• Michael Misialek, MD

Zika Virus: 10 Questions You Need to Know

1. What is Zika virus? A member of the flavivirus group, which includes yellow fever, dengue, and chikungunya viruses, Zika usually causes a mild illness.

2. How does one get the infection? From the bite of an aedes mosquito, which is an aggressive day biter that also carries dengue and chikungunya viruses.

3. Where are people being infected? The new boy on the block is South America, Central America, and the Caribbean. The following countries there have had cases: Barbados, Bolivia, Colombia, Ecuador, El Salvador, French Guyana, Guadeloupe, Guatemala, Guyana, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, St Martin, Surinam, and Venezuela. Cases have also occurred in Puerto Rico. It is anticipated that sooner or later cases will be seen in all of Latin America.

4. Does infection exist in other areas? Yes – in 18 countries in Africa, 8 in Oceania, and 8 in Asia, so far.

5. What is the illness like? In general, it’s very mild and only very rarely fatal. Symptoms include rash, fever, joint pains, red eyes, muscle pain, and headache – a lot like dengue or chikungunya. And four out of five people have no symptoms at all.

6. If it’s mild, why all the fuss? In pregnancy, the virus had been associated with a marked rise in the incidence of microcephaly, in which the brain of the baby is tiny and the child has major neurologic disability. In Brazil, for example, it is estimated that more than 500,000 people have been infected since mid-2015, with about 3,500 cases of microcephaly resulting. The first case in the US of Zika-related microcephaly was reported on Jan 16 in a woman who had been in Brazil last summer.

7. What is the CDC recommending? They recommend that pregnant women or those trying to become pregnant “consider postponing travel” to involved areas. If such travel must take place, measures to avoid mosquito bites are essential, including during the day.

Women who are pregnant (in any trimester):

  • Consider postponing travel to any area where Zika virus transmission is ongoing.

  • If you must travel to one of these areas, talk to your doctor first and strictly follow steps to prevent mosquito bites during your trip.

Women who are trying to become pregnant:

  • Before you travel, talk to your doctor about your plans to become pregnant and the risk of Zika virus infection.

  • Strictly follow steps to prevent mosquito bites during your trip.

8. Is there a test for infection? Yes. The CDC runs antibody tests, which usually turn positive about a week into the infection.

9. Is there treatment or a vaccine? No.

10. What should an obstetrician do? Detailed guidelines were just issued by CDC, including an algorithm for care.

Basically, all pregnant women should be asked whether they have traveled while pregnant to areas of Zika transmission and, if so, whether they had any symptoms within two weeks of the travel. If they did have such symptoms, testing is recommended. If not, serial ultrasound examinations are recommended looking for microcephaly or intracranial calcifications, with further testing recommended if such are present. Testing in some situations may include amniocentesis for Zika PCR testing.

Adapted from a notice by Dr. Mark Drapkin, Newton-Wellesley Hospita, Newton, MA

#zika #mosquito #virus #microcephaly

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