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Zika virus disease

Definition

Zika is a virus passed to humans by the bite of infected mosquitoes. Symptoms include fever, joint pain, rash, and red eyes (conjunctivitis).

For the most up-to-date information, please visit the Centers for Disease Control and Prevention's (CDC) website at: www.cdc.gov/zika/.

Alternative Names

Zika virus infection; Zika virus; Zika

Causes

The Zika virus is named after the Zika forest in Uganda, where the virus was first discovered in 1947.

HOW ZIKA CAN SPREAD

Mosquitoes spread the Zika virus from person to person.

  • Mosquitoes acquire the virus when they feed on infected people. They then spread the virus when they bite other people.
  • The mosquitoes that spread Zika are the same type that spread dengue fever and chikungunya virus. These mosquitoes usually feed during the day.

Zika can be passed from a mother to her baby.

  • This can happen in the uterus or at the time of birth. 
  • Zika is not spread through breastfeeding.

The virus can be spread through sex.

  • People with Zika can spread the disease to their sex partners before symptoms begin, while they have symptoms, and after symptoms end.
  • The virus can also be passed during sex by people with Zika who never develop symptoms.
  • No one knows how long Zika remains in sperm and vaginal fluids, or how long it can be spread during sex.
  • The virus remains in semen longer than in other body fluids (blood, urine, vaginal fluids).

Zika can also be spread through:

  • Blood transfusion
  • Exposure in a laboratory

WHERE ZIKA IS FOUND

Before 2015, the virus was found mainly in Africa, Southeast Asia, and the Pacific Islands. In May 2015, the virus was discovered for the first time in Brazil.

It has now spread to many territories, states, and countries in:

  • Caribbean Islands
  • Central America
  • Mexico
  • South America
  • Pacific Islands
  • Africa

The virus was confirmed in Puerto Rico, American Samoa, and United States Virgin Islands.

The disease has been found in travelers coming to the United States from affected areas. Zika has also been discovered in one area in Florida, where the virus is being spread by mosquitoes.

Symptoms

Only about 1 in 5 people infected with Zika virus will have symptoms. This means that you can have Zika and not know it.

Symptoms tend to occur 2 to 7 days after being bitten by an infected mosquito. They include:

  • Fever
  • Rash
  • Joint pain
  • Red eyes (conjunctivitis)
  • Muscle pain
  • Headache

Symptoms are usually mild, and last for a few days to a week before going away entirely.

Exams and Tests

If you have symptoms of Zika and have recently traveled to an area where the virus is present, your health care provider may do a blood test to check for Zika. You also may be tested for other viruses spread by mosquitoes, such as dengue and chikungunya.

Treatment

There is no treatment for Zika. Like the flu virus, it has to run its course. You can take steps to help relieve symptoms:

  • Drink plenty of fluids to stay hydrated.
  • Get plenty of rest.
  • Take acetaminophen (Tylenol) to relieve pain and fever.
  • DO NOT take aspirin, ibuprofen (Motrin, Advil), naproxen (Aleve, Naprosyn), or any other nonsteroidal anti-inflammatory until your provider confirms that you do not have dengue. These medicines can cause bleeding in people with dengue.

Possible Complications

A Zika infection during pregnancy can cause a rare condition is called microcephaly. It occurs when the brain does not grow as it should in the womb or after birth and causes babies to be born with a smaller-than-normal head.

Intense research is currently being done to understand how the virus may spread from mothers to unborn babies and how the virus may affect babies.

Some people infected with Zika have later developed Guillain-Barré syndrome. It is unclear why this may occur.

When to Contact a Medical Professional

Call your health care provider if you develop symptoms of Zika. Let your provider know if you have traveled recently in an area where the virus is spread. Your provider may do a blood test to check for Zika and other mosquito-borne illnesses.

Call your health care provider if you or your partner has been to an area where Zika is present, or live in an area with Zika and you are pregnant or thinking about becoming pregnant.

Prevention

There is no vaccine to protect against Zika. The best way to avoid getting the virus is to avoid getting bit by mosquitoes.

The CDC recommends that all people traveling to areas where Zika is present take steps to protect themselves from mosquito bites.

  • Cover up with long sleeves, long pants, socks, and a hat.
  • Use clothing coated with permethrin.
  • Use insect repellent with DEET, picaridin, IR3535, oil of lemon eucalyptus, or para-menthane-diol. When using sunscreen, apply insect repellent after you apply sunscreen.
  • Sleep in a room with air conditioning or with windows with screens. Check screens for large holes.
  • Remove standing water from any outside containers such as buckets, flower pots, and birdbaths.
  • If sleeping outside, sleep under a mosquito net.

When you return from travel to an area with Zika, you should take steps to prevent mosquito bites for 3 weeks. This will help ensure you don’t spread Zika to mosquitoes in your area.

