Zika virus infection natural history, complications, and prognosis: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Zika virus}} | {{Zika virus}} | ||
{{CMG}}; {{AE}} {{LRO}} | {{CMG}}; {{AE}} {{YD}}, {{LRO}}, {{SSK}}, {{YK}} | ||
==Overview== | ==Overview== | ||
Patients | Patients who are exposed to Zika virus will develop symptoms 3 and 12 days after contracting the disease. Symptoms will typically begin with a mild [[headache]] and [[fever]], then progress to include a [[maculopapular rash]] spreading across the body within 24 hours, followed by [[back pain]] and [[conjunctivitis]]. The symptoms typically last between 4 and 7 days. The prognosis is usually excellent, with the majority of patients recovering fully. Complications include [[neurological]] and possibly [[congenital]] sequelae, particularly [[Guillain-Barré syndrome]] and [[microcephaly]]. According to WHO, ZIKV infection during pregnancy is the cause of congenital brain abnormalities including microcephaly. | ||
==Natural History== | ==Natural History== | ||
*The symptoms of Zika virus infection usually develop between 3 and 12 days after | *The symptoms of Zika virus infection usually develop between 3 and 12 days after an individual contracts the disease.<ref name="factsheet">{{cite web |url=http://ecdc.europa.eu/en/healthtopics/zika_virus_infection/factsheet-health-professionals/Pages/factsheet_health_professionals.aspx |title=Zika Virus Infection Factsheet for Health Professionals |last1= |first1= |last2= |first2= |date=November 11, 2015 |website=European Centre for Disease Prevention and Control |publisher= |access-date=December 11, 2015 |quote=}}</ref> | ||
*Zika virus infection symptoms will usually begin with a mild headache. Within 24 hours, | *Zika virus infection symptoms will usually begin with a mild [[headache]] and [[fever]]. Within 24 hours, symptoms progress to include a maculopapular rash across the face, neck, trunk, upper arms, palms, and soles, malaise, and back pain follow shortly.<ref name="pmid19788800">{{cite journal| author=Hayes EB| title=Zika virus outside Africa. | journal=Emerg Infect Dis | year= 2009 | volume= 15 | issue= 9 | pages= 1347-50 | pmid=19788800 | doi=10.3201/eid1509.090442 | pmc=PMC2819875 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19788800 }} </ref> | ||
* | *Zika virus infection is usually self-limited, and symptoms typically last 4-7 days.<ref name="factsheet">{{cite web |url=http://ecdc.europa.eu/en/healthtopics/zika_virus_infection/factsheet-health-professionals/Pages/factsheet_health_professionals.aspx |title=Zika Virus Infection Factsheet for Health Professionals |last1= |first1= |last2= |first2= |date=November 11, 2015 |website=European Centre for Disease Prevention and Control |publisher= |access-date=December 11, 2015 |quote=}}</ref> | ||
**The rash | **The rash typically begins to fade after the second day.<ref name="pmid19788800">{{cite journal| author=Hayes EB| title=Zika virus outside Africa. | journal=Emerg Infect Dis | year= 2009 | volume= 15 | issue= 9 | pages= 1347-50 | pmid=19788800 | doi=10.3201/eid1509.090442 | pmc=PMC2819875 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19788800 }} </ref> | ||
**The fever | **The fever usually defervesces after the 3rd day.<ref name="pmid19788800">{{cite journal| author=Hayes EB| title=Zika virus outside Africa. | journal=Emerg Infect Dis | year= 2009 | volume= 15 | issue= 9 | pages= 1347-50 | pmid=19788800 | doi=10.3201/eid1509.090442 | pmc=PMC2819875 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19788800 }} </ref> | ||
*Once a person has been infected, he or she is likely to be protected from future infections. | |||
==Complications== | ==Complications== | ||
Complications that may develop from Zika virus infection include [[neurological]] disease and possibly [[congenital]] malformation:<ref name="EpiAlert">{{cite web |url=http://www.paho.org/hq/index.php?option=com_docman&task=doc_view&Itemid=270&gid=32405&lang=en |title=Epidemiological Alert: Neurological Syndromes, Congenital Malformations, and Zika Virus Infection. Implications for Public Health in the Americas |last1= |first1= |last2= |first2= |date=December 1, 2015 |website=Pan American Health Organization|publisher=Pan American Health Organization |access-date=December 11, 2015 |quote=}}</ref> | |||
* | '''Infected males and non-pregnant women''' | ||
