Symptoms, Diagnosis, Treatment

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  • Symptoms
    • Only about 1 in 5 people infected with Zika virus are symptomatic.
    • The illness is usually mild with symptoms lasting for several days to a week.
    • Common characteristic clinical findings are acute onset of fever with maculopapular rash, arthralgia, or conjunctivitis. Other commonly reported symptoms include myalgia and headache.
    • The incubation period (the time from exposure to symptoms) for Zika virus disease is not known, but is likely to be a few days to a week.
    • Rarely has Zika proven fatal.
    • Zika virus usually remains in the blood of an infected person for about a week but it can be found longer in some people.
  • Diagnosis
    • Based on the typical clinical features, the differential diagnosis for Zika virus infection is broad. In addition to dengue, chikungunya, and yellow fever, other considerations include leptospirosis, malaria, rickettsia, group A streptococcus, rubella, measles, and parvovirus, enterovirus, adenovirus, and alphavirus infections.
    • In 2016, Zika virus disease became a nationally notifiable condition.
    • There are currently no commercially available diagnostic tests for Zika virus disease. The FDA has issued an Emergency Use Authorization (EUA) for a diagnostic tool for Zika virus that will be distributed to qualified laboratories and, in the United States, those that are certified to perform high-complexity tests.
    • During the first week after onset of symptoms, Zika virus disease can often be diagnosed by performing reverse transcriptase-polymerase chain reaction (RT-PCR) on serum. In addition, now urine samples should be collected less than 14 days after onset of symptoms for rRT-PCR testing. Virus-specific IgM and neutralizing antibodies typically develop toward the end of the first week of illness; cross-reaction with related flaviviruses (e.g., dengue and yellow fever viruses) is common and may be difficult to discern.
    • Due to concerns of microcephaly associated with maternal Zika viral infection, fetuses and infants of women infected with Zika virus during pregnancy should be evaluated expeditiously for possible congenital infection and neurologic abnormalities. Reporting through the CDC’s US Zika pregnancy registry is also strongly encouraged.
  • Treatment
    • No vaccine is currently available nor are there specific medicines to treat Zika infections.
    • Treat the symptoms:
      • Get plenty of rest.
      • Drink fluids to prevent dehydration.
      • Take medicine such as acetaminophen (Tylenol®) to relieve fever and pain.
      • Do not take aspirin and other non-steroidal anti-inflammatory drugs; if dengue and not Zika, could potentiate Dengue Shock Syndrome.
      • If you are taking medication for another medical condition, talk to your healthcare provider before taking additional medication.
      • If you have Zika, prevent mosquito bites for the first week of your illness.
        •  During the first week of infection, Zika virus can be found in the blood and passed from an infected person to a mosquito through mosquito bites.
        • An infected mosquito can then spread the virus to other people.

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