Zika Virus

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KEY POINTS

• Zika virus infection can be spread by mosquito bites or by having unprotected sex.
• There is no medicine that cures Zika virus infection. In most cases, you can care for yourself at home. If you have a serious infection, you may need to stay at the hospital.
• Zika virus infections in pregnant women can infect the baby and cause serious birth defects. The Centers for Disease Control and Prevention (CDC) recommends that women who are pregnant, or who might become pregnant, should NOT travel to areas where Zika virus has been reported.
• To avoid mosquito bites, stay in places that are clean, insect free, and have window screens or air conditioning when you travel. Avoid wearing perfume or other scented products because they can attract mosquitoes. Wear long pants and long-sleeved shirts, and use an insect repellent whenever you are outdoors.

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What is Zika virus?

Zika is a virus related to the viruses that cause yellow fever and Ebola. Zika virus infection can be spread by mosquito bites or by having unprotected sex.

What is the cause?

Infected Aedes mosquitoes can pass the virus when they bite you. Aedes mosquitoes are found in the US in several southern and central states, as well as in the Caribbean, Central America, South America, Africa, southern Europe, and Southeast Asia. This kind of mosquito tends to bite both during daytime and at night. Mosquitos in some parts of the US have infected people with Zika virus.

Zika virus may be spread by contact with infected blood, for example, through blood transfusion, organ transplant, or the sharing of needles or syringes contaminated with blood. Zika virus is spread through sexual contact also. The disease can be spread by people who do not have any symptoms and may not know they carry the virus.

Zika virus may also be spread from a mother to her unborn baby, which can cause serious birth defects. There is no evidence that there is a risk of birth defects in future pregnancies after you have had Zika virus infection.

What are the symptoms?

Often there are no symptoms. When symptoms do occur, they usually start 3 to 12 days after a mosquito bite. Symptoms last a few days to a week, and may include:

• Fever
• Rash
• Headache
• Joint and muscle pain
• Vomiting
• Eye redness and swelling, and pain behind the eyes

If a baby is infected before birth, the baby may be born with a small head and a brain that has not developed properly. Children may have learning problems, delays in walking and talking, or other problems.

In some areas where Zika virus has been reported, there are more cases of Guillain-Barré syndrome (GBS). GBS is a rare disorder that causes the body's immune system to attack the nerves. The damage to nerves causes muscle weakness, tingling, and sometimes paralysis. For most people symptoms last a few weeks or several months and then go away. It is not known if Zika virus increases the risk for GBS.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. You may have blood tests to rule out infections with other viruses such as dengue or chikungunya.

Women who are pregnant should have blood tests for Zika virus at least twice during pregnancy, even if they have no symptoms. Women who have symptoms should get tested right away.

How is it treated?

There is no medicine that cures Zika virus. If your symptoms are mild, they will usually go away on their own. In most cases you can care for yourself at home. If you have a serious infection, you may need to stay at the hospital. You may be given IV fluids, pain relievers, or other treatments.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. In addition:

• Rest.
• Take acetaminophen for fever, headache, or muscle aches. Read the label and take as directed. Unless recommended by your healthcare provider, you should not take this medicine for more than 10 days. Acetaminophen may cause liver damage or other problems. Unless recommended by your provider, don't take more than 3000 milligrams (mg) in 24 hours. To make sure you don’t take too much, check other medicines you take to see if they also contain acetaminophen. Ask your provider if you need to avoid drinking alcohol while taking this medicine.
• Do not take nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin, without your healthcare provider’s approval. If you have the dengue virus instead of Zika virus, these medicines may cause severe or life-threatening bleeding.
• Drink a lot of clear liquids. Water, broth, juice, electrolyte solutions, and noncaffeinated drinks are best. When you have a high fever, your body needs more liquid because you lose more water in your breath and from your skin.

Ask your provider:

• How and when you will get your test results
• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

How can I help prevent Zika virus?

Take these precautions to avoid mosquito bites:

• If you are planning to travel:
  • Schedule travel to tropical areas during seasons when mosquitoes are less active.
  • Stay in places that are clean, insect free, and have air conditioning, window screens, or mosquito nets.

Zika virus infections in pregnant women can infect the baby and cause serious birth defects. The Centers for Disease Control and Prevention (CDC) recommends that women who are pregnant, or who might become pregnant, should NOT travel to areas where Zika virus has been reported.

• Avoid wearing perfume or other scented products because they can attract mosquitoes.
• Wear long pants and long-sleeved shirts.
• Use an insect repellent whenever you are outdoors. Don't use more repellent than recommended in the package directions. Don't put repellent on open wounds or rashes. Don’t put it near your eyes or mouth. When using sprays for the skin, don’t spray the repellent directly on your face. Spray the repellent on your hands first and then put it on your face. Then wash the spray off your hands.
  • Adults should use repellent products with no more than 35% DEET. Wash it off your body when you go back indoors.
  • Picaridin may irritate the skin less than DEET and appears to be just as effective.
  • Spray clothes with repellents because mosquitoes may bite through thin clothing. Products containing permethrin are recommended for use on clothing, shoes, bed nets, and camping gear. Permethrin-treated clothing repels and kills ticks, mosquitoes, and other insects and can keep working after laundering. Permethrin should be reapplied to clothing according to the instructions on the product label. Some commercial products are available pretreated with permethrin. Permethrin does not work as a repellent when it is put on the skin.
  • In some studies, oil of lemon eucalyptus, a plant-based repellent, provided as much protection as repellents with low concentrations of DEET, but it hasn't been as well tested as DEET. Oil of lemon eucalyptus should not be used on children under age 3.
• Install or repair window and door screens so it is harder for mosquitoes to get indoors.
• Mosquitoes lay eggs in water. To reduce mosquito breeding, drain standing water. Routinely empty water from flowerpots, pet bowls, clogged rain gutters, swimming pool covers, buckets, barrels, cans, and other items that collect water.

To prevent sexually transmitted disease, choose not to have sex, or use latex or polyurethane condoms during foreplay and every time you have vaginal, oral, or anal sex for at least 6 months after last possible exposure.

Zika virus has been shown to live in a male’s semen longer than in other body fluids. If a male has been diagnosed or has had symptoms of Zika virus, he should continue to use condoms for at least 6 months.

You can get more information from:

• World Health Organization
  http://www.who.int/csr/don/en/index.html
• The Centers for Disease Control and Prevention
  888-232-3228
  http://www.cdc.gov