Commentary on Zika virus infection’s Symptoms, Causes, and Treatment

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Zika virus (ZIKV) infection, also known as zika fever, is a disease caused by flavivirus spread through the bite of an infected mosquito from the aedes genus. It is the same mosquito which transmits dengue, chikungunya, and yellow fever. Person-to-person contact (e.g., sexual contact), blood transfusions, organ transplants, and maternal-fetal vertical transmission can also spread infection. In most cases, Zika infection causes a mild, self-limiting disease. Today, zika virus infections have piqued the interest of the international medical community, owing to their role in causing microcephaly (a baby’s head is significantly smaller than expected for the baby’s age) and other neurological abnormalities caused by maternal infections.

The Zika virus was initially isolated from a rhesus monkey in Uganda in 1947. The first report of human infection happened in 1954 in Nigeria. Until 2007, Zika virus infections were mostly thought to have limited geographical distribution. However, subsequent outbreaks of infection in Pacific islands and South America, along with reports that the virus could cause nervous system abnormalities in newborns, piqued the interest of a wide range of scientists. Zika transmission continues in various countries, however it has remained at low levels from 2018 until the present. Currently, the World Health Organization reported that a total of 92 cases with current or previous Zika Virus transmission throughout five of the six WHO Regions (all except the Eastern Mediterranean Region) as of May 2024. In this report, the South East Asian Region consists of Bangladesh, India, Indonesia, Maldives, Myanmar, Sri Lanka, and Thailand with a total of 7 regions.

Clinical signs	Zika fever	Dengue	Chikungunya
Fever (duration)	No fever or subfebrile temperature <38℃ (1-2 days)	Over 38℃ (4-7 days)	Over 38℃ (2-3 days)
Skin rash	On 1st and 2nd day after onset happens in about 90% of cases	On 4th day after onset (happens in about 30-50% of cases)	On 2nd and 5th day after onset (happens in about 50% of cases)
Muscle soreness (Frequency)	++/+++	+++/+++	+/+++
Joint pain (Frequency)	++/+++	+/+++	+++/+++
Joint pain (Intensity)	Mild/Moderate	Mild	Moderate/Severe
Joint swelling	Common, Mild	Rare	Common, Moderate-Severe
Eye redness	50-90% Cases	Rare	30% Cases
Swollen Lymph	+	++	++
Enlarged Liver	–	+++	–
Low WBC or Thrombocytes	-/+	+++	+++
Headache	++	+++	++
Itchy	Moderate/Severe	Mild	Mild
Neurological Symptoms	More Common than dengue and Chikungunya	Rare	Rare (Most common in Newborn)

Zika virus infection may be suspected based on symptoms of people living in or visiting places with Zika virus transmission and/or Aedes mosquito vector. The testing for ZIKV infection is based on the likelihood of exposure, symptoms, and pregnant status. Routine laboratory tests are usually normal, but moderate low white blood cell count, low thrombocytes, and increased liver function may be seen. The Zika virus infection can also be detected with PCR and antibodies. It is recommended for pregnant women who travel from Zika-infected areas and have 2 or more symptoms of ZIKV infection to have regular fetal ultrasound examination, which can be detected as early as 18-20 weeks of gestation.

ZIKV infection has been linked to Guillain-Barré Syndrome, as well as unfavorable pregnancy outcomes such as an increased risk of preterm birth, fetal mortality and stillbirth, and congenital deformities known as congenital Zika syndrome (CZS). Congenital Zika syndrome include

There are no particular treatments available for ZIKV infection. The disease’s course is typically self-limiting, and the primary treatment is bed rest and supportive care, which includes increased fluid intake to prevent dehydration and the administration of antipyretic to relieve temperature and analgesics.There is currently no vaccination or antiviral medication available for ZIKV. However, if dengue fever is suspected as the cause of the patient’s symptoms, aspirin and other nonsteroidal anti-inflammatory medicines should be avoided.

Preventive strategies include controlling the growth of the vector (Aedes mosquito), eliminating it, and preventing mosquito bites. The sexual mode of transmission can be avoided by using protection or abstaining from sexual intercourse. Mosquito bites can be prevented by wearing long-sleeved shirts and pants, using insect repellent, and being indoors as much as possible (with air conditioning, window/door screens, and/or mosquito nets). Aedes mosquitoes breed in stagnant water, thus eliminating stagnant water pools both inside and outside the homes, schools, and work sites and covering water storage containers should be prioritized. It is best to avoid going to areas with high zika virus infection cases but if you must visit such locations, you need to consult a doctor before traveling.

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