Zika virus: Difference between revisions
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==Background== | ==Background== | ||
*First reported case in US on Jan 13, 2016 in patient who returned to Houston,TX after traveling to Latin America<ref>Faccini-Martínez ÁA, Botero-García CA, Benítez-Baracaldo FC, Pérez-Díaz CE. With regard about the case of Dengue, Chikungunya and Zika co-infection in a patient from Colombia. J Infect Public Health. 2016. PMID: 26837723</ref> | |||
*Transmitted to humans through<ref>Hayes EB. Zika virus outside Africa. Emerg Infect Dis. 2009;15:1347–50.</ref>: | |||
**Bites from Aedes mosquito | |||
**Perinatal transmission | |||
**Rare case reports of sexual<ref>Musso D, Roche C, Robin E, Nhan T, Teissier A, Cao-Lormeau VM. Potential sexual transmission of Zika virus. Emerg Infect Dis. 2015; 21(2): 359-61. PMID: 25625872</ref> and blood-blood<ref>Musso D, Nhan T, Robin E, et al. Potential for Zika virus transmission through blood transfusion demonstrated during an outbreak in French Polynesia, November 2013 to February 2014. Euro Surveill. 2014; 19(14): . PMID: 24739982</ref> transmission | |||
*Travel history is key. Regions with active transmission include<ref>[http://wwwnc.cdc.gov/travel/page/zika-travel-information CDC: Zika Travel Information]</ref>: | |||
**Africa | |||
**Carribean | |||
**Central America/Mexico | |||
**Pacific Islands | |||
**South America | |||
==Clinical Features== | ==Clinical Features<ref>[http://www.cdc.gov/zika/hc-providers/clinicalevaluation.html CDC: Zika Virus: Clinical evaluation and disease]</ref>== | ||
*80% of patients are asymptomatic | |||
*Prodromal symptoms | |||
**[[Fever]], maculopapular rash, [[joint pain]], [[conjunctivitis]] | |||
**After incubation period of 2-14 days | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Fever in Traveler DDX}} | |||
== | {{Travel Skin Conditions DDX}} | ||
==Evaluation== | |||
*Clinical diagnosis | |||
*Testing via PCR and IgM antibody assays via CDC or health department | |||
*Reportable disease<ref>[http://wwwn.cdc.gov/nndss/ CDC: National Notifiable Diseases Surveillance System (NNDSS)]</ref> | |||
==Management== | ==Management== | ||
*Supportive care | |||
**Hydration and antipyretic | |||
**Avoid [[NSAIDs]] and aspirin until [[dengue]] excluded (risk of hemorrhage)<ref>Dick GW, Kitchen SF, Haddow AJ. Zika virus. I. Isolations and serological specificity. Trans R Soc Trop Med Hyg. 1952; 46(5): 509-20. PMID: 12995440</ref> | |||
*Preventative care<ref>Centers for Disease Control and Prevention. Morbidity and Mortality Weekly Report: Interim guidelines for the evaluation and testing of infants with possible congenital Zika virus infection- United States 2016.</ref> | |||
**Women: Avoid travelling to endemic areas if pregnant | |||
***Referral to Maternal-Fetal medicine specialist if pregnant and exposed | |||
**Men: Consider using contraception or abstinence if recently travelled to endemic area and pregnant partner. | |||
==Disposition== | ==Disposition== | ||
*Should be made in consultation with CDC and ID. | |||
==Complications== | |||
*Possible epidemiologic associations between Zika virus infection and: | |||
**Adverse fetal outcomes (congenital microcephaly) | |||
**[[Guillain-Barre syndrome]]<ref>European Centre for Disease Prevention and Control. Rapid risk assessment: Zika virus epidemic in the Americas: potential association with microcephaly and Guillain-Barré syndrome [PDF]. Stockholm, Sweden: European Centre for Disease Prevention and Control; 2015.</ref> | |||
**[[ITP]] | |||
**[[Meningoencephalitis]] | |||
**[[Transverse myelitis]] | |||
==See Also== | ==See Also== | ||
*[[Arbovirus]] | |||
*[[Chikungunya]] | |||
*[[Dengue Fever]] | |||
*[[Malaria]] | |||
*[[Yellow fever]] | |||
==External Links== | ==External Links== | ||
*[http://wwwnc.cdc.gov/travel/page/zika-travel-information CDC: Zika Travel Information] | |||
==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:ID]] | |||
[[Category:Tropical Medicine]] | |||
Latest revision as of 08:27, 29 October 2018
Background
- First reported case in US on Jan 13, 2016 in patient who returned to Houston,TX after traveling to Latin America[1]
- Transmitted to humans through[2]:
- Travel history is key. Regions with active transmission include[5]:
- Africa
- Carribean
- Central America/Mexico
- Pacific Islands
- South America
Clinical Features[6]
- 80% of patients are asymptomatic
- Prodromal symptoms
- Fever, maculopapular rash, joint pain, conjunctivitis
- After incubation period of 2-14 days
Differential Diagnosis
Fever in traveler
- Normal causes of acute fever!