**[[ | *[[Guillain-Barré syndrome]]<ref>{{Cite journal | ||
| author = [[Lucas Masiero Araujo]], [[Maria Lucia Brito Ferreira]] & [[Osvaldo Jm Nascimento]] | |||
| title = Guillain-Barre syndrome associated with the Zika virus outbreak in Brazil | |||
| journal = [[Arquivos de neuro-psiquiatria]] | |||
| volume = 74 | |||
| issue = 3 | |||
| pages = 253–255 | |||
| year = 2016 | |||
| month = March | |||
| doi = 10.1590/0004-282X20160035 | |||
| pmid = 27050856 | |||
}}</ref> | |||
'''Pregnant Women''' | |||
*[[Miscarriage]] | |||
*[[Stillbirth]] | |||
'''Neonate''' | |||
*[[Congenital]] [[microcephaly]]<ref name="pmid27487767">{{cite journal| author=Boeuf P, Drummer HE, Richards JS, Scoullar MJ, Beeson JG| title=The global threat of Zika virus to pregnancy: epidemiology, clinical perspectives, mechanisms, and impact. | journal=BMC Med | year= 2016 | volume= 14 | issue= 1 | pages= 112 | pmid=27487767 | doi=10.1186/s12916-016-0660-0 | pmc=4973112 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27487767 }} </ref> | |||
*Eye disorders<ref name="pmid27487767">{{cite journal| author=Boeuf P, Drummer HE, Richards JS, Scoullar MJ, Beeson JG| title=The global threat of Zika virus to pregnancy: epidemiology, clinical perspectives, mechanisms, and impact. | journal=BMC Med | year= 2016 | volume= 14 | issue= 1 | pages= 112 | pmid=27487767 | doi=10.1186/s12916-016-0660-0 | pmc=4973112 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27487767 }} </ref> | |||
*[[Brain]] [[lesions]] | |||
*Brainstem dysfunction | |||
*Other [[neurologic]] disorders include:<ref name=ZIKA>Complications http://www.who.int/mediacentre/factsheets/zika/en/ (September, 2016) Accessed on September 20, 2016 </ref> | |||
**Brainstem and cerebellar hypoplasia | |||
**Malformations of the head | |||
**Involuntary movements | |||
**[[Seizures]] | |||
**[[Irritability]] | |||
**Brainstem dysfunctions such as difficulty in swallowing | |||
**Limb [[contractures]] | |||
**Hearing and sight abnormalities | |||
**Delayed [[myelination]] | |||
**Severe ventriculomegaly | |||
**Lissencephaly (absence of normal cerebral folds) | |||
==Prognosis== | ==Prognosis== | ||
*The prognosis for Zika virus infection is excellent, with the majority of patients experiencing full recovery within 4-7 days | *The prognosis for Zika virus infection is excellent, with the majority of patients experiencing full recovery within 4-7 days after symptom manifestation.<ref name="factsheet">{{cite web |url=http://ecdc.europa.eu/en/healthtopics/zika_virus_infection/factsheet-health-professionals/Pages/factsheet_health_professionals.aspx |title=Zika Virus Infection Factsheet for Health Professionals |last1= |first1= |last2= |first2= |date=November 11, 2015 |website=European Centre for Disease Prevention and Control |publisher= |access-date=December 11, 2015 |quote=}}</ref> | ||
* | *Congenital or neurological sequelae are the main factors of poor prognosis.<ref name="EpiAlert">{{cite web |url=http://www.paho.org/hq/index.php?option=com_docman&task=doc_view&Itemid=270&gid=32405&lang=en |title=Epidemiological Alert: Neurological Syndromes, Congenital Malformations, and Zika Virus Infection. Implications for Public Health in the Americas |last1= |first1= |last2= |first2= |date=December 1, 2015 |website=Pan American Health Organization|publisher=Pan American Health Organization |access-date=December 11, 2015 |quote=}}</ref> | ||
*Zika virus-related deaths are uncommon, but several deaths have been reported during outbreaks. | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category:Disease]] | |||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yazan Daaboul, M.D., Luke Rusowicz-Orazem, B.S., Serge Korjian M.D., Yamuna Kondapally, M.B.B.S[2]
Overview
Patients who are exposed to Zika virus will develop symptoms 3 and 12 days after contracting the disease. Symptoms will typically begin with a mild headache and fever, then progress to include a maculopapular rash spreading across the body within 24 hours, followed by back pain and conjunctivitis. The symptoms typically last between 4 and 7 days. The prognosis is usually excellent, with the majority of patients recovering fully. Complications include neurological and possibly congenital sequelae, particularly Guillain-Barré syndrome and microcephaly. According to WHO, ZIKV infection during pregnancy is the cause of congenital brain abnormalities including microcephaly.
