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Introdution

The Zika virus, first detected in rhesus monkeys in Uganda in 1947 is a fast emerging mosquito-borne infection. Subsequently, it was first seen in humans in 1952 in Uganda and the United Republic of Tanzania. Outbreak of the disease has been reported in Africa, the Americas, Asia and the Pacific.

  • Genre: Flavivirus
  • Vector: Aedes mosquitoes (which usually bite during the morning and late afternoon/evening hours)
  • Reservoir: Unknown

Potential Complications of Zika Virus Disease

Recently in Brazil, local health authorities noticed an increase in the Guillain-Barre syndrome which coincided with the outbreak of the Zika virus among adults as well as babies born with microcephaly in the northeast part of Brazil. Investigating agencies notice an unusual but increasing body of evidence linking the two. However, studies are on to understand and establish the relationship between microcephaly in babies and the Zika virus. Other potential causes are also being investigated.

Transmission

Through mosquito bites

  • The bite of an infected Aedes species mosquito (A. aegypti and A. albopictus), the same mosquitoes that carry and spread Dengue and Chikungunya viruses.
  • The Aedes mosquitoes typically lay eggs in stagnant water like buckets, bowls, animal dishes, flower pots and vases. They prefer to bite people, and live indoors and outdoors near people.
  • Mosquitoes that spread Chikungunya, Dengue, and Zika aggressively bite both during the day and the night.
  • Mosquitoes that feed on an infected person already become carriers of the virus by biting others.

From mother to child

  • An infected mother can pass on the virus to her newborn around the time of birth.
  • A pregnant and infected woman can transfer the virus to her fetus during pregnancy. Research is on to study the adverse effect of Zika on pregnancy and infant outcomes associated with Zika virus infection during pregnancy.
  • Till date, there are no reports of infants contracting the Zika virus through breastfeeding. Because of the tremendous benefits of breastfeeding, mothers are encouraged to breastfeed despite the widespread nature of Zika.

Through sexual contact

  • The disease can be transmitted by a man through sex.
  • In known cases of men displaying Zika symptoms, the virus transmission can happen before, during or after the development of symptoms.
  • In one such reported case, the virus was spread a few days before the symptoms developed.
  • The virus is usually present in semen longer than in blood.

Through blood transfusion

  • As of February, 1, 2016, there have not been any confirmed blood transfusion transmission cases of the Zika virus in the United States.
  • There have been multiple reports of blood transfusion transmission cases in Brazil and they are currently being investigated.
  • During the French Polynesian outbreak, 2.8% of blood donors tested positive for Zika and in previous outbreaks, the virus has been found in blood donors.

Risks

Anyone who lives in or travels to an area where the Zika virus is rampant and has not been infected with the Zika virus can contract it from mosquito bites. Once a person has been infected, he or she is likely to be protected from future infections.

Prevention

What we know

  • No vaccine has been found yet to treat/prevent Zika virus disease (Zika).
  • The least we can do is prevent Zika by avoiding mosquito bites (see below).
  • Mosquitoes that spread Zika virus bite mostly during the daytime.
  • Mosquitoes that spread Zika virus also spread Dengue and Chikungunya viruses.
  • Prevent sexual transmission of Zika by practicing safe sex with condoms.

Steps to prevent mosquito bites

When traveling to countries where Zika has been reported, you may consider taking the following precautions:

  • Wear long-sleeved shirts and full trousers.
  • Stay in places with air conditioning or have meshes and screens attached to windows and doors to keep mosquitoes at bay.
  • Sleep inside a mosquito net if you are overseas or outside to protect yourself from mosquito bites.
  • Use Environmental Protection Agency (EPA)-registered insect repellents as they are proven safe and effective, even for pregnant and breast-feeding women with the following instructions.
    • Always follow the product label instructions.
    • Reapply insect repellent as directed.
    • Avoid spraying repellent on the skin under clothing.
    • If using sunscreen, apply sunscreen before applying insect repellent.
  • If you have a baby or child:
    • Avid using insect repellent on babies younger than 2 months of age.
    • Your child should be in clothing that covers arms and legs, or
    • The crib, stroller, and baby carrier should be covered with mosquito netting.
    • Never apply insect repellent on a child’s hands, eyes, mouth, and on cut or irritated skin.

If you have Zika, protect others from getting sick

  • During the first week of the infection, Zika virus can be found in the blood and passed from an infected person to another mosquito through mosquito bites. An infected mosquito can then spread the virus to other people.
  • To help prevent others from getting sick, avoid mosquito bites during the first week of illness.
  • Zika virus can be spread by a man to his sex partners.
    • There is no knowledge of how long the virus stays in the semen of men who have had Zika.
    • We do know that the virus can be present in semen longer than in blood.
  • To help prevent spreading Zika from sex, you can use condoms the right way every time you have sex. Not having sex is the best way to be sure that someone does not get sexually transmitted Zika virus.

If you are a man who lives in or has traveled to an area with Zika

  • If your partner is pregnant, either use condoms the right way every time you have vaginal, anal, and oral (mouth-to-penis) sex or do not have sex during the pregnancy.

Symptoms

  • Those infected with the Zika virus are hardly able to tell the disease because the symptoms are not specific but very common like fever, rash, joint pain, or conjunctivitis (red eyes). Other common symptoms include muscle pain and headache. The incubation period (the time from exposure to symptoms) for the Zika virus disease is not known, but is assumed to be a few days to a week.
  • Please see your doctor if you are pregnant and complain of fever, rash, joint pain, or red eyes within 2 weeks after travelling to a place where Zika has been reported. Be sure to tell your health care provider where you traveled.
  • Once bitten by an infected mosquito, the illness is usually mild with symptoms lasting for a few days to a week.
  • Those infected with the Zika virus usually don’t get sick enough to go to the hospital, and they very rarely die of the disease. Due to which many do not even know that they have been infected by the Zika virus.
  • The Zika virus usually remains in the blood of an infected person for about a week but in some cases, it stays longer.

Diagnosis

  • The symptoms of Zika are very similar to those of dengue and chikungunya, diseases that spread through the same mosquitoes that transmit Zika.
  • Consult your healthcare provider if you suspect or develop the symptoms described above or have visited an area where Zika is widespread.
  • If you have recently traveled to a Zika-infected area, please tell your healthcare provider when and where you traveled.
  • Your healthcare provider may order blood tests to look for Zika or other similar viruses like dengue or chikungunya.

Treatment

  • There is no vaccine to prevent or medicine to treat Zika infections.
  • Treat the symptoms.
  • Get plenty of rest.
  • Drink fluids to prevent dehydration.
  • Take medicine such as acetaminophen or paracetamol to relieve fever and pain.
  • Do not take aspirin and other non-steroidal anti-inflammatory drugs.
  • If you are taking medicine for another medical condition, talk to your healthcare provider before taking additional medication.

Information for Pregnant Woman

The Zika virus can transfer from a pregnant woman to her fetus, and it has been found to cause a serious birth defect of the brain called microcephaly in babies of infected mothers. It is well-advised that pregnant women should consider delaying travel to areas infected with Zika. If travel is unavoidable, please inform your doctor and healthcare provider first and strictly follow preventive and precautionary steps to avoid mosquito bites during your trip.

What we know

  • Pregnant women can be infected with Zika virus.
  • The primary way that pregnant women get Zika virus is through the bite of an infected mosquito.
  • Zika virus can be spread by a man to his sex partners.
  • A pregnant woman can pass Zika virus to her fetus.
  • Zika virus can be passed from a pregnant woman to her fetus during pregnancy or at delivery.
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