Presentation
Because many definite or probable cases present normal head circumference values and their mothers do not report having a rash, screening criteria must be revised in order to detect all affected newborn babies. [ncbi.nlm.nih.gov]
However, other Aedes species mosquitoes have been known to spread Zika, and these may be present. [wwwnc.cdc.gov]
Entire Body System
- Cape Verde
Elena Savoia, of Harvard University’s School of Public Health, was relieved to see Cape Verde added to the list. [statnews.com]
Cape Verde, a small nation of islands off the coast of Senegal, reported a case of suspected microcephaly last week, and Dr. Chan said W.H.O. has sent investigators to help analyze it. [nytimes.com]
- Chills
100) 7 (100) 20 (65) 1 (100) Headache 1 (100) 14 (45) 3 (100) 1 (100) Malaise 1 (100) 5 (71) 3 (100) Maculopapular rash 1 (100) 28 (100) 3 (100) Fatigue or myalgia 1 (100) 1 (100) 1 (14) 14 (45) 1 (33) Arthritis and arthralgia 1 (14) 20 (65) 3 (100) Chills [web.archive.org]
On August 31, he experienced the same symptoms and light-headedness and chills, wrist and ankle arthalgia, and symptoms of prostatitis (perineal pain and mild dysuria). However, he remained afebrile. [dx.doi.org]
- Rigor
But a further two – releasing mosquitoes carrying Wolbachia bacteria, and using genetically modified, or transgenic, male mosquitoes to suppress the wild population – “warrant time-limited pilot deployment, accompanied by rigorous monitoring and evaluation [web.archive.org]
In the report published in the New England Journal of Medicine, the CDC authors describe a rigorous weighing of evidence using established scientific criteria. “This study marks a turning point in the Zika outbreak. [cdc.gov]
It is only with this kind of rigorous entomological baseline that we can hope to project future health impacts of these viruses. KEYWORDS: Ae. aegypti; Ae. albopictus; Aedes; ecology; epidemiology; global health [ncbi.nlm.nih.gov]
These measures should be based on an appropriate assessment of public perception, knowledge and information; the impact of risk communication measures should be rigorously evaluated to guide their adaptation and improve their impact. [who.int]
- Developmental Disorder
Identifying infants and young children with developmental disorders in the medical home: an algorithm for developmental surveillance and screening. Pediatrics 2006;118:405–20. [cdc.gov]
Disorders, National Center on Birth Defects and Developmental Disabilities (M.A.H.), Centers for Disease Control and Prevention, Atlanta; and the Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers [doi.org]
Petersen, 770-488-7100, [email protected]. 1 Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC; 2 Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental [web.archive.org]
- Infertility
Control of A. aegypti has been very difficult; however, 2 approaches are being field-tested currently: Release of genetically altered males or sterilized males that mate with wild females whose larval offspring then do not mature or whose eggs are infertile [msdmanuals.com]
Another method which been researched aims to render male mosquitoes infertile by nuclear radiation in the hope to reduce populations; this is done with a cobalt-60 gamma cell irradiator. [en.wikipedia.org]
Center for Immunization and Respiratory Diseases (NCIRD), CDC; 6 Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC; 7 Influenza Division, NCIRD, CDC; 8 Division of Reproductive Endocrinology & Infertility [web.archive.org]
Respiratoric
- Cough
In addition to fever and headache, the patient in this study had a sore throat and cough. Because of the patient’s age, additional information about symptoms was difficult to obtain. [ncbi.nlm.nih.gov]
5 (71) Joint swelling or edema 6 (19) 2 (67) Stomachache 6 (86) Retro-orbital pain 1 (100) 12 (39) Conjunctivitis 1 (14) 17 (55) 1 (33) Anorexia 4 (57) Photophobia 1 (33) Vomiting 1 (14) 3 (10) Diarrhea 3 (43) Constipation 3 (43) Sore throat 1 (100) Cough [web.archive.org]
Gastrointestinal
- Diarrhea
Human infection induces an influenza-like syndrome that is associated with retro-orbital pain, oedema, lymphadenopathy, or diarrhea. Diagnosis of Zika fever requires virus isolation and serology, which are time consuming or cross-reactive. [ncbi.nlm.nih.gov]
