Focus Notes: The Zika Virus

Published: 09/06/16

A Series Of Timely Medical Topics Briefly Summarized By The Forward Focus Team

The biggest medical story of the summer has been the ZIKA virus.  It seems to be in the news constantly, and the information surrounding it can be alarming.  This is a summary of the latest information available on sites such as the Center for Disease Control (CDC).  The topic is changing so quickly that literally while writing this summary, our lab vendor stopped in to tell us the availability of new lab testing for Zika virus that we can send out from our office. 
The Zika virus was first isolated in 1947 in the Zika forest near Entebbe, Uganda.  Zika is a single stranded RNA virus that can be transmitted to humans primarily through the bite of a mosquito.   The Aedes mosquito is the most commonly infected mosquito.  As we are now learning, there can be human transmission of the virus in utero from mother to fetus, and through sexual transmission.  The issues related to sexual transmission and in utero transmission with the subsequent birth defects are what make Zika so frightening. 
Most patients who have Zika virus will actually show no symptoms.  The typical findings in people with symptoms are somewhat nonspecific.  They include fever, a flat or slightly raised red rash, joint pains, and red eyes. Other common features can include muscle pains and headache.  The symptoms of this illness when present are not distinctly different from any other virus.  When present they will usually last several days to 1 week.  Severe symptoms are distinctly uncommon.  
The most worrisome issue is with the transmission of the virus to a fetus.  This can cause a devastating birth defect with severely underdeveloped brains and heads.  The neurological symptoms are profound.  Specific instructions regarding sexual abstinence for women who have been to an endemic area should involve a discussion between the patient and her gynecologist. (A male patient who has traveled to an endemic area and sustained a mosquito bite should also talk with his physician.  A recent article in the Annals of Internal Medicine suggests that Zika can remain in human semen for 2 months after an infection). 
There are a myriad of diseases that can look like Zika virus. They include Dengue Hemorrhagic Fever, Parvovirus, Enterovirus, Adenovirus, and Chikungunya. 
Since there is no specific treatment for Zika Virus, the most important treatment is actually prevention.  That includes liberal use of insect repellent. Also, one should wear long sleeves and pants at times when mosquitoes are prevalent (early morning and dusk).  For those who are diagnosed with Zika, the treatment is rest, fluids and analgesics such as acetaminophen.  Non-steroidal anti-inflammatory drugs such as Ibuprofen and aspirin should be avoided until Dengue Fever is ruled out to avoid the risk of hemorrhage in that disease.  Also patients who are diagnosed should be particularly mindful to avoid further mosquito bites to help lower the risk of further local transmission. This is very important to keep a local epidemic under control. 
There are currently no vaccines available for prevention of Zika virus.  However, there is preclinical testing underway in an attempt to create a vaccine. There is reason to be optimistic that a successful vaccine can be developed soon.
Feel free to contact us if you have any concerns for yourself or a family member about the Zika virus.