Zika virus Treatment- Symptoms, Complications, Investigations, Prevention
Zika virus is a flavivirus. Transmitted primarily by Aedes aegypti mosquitoes.
Clinical Findings
Incubation period- 3–14 days.
50–80% infections are asymptomatic.
Zika virus Symptoms-
Acute onset fever.
Fine maculopapular rash, usually pruritic, in face, trunk, extremities including palms & soles.
Rash may not always present but outlast the fever.
Muscle pain.
Malaise.
Nonpurulent conjunctivitis,
Arthralgias- small joints of hands & feet involved) feaures like chikungunya virus infection but with less arthritis in Zika.
Retroocular headache.
Symptoms may last up to 7 days.
Zika virus Complications:-
Two neurologic complications are of particular concern:
(1) congenital microcephaly- often brain calcifications and other abnormalities, &
(2) Guillain-Barré syndrome.
Neuropathy & myelitis may be seen.
Pregnancy- Zika causes causes birth defects of the CNS called as-
“congenital Zika syndrome.”
Fetal brain disruption sequence, pyramidal and extrapyramidal signs, subcortical calcifications, ocular lesions of chorioretinal atrophy, focal pigmented mottling of retina, & congenital contractures.
during pregnancy- Newborns of women infected with Zika virus have a risk of 5–14% for congenital Zika syndrome & a 4– 6% risk for Zika virus–associated microcephaly.
Still birth, preterm birth, spontaneous abortions & rare deaths.
Like Ebola virus, Zika virus can persist for months in semen. Prostate gland and the testes are the presumed reservoirs. Persistence not seen female reproductive tract.
Zika virus Investigations:-
Diagnosis- by detecting viral RNA- (nucleic acid testing) – in patients with symptoms less than 7 days.
Nucleic acid testing- within 14 days of illness onset.
14 days or more after symptom onset- IgM serology.
Trioplex RT-PCR assay- detects Zika virus, chikungunya virus, and dengue virus RNA, & Zika MAC-ELISA- detects Zika virus IgM antibodies (that usually present up to 12 weeks after onset of illness).
RT-PCR can be performed on placental tissue, amniotic fluid, & CSF.
A positive RT-PCR test- definitively makes the diagnosis of Zika virus, Negative test does not exclude the virus presence.
Pregnant women- confirmed or suspected Zika virus, serial ultrasounds at 3- to 4-week intervals, for assessing fetal anatomy and growth.
Zika virus Treatment:-
Tablet Paracetamol 500mg sos for fever and arthralgia.
Plenty of water.
Aspirin must be avoided in thrombocytopenia seen in Dengue virus may cause hemorrhage.
There are no effective antiviral drugs or vaccine till date approved for Zika virus treatment.
Management depends on supportive & symptomatic care.
Sofosbuvir, use to treat hepatitis C, flavivirus, some ability to inhibit Zika replication & infection in vitro and in mice and appears synergistic with interferon-alpha & interferon-beta.
Sofosbuvir in a mouse model also prevents vertical transmission.
Zika virus Prevention :-
Most effective way is environmental control of mosquitoes & treatment or removal of areas where water is stagnant or builds up.
removal of old tires and debris from endemic areas of infection; and movement toward better living conditions.
Because of microcephaly and Zika virus association during pregnancy, pregnant women should avoid travel to Zika virus is circulating areas.
Monoclonal antibodies appears to provide some relief.
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Influenza Treatment