Most people infected with Zika virus are asymptomatic. Characteristic clinical findings are:
- acute onset of fever with maculopapular rash, arthralgia, or conjunctivitis
- myalgia and headache are commonly reported
- clinical illness is usually mild with symptoms lasting for several days to a week
Severe disease requiring hospitalization is uncommon and case fatality is low. However, there have been cases of Guillain-Barre syndrome reported in patients following suspected Zika virus infection.
Microcephaly & Zika
In a recent article published in the New England Journal of Medicine, the CDC confirmed that Zika is a cause of microcephaly and other birth defects.
Based on the typical clinical features, the differential diagnosis for Zika virus infection is broad. In addition to dengue, other considerations include leptospirosis, malaria, rickettsia, group A streptococcus, rubella, measles, and parvovirus, enterovirus, adenovirus, and alphavirus infections (e.g., Chikungunya, Mayaro, Ross River, Barmah Forest, O’nyong-nyong, and Sindbis viruses).
Preliminary diagnosis is based on the patient’s clinical features, places and dates of travel, and activities. Laboratory diagnosis is generally accomplished by testing serum or plasma to detect virus, viral nucleic acid, or virus-specific immunoglobulin M and neutralizing antibodies. Click for more information about diagnostic testing.
As an arboviral disease, Zika virus is a nationally notifiable condition. Healthcare providers are encouraged to report suspected cases to their state or local health departments to facilitate diagnosis and mitigate the risk of local transmission. State or local health departments are encouraged to report laboratory-confirmed cases to CDC through ArboNET, the national surveillance system for arboviral disease.
No specific antiviral treatment is available for Zika virus disease. Treatment is generally supportive and can include rest, fluids, and use of analgesics and antipyretics. Because of similar geographic distribution and symptoms, patients with suspected Zika virus infections also should be evaluated and managed for possible dengue or chikungunya virus infection. Aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) should be avoided until dengue can be ruled out to reduce the risk of hemorrhage. People infected with Zika, chikungunya, or dengue virus should be protected from further mosquito exposure during the first few days of illness to prevent other mosquitoes from becoming infected and reduce the risk of local transmission.
Source: CDC Website, For Health Care Providers, Clinical Evaluation & Disease: http://www.cdc.gov/zika/hc-providers/clinicalevaluation.html
Pregnancy Outcomes After Maternal Zika Virus Infection During Pregnancy — U.S. Territories, January 1, 2016–April 25, 2017
Pregnant women living in or traveling to areas with local mosquito-borne Zika virus transmission are at risk for Zika virus infection, which can lead to severe fetal and infant brain abnormalities and microcephaly.
Enhanced Epilepsy Surveillance and Awareness Encouraged in the Age of Zika
Recent studies show that seizures and epilepsy are being reported in some infants with congenital Zika virus infection, according to a commentary co-authored by CDC in JAMA Neurology.
CDC: Interim Guidance for Managing Occupational Exposures to Zika Virus for Healthcare PersonnelExternal Link
Zika virus is primarily spread by the bite of an infected Aedes species mosquito. Sexual and maternal-fetal transmission have also been well described. Transmission via transfusion of blood products has been reported in Brazil, but to date, transmission of Zika virus via blood transfusion has not been reported in the United States.
Zika Virus —10 Public Health Achievements in 2016 and Future PrioritiesExternal Link
Zika virus remains a serious threat to world health that is likely to continue until a safe and effective vaccine becomes available and is widely implemented. Threats from mosquito-borne infection are likely to continue until better vector control interventions are developed.
Zika Virus RNA Replication and Persistence in Brain and Placental TissueExternal Link
Zika virus is causally linked with congenital microcephaly and may be associated with pregnancy loss. However, the mechanisms of Zika virus intrauterine transmission and replication and its tropism and persistence in tissues are poorly understood.
Human trials begin for Army-developed Zika purified inactivated virus (ZPIV) vaccineExternal Link
SILVER SPRING, Md. - The Walter Reed Army Institute of Research (WRAIR) began vaccinations today in a Phase 1 human clinical trial to test the safety and immunogenicity of the Zika purified inactivated virus (ZPIV) vaccine.
Local Mosquito-Borne Transmission of Zika Virus — Miami-Dade and Broward Counties, Florida, June–August 2016External Link
During June 30−August 5, 2016, the first recognized outbreak of mosquito-borne transmission of Zika virus in the continental United States occurred in a neighborhood in Miami-Dade County, Florida. Twenty-nine persons with Zika virus infection had likely exposure within an approximate 6-block area. The outbreak ended after aerial spraying to control mosquitoes. No increases in short-term health effects were associated with spraying.
