Zika virus infection natural history, complications, and prognosis

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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]
    • The rash typically begins to fade after the second day.[2]
    • The fever usually defervesces after the 3rd day.[2]
  • 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

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. 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. 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. 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.
  4. 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. 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.
  6. Complications http://www.who.int/mediacentre/factsheets/zika/en/ (September, 2016) Accessed on September 20, 2016