Zika virus infection in Child
Alerts and Notices
SynopsisZika virus is a mosquito-borne single-stranded RNA virus of the Flaviviridae family, closely related to the dengue virus. Human infection is primarily acquired via bites from infected Aedes aegypti or Aedes albopictus mosquitoes in endemic areas: the tropical regions of Africa, Southeast Asia, the South Pacific islands, and more recently, the Americas. In 2015, a Zika virus outbreak was first reported in Brazil, Colombia, and Suriname. Travel-related cases have since been reported in the United States; sexually transmitted cases are suspected to have occurred, and Zika virus has been found in the semen of infected men. Viral shedding has also been documented in vaginal secretions of infected women. A small number of cases of likely local mosquito-borne Zika virus transmission have been reported in Miami, Florida, and Brownsville, Texas. Since late 2016, Zika virus transmission in the Americas has dropped significantly. There have been rare cases of person-to-person nonsexual transmission. There is no apparent sex or age predilection for Zika virus infection.
Twenty to twenty-five percent of patients infected with Zika virus develop clinical manifestations. After being bitten by an infected mosquito, it takes approximately 3-14 days for symptoms to appear. The diagnostic criteria of Zika virus disease include a widespread erythematous macular and papular rash (involving the face, trunk, extremities, palms, and/or soles) and at least one of the following manifestations: fever, arthralgia, arthritis, and/or conjunctivitis. Other symptoms may include myalgias, headache, sore throat, cough, vomiting, and diarrhea.
Symptoms are typically mild, short-lasting (2-7 days), and self-limited. In a 2019 review, rash was seen in 90% of 240 cases. Mucocutaneous hemorrhage occurred in approximately 8% of individuals, and conjunctivitis was seen in just over one-third of individuals. Zika viral infection in pregnant patients has been associated with microcephaly in infants (see congenital Zika virus infection). There are also cases of fetal loss in women who were infected with Zika virus. It is thought that these outcomes are the result of congenital infection with Zika virus. Additionally, Guillain-Barré syndrome and other neurological disorders have been reported in patients after exposure to Zika virus.
Because the clinical presentation overlaps with those of other arboviruses, such as dengue fever and chikungunya, cases may be mistaken for another arboviral infection.
Zika virus has the potential to cause outbreaks, but cases in travelers returning to nonendemic areas are infrequently reported. While Zika virus is spread by the bite of an infected mosquito, there have been reports of it being spread human to human via sexual transmission as well as via blood transfusion.
A92.8 – Other specified mosquito-borne viral fevers
3928002 – Zika virus disease
Differential Diagnosis & Pitfalls
- Related flaviviruses (dengue fever, yellow fever, West Nile virus, tick-borne encephalitis, Japanese encephalitis virus)
- Viral exanthem
- Drug exanthem
- Rubeola (measles)
- Kawasaki disease (occurs primarily in children younger than 6 years)
- HIV primary infection
- O'nyong nyong
Patient Information for Zika virus infection in Child
OverviewZika virus is a mosquito-borne virus that can be transmitted to humans. It is common in tropical regions of Africa, Southeast Asia, and the South Pacific islands, but the virus has also been reported in Latin America and the Caribbean. Travel-related cases of Zika virus have appeared in the United States.
After being bitten by a mosquito, there is a 3-14 day incubation period before symptoms may appear. Zika virus during pregnancy can cause microcephaly, a congenital brain birth defect, or miscarriage.
Who’s At RiskYou are at risk if you live in or travel to tropical areas and are exposed to infected mosquitoes. Zika virus can also spread from blood transfusion and unprotected sex, and rarely from nonsexual personal contact.
Signs & SymptomsZika virus usually does not cause symptoms. If symptoms are present, they typically occur 3-14 days after the virus enters the body. Then, the symptoms generally last for 2-7 days and may include:
- Muscle pain and joint pain
- Red eyes or conjunctivitis (pink eye)
- A rash of red bumps all over the body, starting on the face and moving to the trunk, arms, and legs
- Swollen hands and feet
Self-Care GuidelinesThere are currently no available vaccines for Zika virus. The US Centers for Disease Control and Prevention (CDC) recommends all pregnant individuals avoid traveling to areas with Zika virus outbreaks.
Follow these guidelines to reduce your risk of contracting Zika virus:
- Avoid contact with mosquitoes
- Stay indoors and use air conditioning
- Put up screens on your windows and doors and use mosquito netting
- Wear protective clothing (long sleeves, long pants)
- Use mosquito repellant with at least 10% DEET
- Eliminate standing water around your house
- Avoid traveling to areas reported to have Zika outbreaks, especially if you are pregnant
- Avoid unprotected sex with someone who may have been exposed to infected mosquitoes
When to Seek Medical CareContact your health care provider if you believe you may have Zika virus after you have traveled to an area with an outbreak.
TreatmentsThere is currently no specific treatment for Zika virus. Your health care professional will rule out dengue fever or other, more dangerous infections.
You will be advised against taking aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) until more serious bleeding infections are ruled out, or if you are a child who may be at risk of developing Reye syndrome.
You may be advised to get rest, to take plenty of fluids, and to take acetaminophen (Tylenol) to reduce pain and fever. Symptoms usually last for 2-7 days and go away on their own.
If you are pregnant, your health care provider will help monitor your baby for any complications or the possibility of miscarriage.
Zika virus infection in Child