virus and paralytic disease. “absolutely terrifying”

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