20 (65) 3 (100) Chills 1 (100) 2 (29) 2 (67) Dizziness 5 (71) Joint swelling or edema 6 (19) 2 (67) Stomachache 6 (86) Retro-orbital pain 1 (100) 12 (39) Conjunctivitis 1 (14) 17 (55) 1 (33) Anorexia 4 (57) Photophobia 1 (33) Vomiting 1 (14) 3 (10) Diarrhea [web.archive.org]
[…] virus (strain CP7) (BVDV) (Mucosal disease virus) 1 entry Bovine viral diarrhea virus (strain SD-1) (BVDV) (Mucosal disease virus) 1 entry Bussuquara virus (BUSV) 1 entry Classical swine fever virus (strain Alfort) (CSFV) (Hog cholera virus) 1 entry [expasy.org]
- Abdominal Pain
Other manifestations included anorexia, diarrhea, constipation, abdominal pain, and dizziness. One patient had conjunctivitis but none had rash. The outbreak on Yap Island was characterized by rash, conjunctivitis, and arthralgia ( 1, 2 ). [wwwnc.cdc.gov]
Eyes
- Conjunctival Injection
Predominant maternal clinical features included a pruritic descending macular or maculopapular rash, arthralgias, conjunctival injection, and headache; 27% had fever (short-term and low-grade). [ncbi.nlm.nih.gov]
Conjunctival injection was present in 58% of ZIKV-positive women and in a smaller percentage (40%) of ZIKV-negative women (P=0.03). [doi.org]
- Redness of Eye
Although 4 out of 5 people infected with Zika virus never develop symptoms, when symptoms do occur they may include fever, arthralgia (joint pain), maculopapular rash (red area with small bumps), and conjunctivitis (red, irritated eyes). [web.archive.org]
Symptoms usually last 4 to 7 days and include: Fever Bumpy red rash Pain in your joints and muscles Red, irritated eyes Headache Zika virus infection during pregnancy can cause birth defects of the baby's brain, including an abnormally small head (microcephaly [merckmanuals.com]
- Conjunctival Hyperemia
Finally, an HIV-positive man in Rio de Janeiro, Brazil, presented in May 2015 with 1 day of rash, myalgia, malaise, and conjunctival hyperemia; acute Zika fever was confirmed by Flavivirus genus RT-PCR and sequencing ( 39 ). [doi.org]
Skin
- Skin Rash
The symptoms of Zika virus disease are similar to other arbovirus infections such as dengue, and include fever, skin rashes, conjunctivitis, muscle and joint pain, malaise, and headache. These symptoms are usually mild and last for 2-7 days. [wpro.who.int]
People with Zika virus disease usually have a mild fever, skin rash (exanthema) and conjunctivitis. These symptoms normally last for 2-7 days. There is no specific treatment or vaccine currently available. [web.archive.org]
Its symptoms, similar to those of dengue fever, can cause a fever, headache, muscle and joint pains and a skin rash. There is no specific treatment for the virus and no vaccine. [independent.co.uk]
The virus, endemic in parts Africa, South America, Southeast Asia and some Pacific Islands, has until now been blamed for symptoms such as fever, mild headache, skin rashes, joint pain and conjunctivitis, or “red eye.” [reuters.com]
- Sweating
Conjunctivitis 1 (14) 17 (55) 1 (33) Anorexia 4 (57) Photophobia 1 (33) Vomiting 1 (14) 3 (10) Diarrhea 3 (43) Constipation 3 (43) Sore throat 1 (100) Cough 1 (100) Aphthous ulcer 2 (67) Hypotension 2 (29) Hematuria 1 (14) Prostatitis 1 (33) Hematospermia 1 (33) Sweating [web.archive.org]
- Insect Bite
bites Last updated Sat 20 Feb 2016 More on this story Ennis-Hill coach: Move Rio camp to Zika-free zone Britain's camp for the Rio Olympics should be moved to a Zika-free location outside Brazil, Jessica Ennis-Hill's coach has said. [itv.com]
Neurologic
- Guillain-Barré Syndrome
During the same period, an increase in Guillain-Barré syndrome was reported, suggesting a possible association between Zika virus and Guillain-Barré syndrome. [ncbi.nlm.nih.gov]
[…] the Guillain–Barré syndrome may follow. [doi.org]
For additional information on GBS and vaccines see: Vaccine Safety Concerns- Guillain Barré Syndrome Guillain-Barré syndrome and Flu Vaccine: Questions and Answers [web.archive.org]
- Cerebral Calcification
Cerebral calcifications, cerebral atrophy, ventricular enlargement, and hypoplasia of cerebral structures were seen in multiple infants, with cerebral calcifications seen in infants infected as late as 34 weeks of gestation. [doi.org]
- Encephalopathy
Rarely, ZIKV infection has been associated with conditions such as severe thrombocytopenia, microcephaly and other developmental abnormalities, acute polyneuropathy/Guillain-Barré syndrome, myelitis, meningoencephalitis, transient encephalopathy, provoked [ncbi.nlm.nih.gov]
