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What is Zika Virus Infection?

Zika infection is caused by Zika Virus which is a mosquito-borne single-stranded RNA Flavivirus which is closely related to dengue virus.

Transmission of Zika Virus is from the bite of aedes mosquito which is the same mosquito that spread dengue and chikungunya virus. The mosquitoes tend to lay eggs in and near standing water. The mosquitoes are aggressive day biters. The mosquitoes get infected after biting a zika-infected person and spread the virus by biting uninfected person. 

A mother can pass the zika virus to the fetus during pregnancy and at time of delivery. But they do not pass the zika virus to fetus via breastfeeding hence breastfeeding can be continued. 

​Zika virus can be spread from infected man to his partners as the zika virus stay in the semen longer than in blood. The zika virus only remain in the blood for about a week during infection. ​
Countries affected by Zika Virus 

  • Areas of Africa
  • South east asia 
  • Pacific Islands
  • Brazil
  • US Territories : Commonwealth of Puerto Rico, the US Virgin Islands, and America Samoa​

Symptoms and Diagnosis of Zika Virus 


The incubation period ranges from 3 to 12 days. About 1 in 5 people infected with zika virus will become ill. People seldom get sick enough to be hospitalized and they rarely die from zika virus. Symptoms are usually mild lasting from 4 days to a week. After Zika infection, the infected person is protected against future infection. 

Symptoms of Zika infection are : 
  • Fever 
  • Maculopapular rash 
  • Muscle and joint aches
  • Headache 
  • Conjunctivitis 
There has been cases of Guillian Barre syndrome in some patients . 

Diagnosis of zika virus is confirmed with a serum sample via reverse transcriptase- polymerase chain reaction (RT-PCR) together with urine RT-PCR test within 7 days of symptom onset. RT-PCR urine test can be done within 14 days of the onset of symptoms. 
Suspect cases of Zika virus 

Individual with possible exposure to Zika : 
  • Recent travel (within 2 weeks) to countries affected with Zika OR 
  • Working or living in vicinity where a confirmed zika case is reported within 6 weeks of isolation of confirmed case OR 
  • Working or living in area where on-going Zika transmission is reported. 
AND

  • Presenting with fever and maculopapular rash AND 
  • Any of the the following: 
- Arthralgia (joint pain) 

- Headache 

- Myalgia (muscle pain) 

- Non purulent eye conjunctivitis 

Confirmed case of zika is a case with laboratory confirmation of acute Zika virus infection. 
Treatment of Zika Virus

There is currently no vaccine and specific treatment against zika infection. Just like dengue infection, treatment is just to relieve the symptoms. So basically the symptomatic treatment is adequate hydration, pain relief with just paracetamol, avoid NSAIDS and aspirin and to get plenty of rest. 
Zika Virus and Pregnancy

There is a possibility for Zika virus to be passed to the fetus during pregnancy. The effects of the zika virus on the fetus are currently under studies. 


For pregnant ladies who have traveled to Zika hit countries within the incubation period should seek treatment if she develops symptoms of fever, bodyache, conjunctivitis and rash. Amniotic fluid testing after 15 weeks of gestation can be considered for women tested positive for Zika or for ladies whose fetus show abnormality. 

As Brazil sees a significant rise in Zika infection with babies born with microcephaly (A birth defect whereby the fetus's head size is smaller than those of same age and sex), there seems to be an association between zika infection during pregnancy and birth malformations in baby. However more studies and lab testings have to be conducted to conclude and support the association of zika virus and congenital microcephaly in infected pregnant ladies. 


Other causes of congenital microcephaly are genetics, maternal infections and toxins exposed during pregnancy. 

Currently there is no evidence to suggest that previous zika infection will induce congenital malformations in future pregnancies. The zika virus only remain in the blood for about a week during infection. 
Prevention of Zika Virus 

There is currently no vaccine against Zika virus. 

​Prevention is by avoiding mosquitoes' bites by using insect repellent , wear long sleeved shits & pants, stay in air-conditioned areas or sleep under mosquito bed net. 

There are insect repellents that are safe to use on pregnant women. However for babies below 2 months old, insect repellent should not be used on them. 

As the Zika virus stays in the semen longer than in blood, one should practice safe sex by using condom or simply abstain from sex. No studies to prove how long the virus stay in the semen. 

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