Zika fever


Zika fever

Description, Causes and Risk Factors:

An acute disease probably transmitted by mosquitoes, clinically resembling dengue; caused by Zika virus, a member of the family Flaviviridae (A family of enveloped single-stranded positive sense RNA viruses 40-60 mm in diameter formerly classified as the “group B” arboviruses, including yellow fever and dengue viruses; maintained in nature by transmission from arthropod vectors to vertebrate hosts).

Zika is a flavivirus that is similar to the dengue virus, causing similar but milder symptoms. Like dengue, it is transmitted by mosquitoes. It was first identified in 1947 in rhesus monkey serum in Uganda. In 1978 a small outbreak of acute fever in Indonesia was caused by Zika virus. From the limited cases reported in the literature, Zika is not believed to have long term health effects in people. There is no evidence that this infection has affected pregnant women or their babies in the past.

Information regarding pathogenesis of Zika virus is scarce but mosquito-borne flaviviruses are thought to replicate initially in dendritic cells near the site of inoculation then spread to lymph nodes and the bloodstream. Although flavivirus replication is thought to occur in cellular cytoplasm, 1 study suggested that Zika virus antigens could be found in infected cell nuclei. To date, infectious Zika virus has been detected in human blood as early as the day of illness onset; viral nucleic acid has been detected as late as 11 days after onset. The virus was isolated from the serum of a monkey 9 days after experimental inoculation. Zika virus is killed by potassium permanganate, ether, and temperatures >60°C, but it is not effectively neutralized with 10% ethanol.

It is not spread directly from person-to-person.

Symptoms:

Symptoms May Include:

    A maculopapular rash involving the trunk and extremities that is sometimes pruritic.

  • Conjunctivitis.

  • Joint pain that can affect both large joint and the smaller joints of the hands and feet.

Other Symptoms:

    Fever.

  • Retro-orbital eye pain.

  • Headache.

  • Myalgias.

  • Lower extremity edema.

  • Lymphadenopathy.

  • Diarrhea.

Diagnosis:

Diagnostic tests for Zika virus infection include PCR testson acute-phase serum samples, which detect viral RNA,and other tests to detect specific antibody against Zika virus inserum. An ELISA has been developed at the by Centers for Disease Control and Prevention to detectimmunoglobulin IgM to Zika virus. Cross-reactivity was more frequently noted with dengue virus than with yellow fever, Japanese encephalitis, MurrayValley encephalitis, or West Nile viruses, but there weretoo few samples tested to derive robust estimates of thesensitivity and specificity of the ELISA. IgM was detectable as early as 3 days after onset of illness in some persons; 1 person with evidence of previous flavivirus infection had not developed IgM at day 5 but did have it by day8. Neutralizing antibody developed as early as 5 daysafter illness onset. The plaque reduction neutralization assay generally has improved specificity over immunoassays,but may still yield cross-reactive results in secondary flavivirus infections.

Treatment:

Only supportive care is necessary; there is no vaccine. Travelers should take precautions against mosquito bites. Strategies for prevention and control of Zika virus disease should include promoting the use of insect repellent and interventions to reduce the abundance of potential mosquito vectors. Officials responsible for public health surveillance in the Pacific region and the United States should be alert to the potential spread of Zika virus and keep in mind the possible diagnostic confusion between Zika virus illness and dengue.

NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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