Zika virus disease

Similar disease to other flaviviridae

Clinical manifestations of Zika virus infection are very similar to those of DENV and CHIKV infections, but usually milder. Historically, adult human infection with Zika virus has presented with mild, non-life threatening symptoms in 20% of infected patients, with 80% being clinically asymptomatic during initial infection. Typical acute symptoms persist from days to one week, and include fever (37.9°C or below), maculopapular rash (average duration 6 days), arthralgia (average duration 3.5d, range 1 to 14d) and/or conjunctivitis, myalgia, headache, retro-orbital pain and emesis.

Symptom Dengue Chikungunya Zika
Fever (intensity) +++ ++ +
Mialgia +++ ++ +
Rash + ++ +++
Arthralgia +/- +++ +
Headache +++ + +
Conjunctivitis - ++ +++
Blood dyscrasia ++ +/- -
Shock +++ +/- -
Thrombocytopenia +++ +/- +/-
Neutropenia ++ + ND
Lymphopenia ++ +++ ND

GBS (Guillain-Barrésyndrome) and microcephaly

Recent reports of unusually high rates of GBS (Guillain-Barrésyndrome) and primary microcephaly, which are temporally and spatially associated with the Zika virus outbreak in Brazil, have raised concerns that the virus variant circulating in these regions represents an altered public health threat, with neuropathic and teratogenic outcomes. Nevertheless, the association between ZIKV infection and GBS, microcephaly still needs to be confirmed by laboratory studies. Although there are some cases that show an association with zika virus, we still need to study the possibility of the link between Zika virus and GBS. So do microcephaly.

Death after Zika virus infection of an otherwise healthy patient with sickle cell disease has also been reported, indicating increased risk to otherwise medically compromised individuals. The more severe Zika disease symptoms were not observed during the 2007 Yap Island, Micronesia, Zika outbreak, although approximately 5,000 people were infected. Zika virus infection and disease is now a reportable illness in the United States, and as of February 2016, has spread to other countries and territories.

Zika virus disease related refernces

1, Marina Basarab specialty registrar. et al .Zika virus. BMJ 2016; 352:i1049 doi: 10.1136/bmj.i1049
2, Pinto Júnior VL, et al. Zika virus: a review to clinicians, Acta Med Port 2015 Nov-Dec;28(6):760-765
3, L Zammarchi, et al.Zika virus infection in a traveler returning to Europe from Brazil, March 2015
4, Arturo Galindo-Fraga, et al. Zika virus: A new epidemic on our doorstep. Rev Inves Clin.2015, 67: 329-32