ID Care: An Update on the Zika Virus

October 12, 2016

Zika virus spreads to people through the bite of an infected Aedes species mosquito. These mosquitos can be found in many areas of the US including parts of southern NJ during the summer. Zika can also be passed through sex from a person who has Zika and it can be spread from a pregnant woman to her fetus.

Originally, identified in the Zika forest of the central African country of Uganda Zika virus outbreaks are now happening in many countries in Central and South America and islands in the Caribbean and West Pacific. A complete list of countries with active Zika transmission can be found at www.CDC.gov/zika. In the United States the majority of the cases are imported from these regions, however local Zika virus infection from mosquito bites has only been found in Miami-Dade County in Florida in a small number of cases. Aggressive measures are being taken to control mosquitos to limit risk in these areas.

Many people infected with Zika have no or only mild symptoms. The most common symptoms if present are fever, rash, joint pain, red eyes, muscle pain and headache which can last for several days to a week. These symptoms are similar to other viruses spread through mosquito bites, like dengue and chikungunya. People usually don’t get sick enough to go to the hospital, and they very rarely die of Zika. There have been increased reports of Guillain-Barre syndrome (a rare disorder that can cause muscle weakness and sometimes paralysis) with Zika virus infection. Once a person has been infected with Zika, they are likely to be protected from future infections. There is no specific treatment or vaccine currently for Zika.

The greatest concern for zika infection occurs in pregnant women who can transmit the virus to the unborn baby which can be born with microcephaly, or a small brain as a result of this infection. Other birth defects including eye, hearing and growth disorders have been reported from zika infection of mothers during pregnancy. Hence preventing zika in pregnancy is a paramount concern.

Pregnant women should not travel to these areas and if travel is inevitable or they live in these areas they should take steps to prevent insect bites. Also pregnant woman, who live in these areas and whose partner has travelled to these areas should use condoms to prevent infection during sex or avoid sexual activity during the pregnancy. All pregnant women with possible Zika exposure and signs or symptoms of Zika should be tested for Zika.

Women with Zika should wait at least 8 weeks after symptoms began before trying to get pregnant, and men with Zika should wait at least 6 months after symptoms began. Asymptomatic women and men who traveled to these areas should wait at least 8 weeks before trying to get pregnant.

The diagnosis of Zika virus infection should be suspected in individuals with typical symptoms and exposure risk (residence in or travel to an area where mosquito-borne transmission of Zika virus infection has been reported, or unprotected sexual contact with a person who meets these criteria).

The diagnosis of Zika is confirmed by testing the blood and urine for Zika virus DNA using a test called a PCR within 14 days of symptoms. A positive Zika PCR result in either is diagnostic of Zika virus infection. Zika can be diagnosed 2-12 weeks after illness with an antibody blood test.

Zika virus is “spreading explosively” and the WHO has declared Zika virus and its associated complications a Public Health Emergency of International Concern.

ID Care is the largest enterprise in NJ dedicated to the identification, treatment and prevention of infectious diseases. ID Care is the right specialist to get the right care.

Meena Seenivasan, MD, ID Care

Infectious Disease Blog, Seenivasan, Meena