IDSA Zika Vote Statement
IDSA urges Congress to pass the strongest emergency bill possible to combat Zika and to reject efforts to fund the Zika response at the expense of equally critical health funding.
IDSA Joins Groups in Advocating for Zika Funding
IDSA and 66 other groups joined a letter to leaders in Congress, organized by the March of Dimes, in support of the administration's $1.9 billion emergency spending request to address Zika.
WHO updated interim guidance on the prevention of sexual transmission of Zika virusExternal Link
The primary transmission route of Zika virus is via the Aedes mosquito. However, mounting evidence has shown that sexual transmission of Zika virus is possible and more common than previously assumed.
Updated Counts - Zika Virus InfectionExternal Link
Here are the updated counts of Zika virus infection that have been reported in the US States, Territories and DC.
Zika Virus in the British Virgin IslandsExternal Link
CDC has issued a travel statement regarding ZIka virus infection in the British Virgin Islands
Zika Virus in SingaporeExternal Link
CDC has issued a travel statement regarding Zika virus infection in Singapore.
Hearing Loss in Infants with Microcephaly and Evidence of Congenital Zika Virus Infection External Link
A recent MMWR explores the possible connection seen between Zika virus infection.
August 2016 Update: Interim Guidance for Evaluation and Management of Infants with Possible Congenital Zika Virus InfectionExternal Link
CDC has updated its interim guidance for the evaluation and management of infants with possible congenital Zika virus infection.
CDC adds Antigua and Barbuda and Turks and Caicos to interim travel guidanceExternal Link
CDC has added additional islands to its interim travel advisory
Contraceptive Use Among Nonpregnant and Postpartum Women at Risk for Unintended Pregnancy, and Female High School Students, in the Context of Zika Preparedness — United States, 2011–2013 and 2015
CDC prevention efforts include mosquito surveillance and control, targeted education about Zika virus and condom use to prevent sexual transmission, and guidance for providers on contraceptive counseling to reduce unintended pregnancy.
Operational Risk Communication and Community Engagement PlanExternal Link
Responding to local mosquito-borne transmission of Zika virus.
CDC Advises Pregnant Women to Avoid Area in MiamiExternal Link
CDC has advised that pregnant women or women planning to become pregnant to avoid an area of a one-mile radius just north of downtown Miami, where the locally transmitted cases have been detected.
Breastfeeding in the Context of Zika Virus Interim GuidanceExternal Link
Updated information from WHO on breastfeeding in the context of Zika virus.
Zika Virus Surveillance and Preparedness — New York City, 2015–2016External Link
Zika virus has rapidly spread through the World Health Organization’s Region of the Americas since being identified in Brazil in early 2015. Transmitted primarily through the bite of infected Aedes species mosquitoes, Zika virus infection during pregnancy can cause spontaneous abortion and birth defects, including microcephaly.
Advice for Travellers to the 2016 Summer Olympic and Paralympic GamesExternal Link
The following recommendations are intended to advise national health authorities and health care providers about practices and measures for travelers visiting Brazil to stay safe and healthy.
Zika Virus: Information for CliniciansExternal Link
A PowerPoint providing information to clinicians on diagnosis, reporting, epidemiology, and pregnancy-related issues for suspected and confirmed cases of Zika virus.
Medicaid Benefits Available for the Prevention, Detection and Response to the Zika Virus (PDF)External Link
The purpose of this CMCS Informational Bulletin is to inform Medicaid agencies and interested stakeholders about how Medicaid services and authorities can help states and territories prevent, detect, and respond to the Zika virus, including efforts to prevent the transmission and address health risks to beneficiaries from the Zika virus. We encourage states to use the flexibilities outlined below.
WHO Pregnancy Management in the Context of Zika VirusExternal Link
The mosquito vector that carries the Zika virus thrives in warm climates and particularly in areas of poor living conditions.
CDC Announces Funds for States and Territories to Prepare for ZikaExternal Link
U.S. states and territories can now apply to CDC for funds to fight Zika locally. More than $85 million in redirected funds identified by the Department of Health and Human Services is being made available to support efforts to protect Americans from Zika infection and associated adverse health outcomes, including the serious birth defect microcephaly.