- Malaria
- Dengue
- Leptospirosis
- Typhoid fever
- Typhus
- Viral hemorrhagic fevers
- Chikungunya
- Yellow fever
- Rift valley fever
- Q fever
- Amebiasis
- Zika virus
- Papules
- Insect bites
- Scabies
- Seabather's eruption
- Cercarial dermatitis (Swimmer's Itch)
- Macular
- Sub Q Swelling and Nodules
- Ulcers
- Tropical pyoderma
- Leishmaniasis
- Mycobacterium marinum
- Buruli ulcer
- Dracunculiasis (Guinea Worm disease)
- Linear and Migratory Lesions
- Cutaneous larvae migrans
- Photodermatitis
See also domestic U.S. ectoparasites
Evaluation
- Clinical diagnosis
- Testing via PCR and IgM antibody assays via CDC or health department
- Reportable disease[7]
Management
- Supportive care
- Preventative care[9]
- Women: Avoid travelling to endemic areas if pregnant
- Referral to Maternal-Fetal medicine specialist if pregnant and exposed
- Men: Consider using contraception or abstinence if recently travelled to endemic area and pregnant partner.
- Women: Avoid travelling to endemic areas if pregnant
Disposition
- Should be made in consultation with CDC and ID.
Complications
- Possible epidemiologic associations between Zika virus infection and:
- Adverse fetal outcomes (congenital microcephaly)
- Guillain-Barre syndrome[10]
- ITP
- Meningoencephalitis
- Transverse myelitis
See Also
External Links
References
- ↑ Faccini-Martínez ÁA, Botero-García CA, Benítez-Baracaldo FC, Pérez-Díaz CE. With regard about the case of Dengue, Chikungunya and Zika co-infection in a patient from Colombia. J Infect Public Health. 2016. PMID: 26837723
- ↑ Hayes EB. Zika virus outside Africa. Emerg Infect Dis. 2009;15:1347–50.
- ↑ Musso D, Roche C, Robin E, Nhan T, Teissier A, Cao-Lormeau VM. Potential sexual transmission of Zika virus. Emerg Infect Dis. 2015; 21(2): 359-61. PMID: 25625872
- ↑ Musso D, Nhan T, Robin E, et al. Potential for Zika virus transmission through blood transfusion demonstrated during an outbreak in French Polynesia, November 2013 to February 2014. Euro Surveill. 2014; 19(14): . PMID: 24739982
- ↑ CDC: Zika Travel Information
- ↑ CDC: Zika Virus: Clinical evaluation and disease
- ↑ CDC: National Notifiable Diseases Surveillance System (NNDSS)
- ↑ Dick GW, Kitchen SF, Haddow AJ. Zika virus. I. Isolations and serological specificity. Trans R Soc Trop Med Hyg. 1952; 46(5): 509-20. PMID: 12995440
- ↑ Centers for Disease Control and Prevention. Morbidity and Mortality Weekly Report: Interim guidelines for the evaluation and testing of infants with possible congenital Zika virus infection- United States 2016.
- ↑ European Centre for Disease Prevention and Control. Rapid risk assessment: Zika virus epidemic in the Americas: potential association with microcephaly and Guillain-Barré syndrome [PDF]. Stockholm, Sweden: European Centre for Disease Prevention and Control; 2015.