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Zika Virus - What You Need to Know

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Zika Virus – What you Need to Know

What is Zika Virus disease (Zika)?

Zika is a disease caused by Zika virus that is spread to people primarily through the bite of an infected Aedes species mosquito. The most common symptoms of Zika are fever, rash, joint pain, and conjunctivitis (red eyes). The illness is usually mild with symptoms lasting for several days to a week.

This is an Aedes albopictus female mosquito obtaining a blood meal from a human host. Under experimental conditions the Aedes albopictus mosquito, also known as the Asian tiger mosquito, has been found to be a vector of West Nile virus. Aedes is a genus of the Culicine family of mosquitos.
IMAGE

Zika Virus – What you Need to Know

What is Zika Virus disease (Zika)?

Zika virus is an emerging mosquito-borne virus that was first identified in Uganda in 1947 in rhesus monkeys through a monitoring network of sylvatic yellow fever. It was subsequently identified in humans in 1952 in Uganda and the United Republic of Tanzania. Outbreaks of Zika virus disease have been recorded in Africa, the Americas, Asia and the Pacific.
• Genre: Flavivirus
• Vector: Aedes mosquitoes (which usually bite during the morning and late afternoon/evening hours)
• Reservoir: Unknown

the structure of the Flaviviridae virus (Source: lookfordiagnosis). IMAGE

Zika Virus – History

History

In 1956, researchers reported that a related mosquito species—Ae. aegypti, the yellow fever mosquito—could ferry the virus to mice and monkeys in the lab. In 1968, researchers found the virus in people from Nigeria. And between 1951 and 1981, the virus was found in people from Uganda, Tanzania, Egypt, Central African Republic, Sierra Leone, and Gabon. It also showed up in parts of Asia, including India, Malaysia, the Philippines, Thailand, Vietnam, and Indonesia.
Despite the hints of its widespread presence in humans, there were few case reports of illnesses from Zika. The earliest accounts of Zika illnesses from the 1960s and 1970s describe symptoms of fever, occasional rashes, joint and muscle aches, and tiredness that lasted a few days to about a week—a mild, albeit annoying ailment.
In 1981, researchers reported seven clinically verified cases in Indonesia. The illnesses were marked by the same symptoms, but this time there was also a loss of appetite, diarrhea, dizziness, abdominal pain, and one case of pink-eye.

Zika Virus – History

History

During large outbreaks in French Polynesia and Brazil in 2013 and 2015 respectively, national health authorities reported potential neurological and auto-immune complications of Zika virus disease.
Recently in Brazil, local health authorities have observed an increase in Zika virus infections in the general public as well as an increase in babies born with microcephaly in northeast Brazil. Agencies investigating the Zika outbreaks are finding an increasing body of evidence about the link between Zika virus and microcephaly.


Zika Virus – Transmission

Through mosquito bites

Zika virus is transmitted to people primarily through the bite of an infected Aedes species mosquito. These are the same mosquitoes that spread dengue and chikungunya viruses. IMAGE

• These mosquitoes typically lay eggs in and near standing water in things like buckets, bowls, animal dishes, flower pots and vases. They are aggressive daytime biters, who prefer to bite people, and live indoors and outdoors near people.
• Mosquitoes become infected when they feed on a person already infected with the virus. Infected mosquitoes can then spread the virus to other people through bites.

Zika Virus – Transmission

Rarely, from mother to child

• A mother already infected with Zika virus near the time of delivery can pass on the virus to her newborn around the time of birth, but this is rare.
• It is possible that Zika virus could be passed from mother to fetus during pregnancy. This mode of transmission is being investigated.
• To date, there are no reports of infants getting Zika virus through breastfeeding. Because of the benefits of breastfeeding, mothers are encouraged to breastfeed even in areas where Zika virus is found.

Possibly through infected blood or sexual contact

• There has been one report of possible spread of the virus through blood transfusion and one report of possible spread of the virus through sexual contact.

Zika Virus – Symptoms, Diagnosis, & Treatment

Symptoms
• About 1 in 5 people infected with Zika virus become ill (i.e., develop Zika).
• The most common symptoms of Zika are fever, rash, joint pain, or conjunctivitis (red eyes). Other common symptoms include muscle pain and headache. The incubation period (the time from exposure to symptoms) for Zika virus disease is not known, but is likely to be a few days to a week.
IMAGE
• The illness is usually mild with symptoms lasting for several days to a week.
• Zika virus usually remains in the blood of an infected person for a few days but it can be found longer in some people.
• Severe disease requiring hospitalization is uncommon.
• Deaths are rare.

Zika Virus – Symptoms, Diagnosis, & Treatment

Diagnosis

• The symptoms of Zika are similar to those of dengue and chikungunya, diseases spread through the same mosquitoes that transmit Zika.
• See your healthcare provider if you develop the symptoms described above and have visited an area where Zika is found.
• If you have recently traveled, tell your healthcare provider when and where you traveled.
• Your healthcare provider may order blood tests to look for Zika or other similar viruses like dengue or chikungunya.
IMAGE

Zika Virus – Symptoms, Diagnosis, & Treatment

Treatment

• No vaccine or medications are available to prevent or treat Zika infections.
• Treat the symptoms:
• Get plenty of rest
• Drink fluids to prevent dehydration
• Take medicines, such as acetaminophen or paracetamol, to relieve fever and pain
• Do not take aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen and naproxen. Aspirin and NSAIDs should be avoided until dengue can be ruled out to reduce the risk of hemorrhage (bleeding). If you are taking medicine for another medical condition, talk to your healthcare provider before taking additional medication.
• If you have Zika, avoid mosquito bites for the first week of your illness.
• During the first week of infection, Zika virus can be found in the blood and passed from an infected person to another mosquito through mosquito bites.
• An infected mosquito can then spread the virus to other people

Zika Virus – Affected Areas

Where has Zika virus been found?