Zika Virus Outbreak in Haiti in 2014: Molecular and Clinical DataExternal Link
Zika virus (ZIKV), first isolated in Uganda in 1947, is currently spreading rapidly through South America and the Caribbean. In Brazil, infection has been linked with microcephaly and other serious complications, leading to declaration of a public health emergency of international concern; however, there currently are only limited data on the virus (and its possible sources and manifestations) in the Caribbean.
WHO Statement: Zika virus and the Olympic and Paralympic Games Rio 2016External Link
WHO and the Pan American Health Organization (PAHO) recognize that athletes and visitors are seeking more information on the risks of Zika and ways to prevent infection while attending the Olympic and Paralympic Games Rio 2016
Interim Guidance for Protecting Workers from Occupational Exposure to Zika VirusExternal Link
Interim Guidance for Protecting Workers from Occupational Exposure to Zika Virus
Practice Advisory: Updated Interim Guidance for Care of Women of Reproductive Age During a Zika Virus OutbreakExternal Link
Practice Advisory: Updated Interim Guidance for Care of Women of Reproductive Age During a Zika Virus Outbreak
Zika and the Risk of Microcephaly - NEJMExternal Link
In the current outbreak, thousands of cases of infants with suspected microcephaly or other developmental anomalies of the central nervous system that may be associated with ZIKV infection have been reported in Brazil.
WHO - Prevention of sexual transmission of Zika virus Interim guidanceExternal Link
The primary transmission route of Zika virus is via the Aedes mosquito. However, mounting evidence has shown that sexual transmission of Zika virus is possible and more common than previously assumed.
Zika Virus Information for Healthcare ProvidersExternal Link
Zika virus disease is a nationally notifiable condition. Healthcare providers should report suspected Zika virus disease cases to their state, local, or territorial health department to facilitate diagnosis and mitigate risk of local transmission. State, local, and territorial health departments should report laboratory-confirmed and probable cases to CDC.
CDC Analysis of Data From U.S. Territories Finds Serious Birth DefectsExternal Link
In the U.S. territories, 5 percent of women who had confirmed Zika virus infection during pregnancy had a baby or fetus with Zika virus-associated birth defects, according to a report published today in CDC’s Morbidity and Mortality Weekly Report. Among the women with confirmed Zika infection during the first trimester, 8 percent or nearly 1 in 12 had a baby or fetus with Zika virus-associated birth defects. This report, the first from the U.S. territories, represents the largest number of completed pregnancies with laboratory confirmation of Zika virus infection to date.
Guidance for Areas with Local Zika Virus Transmission in the Continental United States and HawaiiExternal Link
CDC has issued guidance for travel, prevention, testing, and preconception counseling related to risks for pregnant women and couples considering conception in areas of active Zika virus transmission in the continental United States and Hawaii.
Transient Hearing Loss in Adults Associated with Zika Virus InfectionExternal Link
In 2015, during the outbreak of ZIKAV in Brazil, we identified three cases of acute hearing loss after exanthematous illness. Serology yielded finding compatible with ZIKAV as the cause of a confirmed (1patient) and a probable (2 patients) flavivirus infection, indicating an association between ZIKAV infection and transient hearing loss.
Zika virus IgM-specific based diagnostic is highly correlated with detection of neutralising antibodies in neonates with congenital disease (The Journal of Infectious Diseases, October 5)External Link
Detection of Zika IgM in the neonate is confirmatory of congenital Zika and in the CSF of neurologic infection. Therefore, we recommend testing of Zika IgM in neonates suspected of congenital Zika and PRNT in equivocal cases.
Male-to-Female Sexual Transmission of Zika Virus — United States, January–April 2016 External Link
We report on 9 cases of male-to-female sexual transmission of Zika virus in the United States occurring January–April 2016.
Co-Infection with Zika and Dengue-2 Viruses in a Traveler Returning from Haiti, 2016: Clinical Presentation and Genetic AnalysisExternal Link
Co-Infection with Zika and Dengue-2 Viruses in a Traveler Returning from Haiti, 2016: Clinical Presentation and Genetic Analysis
Zika virus genital tract shedding in infected women of child-bearing ageExternal Link
Zika virus (ZikV) is associated with adverse fetal outcomes in pregnant women and we recently demonstrated its presence in the female genital tract. Thus, its clearance pattern and possible genital chronicity are important issues for women of child bearing age.
Fetal infection by Zika virus in the third trimester – report of 2 casesExternal Link
Zika virus (ZIKV) infection acquired during pregnancy is associated with congenital microcephaly. We describe 2 cases of ZIKV infection in women in their 36th week of pregnancy whose fetuses had preserved head circumference at birth and findings of subependymal cysts and lenticulostriate vasculopathy in postnatal imaging. These represent the first signs of congenital brain injury acquired due to ZIKV in the third trimester.
