Source: www.theguardian.com
If you have been on the internet, or been watching the news, you would have heard the name Zika mentioned. This has prompted quite a few questions thrown my way on the ever-so-trusted ‘twitter’;
“I am pregnant, what happens if I get Zika?”
“Zika, Who?”
So, allow me to introduce you to Zika.
Zika is a mosquito-bourne viral disease, quite similar to dengue fever and chikugunya. Like them, Aedes mosquitos are considered the main vectors.
About 1 in 5 people infected with Zika virus will become ill. Symptoms are usually (but not restricted to) a low grade fever, muscle and joint pain, malaise, headache, conjunctivitis and skin rash. The symptoms are usually very mild and therefore no action is needed other than some supportive care. Severe disease is uncommon and deaths are rare. However, there is an exception in pregnant women. We will discuss Zika disease in pregnant women, shortly.
Zika is diagnosed by exclusion. Your doctor may make the diagnosis based on your symptoms, travel history and exclusion of other diseases such as dengue, chikugunya, measles and rubella. Your doctor may also do a blood test. The incubation period for zika is 3- 12 days. Like said earlier, there is no specific treatment for zika, but symptoms will usually resolve within a week.
Treatment
So far, there are no vaccines nor medications available to prevent or treat Zika infections. If you do contract Zika, the treatment is supportive care. Therefore :
- get plenty of rest
- keep yourself well hydrated by drinking plenty of water
- take paracetamol to relieve your fever
- avoid non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen until dengue has been ruled out (to avoid hemorrhagic disease)
- avoid mosquito bites, as it can be passed on through mosquito bites
Zika and pregnancy
There has been growing concerns that pregnant women who become infected with Zika virus may transmit the disease to their foetus. There have been reports on an increasing body of evidence in severe foetal birth defects and poor pregnancy outcome in babies whose mothers were infected with Zika virus while pregnant.
The latest report were from Brazil, stating concerns that babies with mothers infected during pregnancy, were born with microcephaly. Microcephaly is a rare neurological condition in which an infant’s head is significantly smaller than the heads of other children of the same age and sex. Children with microcephaly often have developmental issues. However, further additional international research is needed in confirming the link between Zika virus with this condition.
Because there is still uncertainty of this link between Zika virus and foetal birth defects, women who are pregnant or plan to become pregnant in the near future should delay any travel plans to areas known Zika virus cases. If travel is unavoidable, pregnant women (or those planning to be) should take all precautions to avoid mosquito bites.
- Wear long-sleeved shirts and long pants
- Use insect repellents containing DEET, picaridin, oil of lemon eucalyptus (OLE), or IR3535. Always use as directed.
- Insect repellents containing DEET, picaridin, and IR3535 are safe for pregnant and nursing women and children older than 2 months when used according to the product label. Oil of lemon eucalyptus products should not be used on children under 3 years of age.
- If you use both sunscreen and insect repellent, apply the sunscreen first and then the repellent.
- Use permethrin-treated clothing and gear (such as boots, pants, socks, and tents).
- Use bed nets as necessary
- Stay and sleep in screened-in or air-conditioned rooms.
- Identify and eliminate possible mosquito breeding sites
(quoted from the New Zealand Ministry of Health)
If you are pregnant and develop a rash, red eyes, fever, or joint pain within 14 days of travel to a Zika virus infected country, please consult your health care provider and let them know your travel history.
Countries reporting local transmission of confirmed Zika virus infections in past nine months, as of 19 Jan 2016
- Barbados •Bolivia •Brazil •Cape Verde •Colombia •Ecuador •El Salvador •Fiji •French Guiana •Guadeloupe •Guatemala •Guyana •Haiti •Honduras •Maldives •Martinique •Mexico •New Caledonia •Panama •Paraguay •Puerto Rico •Saint Martin •Samoa •Solomon Islands •Suriname •Thailand •Venezuela
Dr Afida Sohana is a senior medical officer currently working in Hawke’s Bay Fallen Soldier’s Memorial Hospital, New Zealand. She plans to return home to Malaysia soon and serve as a General Practitioner with interest in Obs & Gynea.
References:
- Zika Virus Outside Africa, Emerging Infectious Disease Journal; Vol 15, No 9 – Sept 2009
- CDC leaflet – Zika Symptoms, Diagnosis & Treatment
- http://ecdc.europa.eu/en/healthtopics/zika_virus_infection/factsheet-health-professionals/Pages/factsheet_health_professionals.aspx
- http://www.health.govt.nz/our-work/diseases-and-conditions/zika-virus
[This article belongs to The Malaysian Medical Gazette. Any republication (online or offline) without written permission from The Malaysian Medical Gazette is prohibited.]