• Prior to 2015, Zika virus outbreaks have occurred in areas of Africa, Southeast Asia, and the Pacific Islands.
• In May 2015, the Pan American Health Organization (PAHO) issued an alert regarding the first confirmed Zika virus infections in Brazil.
• Currently, outbreaks are occurring in many countries.
• Zika virus will continue to spread and it will be difficult to determine how the virus will spread over time.

Countries that have past or current evidence of Zika virus transmission (as of January 2016)
IMAGE

Zika Virus – Affected Areas

Location of current Zika Virus alerts as of January 19th 2016 – from Healthmap.org
IMAGE

Zika Virus – Affected Areas

Where has Zika virus been found?

• Prior to 2015, Zika virus outbreaks have occurred in areas of Africa, Southeast Asia, and the Pacific Islands.
• In May 2015, the Pan American Health Organization (PAHO) issued an alert regarding the first confirmed Zika virus infections in Brazil.
• Currently, outbreaks are occurring in many countries.
• Zika virus will continue to spread and it will be difficult to determine how the virus will spread over time.

Zika in the United States and its territories.

• No locally transmitted Zika cases have been reported in the continental United States, but cases have been reported in returning travelers.
• Locally transmitted Zika virus has been reported in the Commonwealth of Puerto Rico.
• With the recent outbreaks, the number of Zika cases among travelers visiting or returning to the United States will likely increase.
• These imported cases could result in local spread of the virus in some areas of the USA.

Zika Virus – Affected Areas

Countries and territories with active Zika virus transmission January 26, 2016
IMAGE

Zika Virus – Affected Areas

Countries and territories with active Zika virus transmission

The Americas

• Barbados
• Bolivia
• Brazil
• Colombia
• Dominican Republic
• Ecuador
• El Salvador
• French Guiana
• Guadeloupe
• Guatemala
• Guyana
• Haiti
• Honduras
• Martinique
• Mexico
• Panama
• Paraguay
• Puerto Rico
• Saint Martin
• Suriname
• U.S. Virgin Islands
• Venezuela

OCEANIA/PACIFIC ISLANDS
• Samoa

AFRICA
• Cape Verde

As of January 26, 2016

Zika Virus – Prevention

Prevention

• No vaccine exists to prevent Zika virus disease (Zika).
• Prevent Zika by avoiding mosquito bites (see below).
• Mosquitoes that spread Zika virus bite mostly during the daytime.
• Mosquitoes that spread Zika virus also spread dengue and chikungunya viruses.
IMAGE

Zika Virus – Prevention

Prevention

• Wear long-sleeved shirts and long pants.
• Stay in places with air conditioning or that use window and door screens to keep mosquitoes outside.
• Sleep under a mosquito bed net if you are overseas or outside and are not able to protect yourself from mosquito bites.
• Use Environmental Protection Agency (EPA)-registered insect repellents. All EPA-registered insect repellents are evaluated for effectiveness.
• Always follow the product label instructions
• Reapply insect repellent as directed.
• Do not spray repellent on the skin under clothing.
• If you are also using sunscreen, apply sunscreen before applying insect repellent.

Zika Virus – Prevention

FOR PROTECTION AGAINST MOSQUITOES

Products with one of the following active ingredients can also help prevent mosquito bites. Higher percentages of active ingredient provide longer protection.

• DEET
• Picaridin (also known as KBR 3023, Bayrepel, and icaridin. Products containing picaridin include Cutter Advanced, Skin So Soft Bug Guard Plus, and Autan [outside the US])
• Oil of lemon eucalyptus (OLE) or PMD (Products containing OLE include Repel and Off! Botanicals)
• IR3535 (Products containing IR3535 include Skin So Soft Bug Guard Plus Expedition and SkinSmart)


Zika Virus – Prevention

Treat clothing and gear with permethrin or purchase permethrin-treated items.

• Treated clothing remains protective after multiple washings. See product information to learn how long the protection will last.
• If treating items yourself, follow the product instructions carefully.
• Do NOT use permethrin products directly on skin. They are intended to treat clothing
IMAGE

Zika Virus – Prevention

If you have a baby or child:

• Do not use insect repellent on babies younger than 2 months of age.
• Dress your child in clothing that covers arms and legs, or
• Cover crib, stroller, and baby carrier with mosquito netting.
• Do not apply insect repellent onto a child’s hands, eyes, mouth, and cut or irritated skin.
• Adults: Spray insect repellent onto your hands and then apply to a child’s face.
IMAGE

Zika Virus – Prevention

If you have Zika, protect others from getting sick

• During the first week of infection, Zika virus can be found in the blood and passed from an infected person to another mosquito through mosquito bites. An infected mosquito can then spread the virus to other people.
• To help prevent others from getting sick, avoid mosquito bites during the first week of illness.
IMAGE

Further Information

If you have Zika, protect others from getting sick

http://wwwnc.cdc.gov/travel/page/zika-travel-information
http://www.cdc.gov/mmwr/zika_reports.html
http://www.who.int/mediacentre/factsheets/zika/en/
http://ecdc.europa.eu/en/healthtopics/zika_virus_infection/Pages/index.aspx
http://www.health.govt.nz/our-work/diseases-and-conditions/zika-virus