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.

Comment

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)

Citation(s):

Reader Comments (1)

HAMED ALKAFF

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? .

Your Comment

(will not be published)

Filtered HTML

  • Allowed HTML tags: <a> <em> <strong> <cite> <blockquote> <code> <ul> <ol> <li> <dl> <dt> <dd>
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Do you have any conflict of interest to disclose?
CAPTCHA
This question is for testing whether you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

* Required

Reader comments are intended to encourage lively discussion of clinical topics with your peers in the medical community. We ask that you keep your remarks to a reasonable length, and we reserve the right to withhold publication of remarks that do not meet this standard.

PRIVACY: We will not use your email address, submitted for a comment, for any other purpose nor sell, rent, or share your e-mail address with any third parties. Please see our Privacy Policy.