What is the Zika virus?
Zika virus belongs to the family of viruses known as Flaviviridae. This virus is an enveloped positive-sense RNA genome that can be translated into viral proteins. Over time, this virus spread and mutated into two different strains: Asian and African strains. The virus was shown to transmit between monkeys and mosquitos with little evidence of human transmission. As it continued to evolve, the USA reported over 4,000 Zika virus cases in 2016 and subsequently after the World Health Organization declared the Zika virus as a public health emergency.
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What causes Zika?
This virus was first identified in Uganda and was revealed to spread by Aedes mosquito bites, a similar mosquito that carries other viruses such as yellow and dengue fever. Zika virus reproduces in the mosquito’s cells and after a few days is found in the saliva. Once this saliva enters the human skin it can infect the fibroblasts of the skin and spread to the blood and lymph nodes.
Transmission of Zika Virus
The Zika virus can be transmitted through various mechanisms with a reproduction number (Ro) between 1-6.
- Mosquito bites- The Aedes mosquito is the major vector of transmission of the virus.
- Sexual intercourse- The virus can be transmitted between people during sex. It has been shown that the virus can replicate in the testis and infect various cells.
- Pregnancy- The virus has demonstrated vertical transmission between mother and fetus during delivery. Studies have revealed the development of high-risk complications such as neurological and cognitive disorders in the fetus after birth.
- Blood transfusion- Although the evidence is minimal, there have been reported cases of the spread of the Zika virus through blood transmission.
Symptoms and Presentation of Zika
Patients with the Zika virus are either asymptomatic or present with mild symptoms.
These symptoms usually last from a couple of days to a week and potentially include:
- Itchy Rash
- Low-grade pyrexia
- Muscle and joint pain
Once a patient is infected with the Zika virus, studies have demonstrated developed immunity against future infections.
Complications from Zika Virus
Zika virus can potentially cause birth defects and miscarriages in pregnant women. The virus can cause congenital Zika which can lead to microcephaly, brain damage, and eye damage. Studies have demonstrated that the zika virus proteins damage the growth pathway of neurons causing microcephaly.
In addition, studies have reported an increase in neurological complications such as Guillain-Barre syndrome leading to temporary or permanent paralysis.
Risk Factors for Zika virus
The most common risk factors that increase your likelihood of developing Zika include:
- Having unprotected sex– The Zika virus is known to be capable of transmitting from one person to another during sexual intercourse.
- Traveling or living in high-risk Zika areas- Tropical and subtropical areas are increased risk Zika areas. It is essential to check with the Control Disease and Prevention regarding areas with high risk and prevalence of the Zika virus prior to travel. Nevertheless, this mosquito is found worldwide and has the potential to spread to other newer areas.
Prevention of Zika virus
If patients are in areas where Zika outbreak is common, then some preventative measures include:
- Wear long-sleeved clothing
- Stay indoors
- Avoid sexual intercourse or wear condoms
- Use mosquito repellent to prevent mosquito bites
- Screening of potential blood donors
Diagnosis of Zika
The diagnosis of Zika is determined partly by the patient’s travel and medical history. Physicians will ask patients to be thorough about previous trips, sexual intercourse, and mosquito bites. In addition, to confirm diagnosis patients will need to undergo testing which may include RT-PCR or laboratory testing (blood and urine). For pregnant women, an ultrasound may be performed to look for any brain damage to the fetus as well as amniocentesis to screen for the potential virus.
Treatment of Zika
Currently, there is no definitive treatment for the Zika virus but there are over-the-counter medications that can be taken to relieve symptoms. Patients should drink lots of fluids, rest, and if symptoms exacerbate should seek immediate medical help.
To date, no vaccines have been approved for use against the Zika virus however there are multiple clinical trials on the way. For example, the Food and Drug Administration approved the first clinical trial for the Zika vaccine back in 2016. There continues to be research into this field in hopes of protecting people, especially the pregnant population.
Zika is a mosquito-borne illness that does not cause severe symptoms. Currently, there is no definitive treatment, and patients infected should drink plenty of fluids and rest. It is important to know the associated risk factors of the Zika virus so that patients can reduce their risk. There continue to be new advances in the research for better diagnostic and treatment options for patients infected with Zika. The pregnant population is an ongoing target due to the negative consequences associated with vertical transmission to the fetus such as microcephaly.
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