Clinical Aspects
Most people infected with Zika virus are asymptomatic. Characteristic clinical findings are:
- acute onset of fever with maculopapular rash, arthralgia, or conjunctivitis
- myalgia and headache are commonly reported
- clinical illness is usually mild with symptoms lasting for several days to a week
Severe disease requiring hospitalization is uncommon and case fatality is low. However, there have been cases of Guillain-Barre syndrome reported in patients following suspected Zika virus infection.
Microcephaly & Zika
In a recent article published in the New England Journal of Medicine, the CDC confirmed that Zika is a cause of microcephaly and other birth defects.
Diagnostics
Based on the typical clinical features, the differential diagnosis for Zika virus infection is broad. In addition to dengue, other considerations include leptospirosis, malaria, rickettsia, group A streptococcus, rubella, measles, and parvovirus, enterovirus, adenovirus, and alphavirus infections (e.g., Chikungunya, Mayaro, Ross River, Barmah Forest, O’nyong-nyong, and Sindbis viruses).
Preliminary diagnosis is based on the patient’s clinical features, places and dates of travel, and activities. Laboratory diagnosis is generally accomplished by testing serum or plasma to detect virus, viral nucleic acid, or virus-specific immunoglobulin M and neutralizing antibodies. Click for more information about diagnostic testing.
As an arboviral disease, Zika virus is a nationally notifiable condition. Healthcare providers are encouraged to report suspected cases to their state or local health departments to facilitate diagnosis and mitigate the risk of local transmission. State or local health departments are encouraged to report laboratory-confirmed cases to CDC through ArboNET, the national surveillance system for arboviral disease.
Treatment
No specific antiviral treatment is available for Zika virus disease. Treatment is generally supportive and can include rest, fluids, and use of analgesics and antipyretics. Because of similar geographic distribution and symptoms, patients with suspected Zika virus infections also should be evaluated and managed for possible dengue or chikungunya virus infection. Aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) should be avoided until dengue can be ruled out to reduce the risk of hemorrhage. People infected with Zika, chikungunya, or dengue virus should be protected from further mosquito exposure during the first few days of illness to prevent other mosquitoes from becoming infected and reduce the risk of local transmission.
Source: CDC Website, For Health Care Providers, Clinical Evaluation & Disease: http://www.cdc.gov/zika/hc-providers/clinicalevaluation.html
CDC Alerts
- Pregnancy Outcomes After Maternal Zika Virus Infection During Pregnancy — U.S. Territories, January 1, 2016–April 25, 2017
- Enhanced Epilepsy Surveillance and Awareness Encouraged in the Age of Zika
- Interim Guidance for Managing Occupational Exposures to Zika Virus for Healthcare Personnel
- CDC Updates Zika Guidance for South Florida
Other Resources
- Zika Virus —10 Public Health Achievements in 2016 and Future Priorities
- Zika Virus RNA Replication and Persistence in Brain and Placental Tissue
- Human trials begin for Army-developed Zika purified inactivated virus (ZPIV) vaccine
- Local Mosquito-Borne Transmission of Zika Virus — Miami-Dade and Broward Counties, Florida, June–August 2016
- IDSA Zika Vote Statement
- IDSA Joins Groups in Advocating for Zika Funding
- WHO updated interim guidance on the prevention of sexual transmission of Zika virus
- Updated Counts - Zika Virus Infection