Natural History
- The symptoms of Zika virus infection usually develop between 3 and 12 days after an individual contracts the disease.[1]
- Zika virus infection symptoms will usually begin with a mild headache and fever. Within 24 hours, symptoms progress to include a maculopapular rash across the face, neck, trunk, upper arms, palms, and soles, malaise, and back pain follow shortly.[2]
- Zika virus infection is usually self-limited, and symptoms typically last 4-7 days.[1]
- Once a person has been infected, he or she is likely to be protected from future infections.
Complications
Complications that may develop from Zika virus infection include neurological disease and possibly congenital malformation:[3]
Infected males and non-pregnant women
Pregnant Women
Neonate
- Congenital microcephaly[5]
- Eye disorders[5]
- Brain lesions
- Brainstem dysfunction
- Other neurologic disorders include:[6]
- Brainstem and cerebellar hypoplasia
- Malformations of the head
- Involuntary movements
- Seizures
- Irritability
- Brainstem dysfunctions such as difficulty in swallowing
- Limb contractures
- Hearing and sight abnormalities
- Delayed myelination
- Severe ventriculomegaly
- Lissencephaly (absence of normal cerebral folds)
Prognosis
- The prognosis for Zika virus infection is excellent, with the majority of patients experiencing full recovery within 4-7 days after symptom manifestation.[1]
- Congenital or neurological sequelae are the main factors of poor prognosis.[3]
- Zika virus-related deaths are uncommon, but several deaths have been reported during outbreaks.
References
- ↑ 1.0 1.1 1.2 "Zika Virus Infection Factsheet for Health Professionals". European Centre for Disease Prevention and Control. November 11, 2015. Retrieved December 11, 2015.
- ↑ 2.0 2.1 2.2 Hayes EB (2009). "Zika virus outside Africa". Emerg Infect Dis. 15 (9): 1347–50. doi:10.3201/eid1509.090442. PMC 2819875. PMID 19788800.
- ↑ 3.0 3.1 "Epidemiological Alert: Neurological Syndromes, Congenital Malformations, and Zika Virus Infection. Implications for Public Health in the Americas". Pan American Health Organization. Pan American Health Organization. December 1, 2015. Retrieved December 11, 2015.
- ↑ Lucas Masiero Araujo, Maria Lucia Brito Ferreira & Osvaldo Jm Nascimento (2016). "Guillain-Barre syndrome associated with the Zika virus outbreak in Brazil". Arquivos de neuro-psiquiatria. 74 (3): 253–255. doi:10.1590/0004-282X20160035. PMID 27050856. Unknown parameter
|month=ignored (help) - ↑ 5.0 5.1 Boeuf P, Drummer HE, Richards JS, Scoullar MJ, Beeson JG (2016). "The global threat of Zika virus to pregnancy: epidemiology, clinical perspectives, mechanisms, and impact". BMC Med. 14 (1): 112. doi:10.1186/s12916-016-0660-0. PMC 4973112. PMID 27487767.
- ↑ Complications http://www.who.int/mediacentre/factsheets/zika/en/ (September, 2016) Accessed on September 20, 2016