Viremia and Clinical Presentation in Nicaraguan Patients Infected with Zika Virus, Chikungunya Virus, and Dengue VirusExternal Link
Zika virus (ZIKV), chikungunya virus (CHIKV), and dengue virus (DENV) cocirculate in Nicaragua. In this study, we sought to compare the quantified viremia and clinical presentation of patients infected with 1 or more of these viruses.
Facial Puffiness in a Returning Traveler From Puerto Rico: Chikungunya, Dengue Fever, or Zika Virus?External Link
A 41-year-old woman was admitted with fever, rash, headache, and myalgias/arthralgias for 4 days after returning to New York from Puerto Rico, where she reported multiple mosquito bites. One day before admission, a generalized nonpruritic maculopapular rash had developed. The patient reported fevers at home but she was afebrile on admission. Physical examination was remarkable for a generalized maculopapular rash that spared her palms and soles, conjunctival suffusion, facial puffiness, and palatal petechiae. No adenopathy or ankle edema was present on admission.
Adenosine analog NITD008 is a potent inhibitor of Zika virusExternal Link
The ongoing Zika virus (ZIKV) outbreaks have raised global concerns due to its unexpected clinical manifestations.
Zika-induced antibody response enhances dengue serotype 2 replication in vitroExternal Link
Zika virus has emerged in the Americas, where dengue virus is endemic. Among the 4 serotypes of dengue virus, antibody-dependent enhancement is thought to enhance viral replication and disease severity. Reports suggest that anti–dengue virus antibody may enhance Zika virus replication.
Outbreak of Zika virus infection, Chiapas StateExternal Link
After decades of obscurity, Zika virus (ZIKV) has spread through the Americas since 2015 accompanied by congenital microcephaly and Guillain-Barré syndrome. Although these epidemics presumably involve transmission by Aedes aegypti, no direct evidence of vector involvement has been reported, prompting speculation that other mosquitoes such as Culex quinquefasciatus could be involved.
Zika Virus Infection Associated with Severe ThrombocytopeniaExternal Link
We report two patients that developed severe thrombocytopenia after Zika virus (ZIKV) infection. The first patient had 1000 platelets/μL and died after multiple hemorrhages. The second patient had 2000 platelets/μL, had melena and ecchymoses, and recovered after receiving intravenous immunoglobulin. ZIKV may be associated with immune-mediated severe thrombocytopenia.
Nucleoside inhibitors of Zika virusExternal Link
There is growing evidence that Zika virus (ZIKV) can cause devastating infant brain defects and other neurological disorders in humans. However, no specific antiviral therapy is available at present.
Guillain-Barré syndrome and Zika virusExternal Link
On 1 February 2016, Zika virus (ZIKV) was declared a public health emergency of international concern by the World Health Organization. This relatively unknown flavivirus from the Flaviviridae family of viruses such as dengue and yellow fever is now linked to 2 main neurological complications: microcephaly and Guillain-Barré syndrome (GBS).
Clinical and Imaging Findings in an Infant with Zika EmbryopathyExternal Link
Recent Zika virus (ZIKV) outbreaks have been associated with an increased incidence of neonatal microcephaly. Subsequently, tropism for the brain was established in human fetal brain tissue.
Sexual Transmission of Zika Virus: Implications for Clinical Care and Public Health PolicyExternal Link
Zika Virus: Implications for Public HealthExternal Link
The World Health Organization has declared the current Zika virus (ZIKV) epidemic a public health emergency of international concern.
Time to empower RIDL and Wolbachia against ZikaExternal Link
RIDL (release of insects with dominant lethality) and Wolbachia are 2 potentially powerful tools in the fight against Zika, but their technological advancement is being hampered by policy barriers. In this study, we discuss what could be done to overcome these regulatory deadlocks.
Six Ways to Prevent the Spread of Zika Virus
Protect yourself and your family this summer with this infographic from IDSA.
IDSA Recommendations on Addressing the Zika Virus Outbreak
In response to the current Zika virus outbreak in the Americas, IDSA developed policy recommendations on how best to address Zika virus both within the US and globally. These recommendations aim to ensure adequate federal support to strengthen our public health prevention and control, diagnostic development, medical countermeasures research and development, and global health activities. IDSA relayed these recommendations in a letter to the Senate Health, Education, Labor, and Pensions (HELP) Committee, which held a hearing on the Zika virus outbreak on February 24.