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Last updated: 16th Sept 2016

Zika: A clinical guide

Transmission

Mosquito outline

The key transmission route is through bites from infected Aedes mosquitoes.

Mosquito outline

In the Americas, the main carrier is Aedes aegypti. Aedes albopictus may also be a competent vector.


baby symbol

There is evidence to support mother to fetus transmission
in utero.


heart symbol

Probable sexual transmission
has been reported.


Blood drop symbol

Transmission through transfusion
of infected blood is a possibility.

Transmission

Mosquito outline

The key transmission route is through bites from infected Aedes mosquitoes.

Mosquito outline

In the Americas, the main carrier is Aedes aegypti. Aedes albopictus may also be a competent vector.


baby symbol

There is evidence to suggest trans-placental or perinatal transmission during delivery.


heart symbol

Probable sexual transmission has been reported.


Blood drop symbol

Infection through transfusion of infected blood
is a possibility.

Prevention

Pregnant woman outline

Pregnant women should avoid travel to outbreak areas

Long clothing symbol

Bite prevention measures should be used day and night by travellers in outbreak areas:

  • Long clothing
  • Insect repellent
  • Mosquito nets over beds
Condom in packet illustration

Condoms should be used by men returning from outbreak areas:

  • Asymptomatic: 28 days
  • Symptomatic: 6 months

Symptoms

Symptoms are usually mild and may go unnoticed.
Diagnosis should be guided by likely exposures and diagnostic tests.

Incubation 3–12 days Mild symptoms 2–7 days Arthralgia Myalgia Non-purulentconjunctivitis Conjunctivalhyperaemia Headache Malaise Peripheral oedema / gastrointestinal disturbance have also been observed Rash Above 37.2°C Raised bodytemperature
! Alternative diagnoses Dengue Chikungunya HIV seroconversion Measles Group A streptococcus Rubella Secondary syphilis Leptospirosis Parvovirus Enterovirus Malaria Rickettsia Consider other infections which may present with similar symptoms

Complications

An increase in congenital microcephaly has been reported in areas experiencing Zika virus outbreaks. The association is, as yet, unconfirmed.

Felipe Dana/AP/PA

Interim advice from Public Health England Last updated:1st Feb 2016 Refer tofetal medicineservice Fetalultrasound + Offer fetalultrasound Repeatevery 4weeks Treatment and management During travelor within twoweeks ofreturn Zika virussymptomsreported Zika virussymptoms notreported Currentsymptoms Nocurrentsymptoms Pregnantwoman withhistory of travelto affectedregion Submitsamples fortesting: Zikavirus PCRresults: Abnormalultrasoundfindings Urine EDTAplasma Serum Negative Inconclusive Positive Data source:https://www.gov.uk/government/publications/zika-virus-interim-algorithm-for-assessing-pregnant-women-with-a-history-of-travel