The CDC makes these recommendations for women who are pregnant:

  • Do not travel to any area where the Zika virus occurs.
  • 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.
  • If you are pregnant and have traveled to an area where Zika is present, tell your health care provider.
  • If you travel to an area with Zika, you should be tested for Zika within 2 weeks of returning home, whether or not you have symptoms.
  • If you live in an area with Zika, you should talk with your health care provider all during your pregnancy. You will be tested for Zika during your pregnancy.
  • If you live in an area with Zika and have symptoms of Zika at any time while you are pregnant, you should be tested for Zika.
  • If your partner has recently traveled to an area where Zika is present, abstain from sex or use condoms correctly every time you have sex for the entire time of your pregnancy. This includes vaginal, anal, and oral sex (mouth-to-penis or fellatio).

The CDC makes these recommendations for women who are trying to become pregnant:

  • Do not travel to areas with Zika.
  • 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.
  • If you live in an area with Zika, talk to your doctor about your plans to become pregnant, the risk of Zika virus infection during your pregnancy, and your partner’s possible exposure to Zika.
  • If you have symptoms of the Zika virus, you should wait 8 weeks after you were first infected before attempting to become pregnant.
  • If you or your partner has traveled to an area where Zika is present, but have no symptoms of Zika, you should wait 8 weeks after the last date of your exposure to attempt to become pregnant.
  • If your partner has Zika symptoms, you should wait at least 6 months before attempting to become pregnant.

The CDC makes these recommendations for women who are NOT trying to become pregnant:

  • Men with Zika symptoms should not have sex or should use condoms for 6 months after symptoms began.
  • Women with Zika symptoms should not have sex or should use condoms for 8 weeks after symptoms began.
  • Men and women who do NOT have Zika symptoms should not have sex or should use condoms for 8 weeks after coming home from traveling to an area with Zika.
  • Men and women who live in areas with Zika should not have sex or should use condoms for the entire time Zika is in the area.

Zika can't be spread after the virus has passed from the body. However, it's unclear how long Zika may remain in vaginal fluids or semen.

Areas where the Zika virus occurs are likely to change, so be sure to check the CDC website for the most recent list of countries affected and for the latest travel advisories.

If you get Zika, try to avoid getting bitten by mosquitoes so you do not pass the virus to others.

References

Brooks JT, Friedman A, Kachur RE, LaFlam M, Peters PJ, Jamieson DJ. Update: interim guidance for prevention of sexual transmission of Zika virus - United States, July 2016. Updated July 25, 2016. MMWR Morb Mortal Wkly Rep. 2016;65(29):745-747. www.cdc.gov/mmwr/volumes/65/wr/mm6529e2.htm?s_cid=mm6529e2_w. Accessed August 15, 2016.

Centers for Disease Control and Prevention. All countries & territories with active Zika virus transmission. www.cdc.gov/zika/geo/index.html. Updated August 12, 2016. Accessed August 15, 2016.

Centers for Disease Control and Prevention. Pregnant women. www.cdc.gov/zika/pregnancy/protect-yourself.html. Updated August 12, 2016. Accessed August 15, 2016.

Centers for Disease Control and Prevention. Protect yourself during sex. www.cdc.gov/zika/prevention/protect-yourself-during-sex.html. Updated August 5, 2016. Accessed August 15, 2016.

Centers for Disease Control and Prevention. Protect yourself and others. www.cdc.gov/zika/prevention/protect-yourself-and-others.html. Updated July 25, 2016. Accessed August 15, 2016.

Centers for Disease Control and Prevention. Zika virus for health care providers: clinical evaluation and disease. www.cdc.gov/zika/hc-providers/preparing-for-zika/clinicalevaluationdisease.html. Updated June 28, 2016. Accessed August 15, 2016.

Centers for Disease Control and Prevention. Zika virus: symptoms, diagnosis, and treatment. www.cdc.gov/zika/symptoms/index.html. Updated June 21, 2016. Accessed August 15, 2016.

Centers for Disease Control and Prevention. Zika virus: transmission and risks. www.cdc.gov/zika/transmission/index.html. Updated July 25, 2016. Accessed August15, 2016.

Johansson MA, Mier-Y-Teran-Romero L, Reefhuis J, Gilboa SM, Hills SL. Zika and the risk of microcephaly. N Engl J Med. 2016;375(1):1-4. PMID: 27222919. www.ncbi.nlm.nih.gov/pubmed/27222919.

Oduyebo T, Igbinosa I, Petersen EE, et al. Update: interim guidance for health care providers caring for pregnant women with possible Zika virus exposure - United States, July 2016. Updated July 25, 2016. MMWR Morb Mortal Wkly Rep. 2016;65(29):739-744. www.cdc.gov/mmwr/volumes/65/wr/mm6529e1.htm?s_cid=mm6529e1_w.htm. Accessed August 15, 2016.


Review Date: 1/28/2016
Reviewed By: Arnold Lentnek, MD, Infectious Diseases Medical Practice of NY and Clinical Research Center of CT. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Editorial update: 08/15/2016.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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