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  • Zika Resources

    Clinical Aspects

    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:

    IDSA Global Health on Zika

    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.

    JAMA Neurology: Enhanced Epilepsy Surveillance and Awareness in the Age of Zika

    JAMA Neurology: Enhanced Epilepsy Surveillance and Awareness in the Age of Zika


    CDC: Interim Guidance for Managing Occupational Exposures to Zika Virus for Healthcare Personnel

    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.

    CDC Updates Zika Guidance for South Florida

    The CDC will shift the time-frame, and its area of potential increased risk, for blood and tissue sample guidance for Zika transmission for residents of South Florida, according to the agency.


    Transient Hearing Loss in Adults Associated with Zika Virus Infection

    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)

    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 (Clinical Infectious Diseases, October 19)

    We report on nine cases of male-to-female sexual transmission of Zika virus in the United States occurring January–April 2016. This report summarizes new information about both timing of exposure and symptoms of sexually transmitted Zika virus disease, and results of semen testing for Zika virus from two male travelers.

    Co-Infection with Zika and Dengue-2 Viruses in a Traveler Returning from Haiti, 2016: Clinical Presentation and Genetic Analysis

    Co-Infection with Zika and Dengue-2 Viruses in a Traveler Returning from Haiti, 2016: Clinical Presentation and Genetic Analysis (Clinical Infectious Diseases, September 30)

    Infectious Diseases Experts Stress Importance of Testing and Prevention in Response to Confirmed Local Transmission of Zika Virus

    Florida health officials and the Centers for Disease Control and Prevention (CDC) today confirmed local transmission of the Zika virus in a specific area of Dade and Broward Counties in Florida, emphasizing the need for robust, ongoing Zika surveillance and response preparedness wherever Zika-transmitting mosquitos are found in the US. Infectious diseases physicians are urging the public to take measures to protect themselves from contracting the virus while also urging Congress to provide the funding necessary for an appropriate public health response.

    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 (PDF)

    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.

    IDSA Global Health on Zika

    IDSA Global Health and the Scientific Advisory Committee compiled the most up-to-date Zika research, data and resources.

    Zika Virus —10 Public Health Achievements in 2016 and Future Priorities

    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. The severe consequences of Zika virus infection require a long-term approach with dedicated resources. Important future priorities include continuing to protect pregnant women and fetuses and infants from Zika virus infection; developing improved diagnostics, including the ability to distinguish among flaviviruses serologically; collaborating among government and private partners to accelerate vaccine development; developing and implementing improved vector surveillance and control strategies and capacities; improving contraceptive access to reduce unintended pregnancies; and improving understanding of the long-term outcomes for infants exposed to Zika virus in utero. Much remains to be done to protect pregnant women and fetuses and infants from Zika virus infection; the rapid action, dedication, and collaboration demonstrated by the global public health community during the past year provide a solid foundation for future work.

    Zika Virus RNA Replication and Persistence in Brain and Placental Tissue

    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. These findings demonstrate that Zika virus replicates and persists in fetal brains and placentas, providing direct evidence of its association with microcephaly. Tissue-based reverse transcription PCR extends the time frame of Zika virus detection in congenital and pregnancy-associated infections. 

    Human trials begin for Army-developed Zika purified inactivated virus (ZPIV) vaccine

    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 2016

    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.

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