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Zika virus disease

Overview

Zika (Zee-ka) virus disease is a mosquito-borne viral infection that primarily occurs in tropical and subtropical areas of the world. Most people infected with Zika virus have no signs and symptoms, while others report mild fever, rash and muscle pain. Other signs and symptoms may include headache, red eyes (conjunctivitis) and a general feeling of discomfort.

Zika virus infections during pregnancy have been linked to miscarriage and can cause microcephaly, a potentially fatal congenital brain condition. Zika virus also may cause other neurological disorders such as Guillain-Barre syndrome.

Researchers are working on a Zika virus vaccine. For now the best prevention is to prevent mosquito bites and reduce mosquito habitats.

Symptoms

As many as four out of five people infected with Zika virus have no signs or symptoms. When symptoms do occur, they usually begin two to seven days after being bitten by an infected mosquito. Signs and symptoms of Zika virus disease most commonly include:

  • mild fever
  • rash
  • joint or muscle pain

Other signs and symptoms may include:

  • headache
  • red eyes (conjunctivitis)

Most people recover fully, with symptoms resolving in about a week.

When to see a doctor

See your doctor if you think you or a family member may have Zika virus, especially if you have recently traveled to an area where there's an ongoing outbreak. The Centers for Disease Control and Prevention (CDC) has blood tests to look for Zika virus or similar diseases such as dengue or chikungunya viruses, which are spread by the same type of mosquitoes.

Causes

Zika virus is transmitted primarily through the bite of an infected Aedes species mosquito, which is found throughout the world. It was first identified in the Zika Valley in Africa in 1947, but outbreaks have since been reported in southeastern and southern Asia, the Pacific Islands and the Americas.

When a mosquito bites a person infected with a Zika virus, the virus enters the mosquito. When the infected mosquito then bites another person, the virus enters that person's bloodstream.

Spread of the virus through sexual contact and blood transfusion have been reported.

Risk factors

Factors that put you at greater risk of developing Zika virus disease include:

  • Living or traveling in areas where there have been outbreaks. Being in tropical and subtropical areas increases your risk of exposure to the virus that causes Zika virus disease. Especially high-risk areas include several islands of the Pacific region, a number of countries in Central, South and North America, and islands near West Africa. Because the mosquito that carries Zika virus is found worldwide, it's likely that outbreaks will continue to spread to new regions.

    The mosquitoes that carry Zika virus are found in some parts of the United States, including Puerto Rico and South Florida.

  • Having unprotected sex. Isolated cases of sexually transmitted Zika virus have been reported. The CDC advises abstinence from sexual activity during pregnancy or condom use during all sexual contact for men with a pregnant sex partner if the man has traveled to an area of active Zika virus transmission.

Complications

Zika virus infections during pregnancy have been linked to miscarriage and microcephaly, a potentially fatal congenital brain condition. Zika virus also may cause other neurological disorders such as Guillain-Barre syndrome.

Diagnosis

Your doctor will likely ask about your medical and travel history. Be sure to describe international trips in detail, including the countries you and your sexual partner have visited and the dates, as well as any contact you may have had with mosquitoes.

Talk to your doctor about which tests for Zika virus — or similar diseases such as dengue or chikungunya viruses, which are spread by the same type of mosquitoes — are available in your area.

A pregnant woman with no symptoms of Zika virus infection with a history of recent travel to an area with active Zika virus transmission can be offered testing two to 12 weeks after her return.

Following positive, inconclusive or negative test results, care providers may:

  • Perform an ultrasound to detect microcephaly or other abnormalities of the brain
  • Offer to take a sample of amniotic fluid using a hollow needle inserted into the uterus (amniocentesis) to screen for Zika virus

Treatment

No specific antiviral treatment for Zika virus disease exists. Treatment is aimed at relieving symptoms with rest, fluids and medications — such as acetaminophen (Tylenol, others) and ibuprofen (Advil, Motrin IB, others) — to relieve joint pain and fever.

No vaccine exists to prevent Zika virus.

Preparing for an appointment

You'll likely start by seeing your primary care provider. But you also might be referred to a doctor who specializes in infectious diseases or travel medicine.

Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well-prepared for your appointment. Here's some information to help you get ready, and what to expect from your doctor.

What you can do

Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.

  • Write down key personal information. List your international travel history, with dates and countries visited and medications taken while traveling. Bring a record of your immunizations, including pre-travel vaccinations.
  • Make a list of all your medications. Include any vitamins or supplements you take regularly.
  • Write down questions to ask your doctor. Preparing a list of questions can help you make the most of your time with your doctor. List your questions from most important to least important in case time runs out.

For Zika virus disease, some basic questions to ask your doctor include:

  • What's the most likely cause of my symptoms?
  • What kinds of tests do I need?
  • What treatments are available?
  • How long will it be before I'm feeling better?
  • Are there any long-term effects of this illness?
  • Do you have any brochures or other printed material that I can take home with me? What websites do you recommend?

What to expect from your doctor

Be prepared to answer questions from your doctor, such as:

  • When did your symptoms begin?
  • Are you pregnant or trying to become pregnant? Do you use condoms?
  • Have your symptoms been continuous or occasional?
  • How severe are your symptoms?
  • Does anything seem to make your symptoms better or worse?
  • Where have you traveled in the past month?
  • Were you bitten by mosquitoes while traveling?
  • Have you been in contact recently with anyone who was ill?

Prevention

There is no vaccine to protect against Zika virus disease.

The CDC recommends all pregnant women avoid traveling to areas where there is an outbreak of Zika virus. If you are trying to become pregnant, talk to your doctor about any upcoming travel plans and the risk of getting infected with Zika virus.

If you have a male partner who lives in or has traveled to an area where there is an outbreak of Zika virus, the CDC recommends abstaining from sex during pregnancy or using a condom during sexual contact.

If you are living or traveling in tropical areas where Zika virus is known to be, these tips may help reduce your risk of mosquito bites:

  • Stay in air-conditioned or well-screened housing. The mosquitoes that carry the Zika virus are most active from dawn to dusk, but they can also bite at night. Consider sleeping under a mosquito bed net, especially if you are outside.
  • Wear protective clothing. When you go into mosquito-infested areas, wear a long-sleeved shirt, long pants, socks and shoes.
  • Use mosquito repellent. Permethrin can be applied to your clothing, shoes, camping gear and bed netting. You also can buy clothing made with permethrin already in it. For your skin, use a repellent containing at least a 10 percent concentration of DEET.

    When used as directed, insect repellents that are registered with the Environmental Protection Agency (EPA) are proven safe and effective for pregnant and breast-feeding women.

  • Reduce mosquito habitat. The mosquitoes that carry the Zika virus typically live in and around houses, breeding in standing water that can collect in such things as animal dishes, flower pots and used automobile tires. Reduce the breeding habitat to lower mosquito populations.

Zika virus transmitted through blood transfusion

All blood donations are now screened for Zika virus. To further reduce the risk of transmitting Zika virus through blood transfusion in areas where there are no active Zika virus outbreaks, the Food and Drug Administration recommends not donating blood for four weeks if you:

  • Have a history of Zika virus infection
  • Traveled or lived in an area with active Zika virus transmission
  • Have symptoms that are suggestive of Zika virus infection within two weeks of travel from an area with Zika virus
  • Have had sexual contact with a male partner who has been diagnosed with Zika virus infection
  • Have had sexual contact with a male partner who has traveled or lived in an area with active Zika virus transmission in the past three months

Last updated: August 23rd, 2017

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