ZIKA FEVER

By Gary M. White, MD


Zika fever (ZF) or Zika disease is a viral illness caused by the Zika virus. The infection is transmitted by the Aedes aegypti mosquito. Maternal infection with the Zika virus can predispose to the development of microcephaly. If possible, pregnant women or women who will be trying to get pregnant in the near future should avoid travel to places endemic for Zika fever.

Complications of Zika Virus Infection

Modes of transmission

Clinical

The incubation period is 3-12 days. The majority of patients are asymptomatic. Typical symptoms of ZF include a maculopapular rash, pruritus, joint pain, and red eyes. Fever does occur, but is less common. Other symptoms include muscle pain, headache, pain behind the eyes, and vomiting. The rash has been described as maculopapular, but others say it is more typically comprised of many red papules [JAMA Derm 2016;152;691].

In 119 cases of confirmed zika virus infection [Dermatology News, May 2016, p. 4], the following were found during the first 4 days: rash (97%), itching (79%), prostration (73%), headache (66%), arthralgias (63%), myalgia (61%), and fever (36%).

See this CDC webpage for diagnostic tests. PCR (both serum and urine samples) should be submitted.

Treatment

According to the CDC website:

Prevention

If you are traveling to an endemic area, take precautions to avoid mosquito bites, especially if you are pregnant. Typical precautions include using insect repellants such as DEET (safe for pregnant women according to the CDC), wearing long pants and sleeves, and staying indoors behind screens. Pregnant woman should not have unprotected sex with those who have recently traveled to Zika-endemic areas.

References

The non-descript maculopapular rash of Zika Fever. Emerg Infect Dis. 2011 May; 17(5): 880–882

West J Emerg Med. 2016 May; 17(3): 238–244

The non-descript maculopapular rash of Zika Fever. Blog Agusto Aves

Injected conjunctive or "red eyes" from Tuasade

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