Rarely, Zika virus infection has caused encephalopathy in adults. Death due to Zika virus infection is rare. Very uncommonly, Guillain-Barré syndrome (GBS) develops after a Zika virus infection. [msdmanuals.com]
Sjirk Jan Westra, Prenatal screening for Zika encephalopathy with ultrasound: what is the optimal time window?, The Lancet Child & Adolescent Health, 1, 1, (6), (2017). Morgane Belle, David Godefroy, Gérard Couly, Samuel A. [doi.org]
Sjirk Jan Westra, Prenatal screening for Zika encephalopathy with ultrasound: what is the optimal time window?, The Lancet Child & Adolescent Health, 1, 1, (6), (2017). [dx.doi.org]
- Aura
“Everything about Zika is new, and there is an aura of mystery about it, which leaves everyone open to new stories and new ideas about where it came from,” Dr. Maierovitch said. [nytimes.com]
Treatment
Also, a major challenge is how and when such antiviral treatment would be applied, if available. [ncbi.nlm.nih.gov]
Treatment No specific antiviral treatment is available for Zika virus disease. Treatment of symptoms may include rest, fluids, antipyretics, and analgesics. [web.archive.org]
Prognosis
Because of severe brain disease and microcephaly, the fetus was given a poor prognosis for neonatal health. [doi.org]
Human fetal infection with parvovirus B19: maternal infection time in gestation, viral persistence and fetal prognosis. Pediatr Infect Dis J 2002;21:1133–6. CrossRef PubMed Rudolph KE, Lessler J, Moloney RM, Kmush B, Cummings DA. [web.archive.org]
Etiology
For infants with microcephaly or intracranial calcifications who have negative results on all Zika virus tests performed, health care providers should evaluate for other possible etiologies and treat as indicated. [cdc.gov]
Research into the etiology of new clusters of microcephaly and other neurological disorders should be intensified to determine whether there is a causative link to Zika virus and/or other factors or co-factors. [who.int]
The MoH and Secretaries of Health from the affected states led a joint investigation to characterize and identify the etiology of the outbreak, with the support of national research institutes. [doi.org]
Epidemiology
Keywords Zika ZIKV Singapore Asia Epidemiology Outbreak Background By early October 2016, 73 countries had reported autochthonous transmission of Zika virus (ZIKV) since 2007 [ 1 ]. [doi.org]
Publication Zika virus transmission worldwide Publication Communicable disease threats report, 3-9 March 2019, week 10 News Health risks during the Carnival season in Brazil Publication Zika virus infection - Annual Epidemiological Report for 2016 Publication [ecdc.europa.eu]
The Epidemiological Updates are released as new information becomes available regarding events previously shared through Epidemiological Alerts. [web.archive.org]
However, data on the epidemiology and clinical findings of laboratory-confirmed Zika virus disease remain limited. [ncbi.nlm.nih.gov]
Pathophysiology
Drug trials in pregnancy raise several scientific, ethical, and logistic challenges, which are compounded further in ZIKV because of limited knowledge of the disease pathophysiology and a product development pipeline in its infancy. [ncbi.nlm.nih.gov]
[…] criteria for causality, 7 the authors show a consistent, specific, temporal relationship, which is analogous to relationships between ZIKV infection and the Guillain–Barré syndrome observed in other countries. 8,9 What is more difficult to demonstrate is pathophysiological [doi.org]
The pathophysiology of Zika-induced microcephaly is not known and was a subject of active research as of the end of 2016. [en.wikipedia.org]
Prevention
Persons residing in or traveling to areas of active Zika virus transmission should take steps to prevent Zika virus infection through prevention of mosquito bites (http://www.cdc.gov/zika/prevention/). [ncbi.nlm.nih.gov]
Brooks, [email protected], 404-639-3894. 1 Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC; 2 Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC [doi.org]
[…] to prevent mosquito bites. 4. [web.archive.org]
Prevention Mosquito bites Protection against mosquito bites during the day and early evening is a key measure to prevent Zika virus infection. [who.int]