Zika Virus Spreads Quickly in Parts of the Americas

February 2, 2016

Zika Virus Spreads Quickly in Parts of the Americas

  1. Stephen G. Baum, MD

This mosquito-borne virus is challenging public health and affecting travel in Central and South America.

  1. Stephen G. Baum, MD

Zika virus, recognized in 1947 as a member of the RNA flavivirus genus, is transmitted to humans by infected Aedes mosquitoes. Zika outbreaks occurred in Micronesia in 2007 and French Polynesia in 2013; concerns have intensified since Zika infection emerged in Brazil in 2015, coupled with epidemiologically linked neurologic and fetal developmental abnormalities, including microcephaly. Two articles discuss clinically pertinent information about Zika illness.

Like dengue and chikungunya, which have recently spread through Central America and the Caribbean, Zika's most common manifestations — maculopapular rash, arthralgias, conjunctivitis, myalgias, headache, vertigo, and vomiting — start 2 to 7 days after an infected mosquito's bite. However, chikungunya- and dengue-related arthralgias may recur and last for months, whereas Zika illness is usually mild and self-limited and lasts about a week.

The greatest concern in Brazil is Zika's apparent link, without firm proof of causality, to more than 4000 cases of microcephaly in children born to infected mothers. The infection also appears to increase the risk for Guillain-Barré syndrome.

Zika virus infection, diagnosed using reverse-transcriptase polymerase-chain-reaction testing of blood, has also been detected in other body fluids including semen, suggesting possible sexual transmission (supported by one case report). No specific therapy exists. Given that dengue and chikungunya may coexist with Zika infection, nonsteroidal anti-inflammatory drugs should be avoided until and unless dengue is excluded, to prevent exacerbation of thrombocytopenia and hemorrhage.


The extent, spread, and clinical spectrum of Zika infection must still be determined. Pregnant women should avoid exposure. Absent a vaccine or therapy, mosquito control is paramount in containing this epidemic. The culprit mosquitoes (A. aegypti and albopictus) exist in the southern United States. Therefore, patients who import the disease to the U.S. should be protected from mosquito exposure through use of screens, air conditioning, and repellent until they are noninfectious. Infections should be reported to the Centers for Disease Control and Prevention.

Editor Disclosures at Time of Publication

  • Disclosures for Stephen G. Baum, MD at time of publication Consultant / Advisory board Clinical Infectious Diseases (Editorial Advisory Board) Speaker’s bureau UpToDate (author) Editorial boards Medical Letter (Board of Directors, Chairman)


Reader Comments (1)


Is it possible to consider Zika virus as a mutant dengue virus. Dengvanxia vacancine is available in Brazil, so why is not considered world widely at least in the endemic areas? .

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