Zika virus

Background

  • First reported case in US on Jan 13, 2016 in patient who returned to Houston,TX after traveling to Latin America[1]
  • Transmitted to humans through[2]:
    • Bites from Aedes mosquito
    • Perinatal transmission
    • Rare case reports of sexual[3] and blood-blood[4] transmission
  • Travel history is key. Regions with active transmission include[5]:
    • Africa
    • Carribean
    • Central America/Mexico
    • Pacific Islands
    • South America

Clinical Features[6]

Differential Diagnosis

Fever in traveler

Travel-related skin conditions

Papules

Sub Q Swelling and Nodules

Ulcers

Linear and Migratory Lesions

Evaluation

  • Clinical diagnosis
  • Testing via PCR and IgM antibody assays via CDC or health department
  • Reportable disease[7]

Management

  • Supportive care
    • Hydration and antipyretic
    • Avoid NSAIDs and aspirin until dengue excluded (risk of hemorrhage)[8]
  • Preventative care[9]
    • Women: Avoid travelling to endemic areas if pregnant
      • Referral to Maternal-Fetal medicine specialist if pregnant and exposed
    • Men: Consider using contraception or abstinence if recently travelled to endemic area and pregnant partner.

Disposition

  • Should be made in consultation with CDC and ID.

Complications

See Also

External Links

References

  1. Faccini-Martínez ÁA, Botero-García CA, Benítez-Baracaldo FC, Pérez-Díaz CE. With regard about the case of Dengue, Chikungunya and Zika co-infection in a patient from Colombia. J Infect Public Health. 2016. PMID: 26837723
  2. Hayes EB. Zika virus outside Africa. Emerg Infect Dis. 2009;15:1347–50.
  3. Musso D, Roche C, Robin E, Nhan T, Teissier A, Cao-Lormeau VM. Potential sexual transmission of Zika virus. Emerg Infect Dis. 2015; 21(2): 359-61. PMID: 25625872
  4. Musso D, Nhan T, Robin E, et al. Potential for Zika virus transmission through blood transfusion demonstrated during an outbreak in French Polynesia, November 2013 to February 2014. Euro Surveill. 2014; 19(14): . PMID: 24739982
  5. CDC: Zika Travel Information
  6. CDC: Zika Virus: Clinical evaluation and disease
  7. CDC: National Notifiable Diseases Surveillance System (NNDSS)
  8. Dick GW, Kitchen SF, Haddow AJ. Zika virus. I. Isolations and serological specificity. Trans R Soc Trop Med Hyg. 1952; 46(5): 509-20. PMID: 12995440
  9. Centers for Disease Control and Prevention. Morbidity and Mortality Weekly Report: Interim guidelines for the evaluation and testing of infants with possible congenital Zika virus infection- United States 2016.
  10. European Centre for Disease Prevention and Control. Rapid risk assessment: Zika virus epidemic in the Americas: potential association with microcephaly and Guillain-Barré syndrome [PDF]. Stockholm, Sweden: European Centre for Disease Prevention and Control; 2015.