Zika Virus

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KEY POINTS

• Zika virus infection can be spread by mosquito bites or by having unprotected sex. It is not known how long the Zika virus stays in body fluids such as blood and semen.
• There is no medicine that cures Zika virus infection. In most cases, you can care for your child at home. If your child has a serious infection, your child may need to stay at the hospital.
• Zika virus infections in pregnant women can infect the baby and cause serious birth defects. The Centers for Disease Control and Prevention (CDC) recommends that women who are pregnant, or who might become pregnant, should NOT travel to areas where Zika virus has been reported.
• To avoid mosquito bites, stay in places that are clean, insect free, and have window screens or air conditioning when you travel. Don’t use perfume or other scented products on your child’s skin because they can attract mosquitoes. Make sure that your child wears long pants and long-sleeved shirts, and use an insect repellent whenever your child is outdoors.

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What is Zika virus?

Zika is a virus related to the viruses that cause yellow fever and Ebola. Zika virus infection can be spread by mosquito bites or by having unprotected sex. It is not known how long the Zika virus stays in body fluids such as blood and semen.

What is the cause?

Infected Aedes mosquitoes can pass the virus when they bite your child. Aedes mosquitoes are found in the US in some southern and central states, as well as in the Caribbean, Central America, South America, Africa, southern Europe, and Southeast Asia. This kind of mosquito tends to bite both during daytime and at night. Mosquitos in some parts of the US have infected people with Zika virus.

Zika virus may be spread by contact with infected blood such as by blood transfusion, organ transplant, or the sharing of needles or syringes contaminated with blood. Zika virus is spread through sexual contact also. The disease can be spread by people who do not have any symptoms and may not know they carry the virus.

Zika virus may also be spread from a mother to her unborn baby, which can cause serious birth defects. There is no evidence that there is a risk of birth defects in future pregnancies after you have had Zika virus infection.

What are the symptoms?

Often there are no symptoms. When symptoms do occur, they usually start 3 to 12 days after a mosquito bite. Symptoms last a few days to a week, and may include:

• Fever
• Rash
• Headache
• Joint and muscle pain
• Vomiting
• Eye redness and swelling, and pain behind the eyes

If a baby is infected before birth, the baby may be born with a small head and a brain that has not developed properly. These children may have learning problems, delays in walking and talking, or other problems.

In some areas where Zika virus has been reported, there are more cases of Guillain-Barré syndrome (GBS). GBS is a rare disorder that causes the body's immune system to attack the nerves. The damage to nerves causes muscle weakness, tingling, and sometimes paralysis. For most people, symptoms last a few weeks or several months and then go away. It is not known if Zika virus increases the risk for GBS.

How is it diagnosed?

Your healthcare provider will ask about your child's symptoms and medical history and examine your child. Your child may have blood tests to rule out infections with other viruses such as dengue or chikungunya.

All pregnant women should be asked about exposure to Zika virus at every prenatal visit. If you have ongoing possible exposure, you should have blood tests for Zika virus 3 times during pregnancy, even if you don’t have symptoms. Women who have symptoms should get tested right away.

If a pregnant woman has Zika virus symptoms or tests positive for Zika virus, the baby should have tests within 2 days of birth. Tests include:

• A physical exam
• A neurological exam
• An ultrasound of the head
• A newborn hearing test
• Blood tests

If prenatal ultrasound shows that the baby might have congenital Zika virus syndrome, the mother should be tested for Zika virus right away.

How is it treated?

There is no medicine that cures Zika virus. If your child’s symptoms are mild, they will usually go away on their own. In most cases, you can care for your child at home. If the infection is serious, your child may need to stay at the hospital. At the hospital, your child may be given IV fluids, pain medicine, or other treatments.

How can I take care of my child?

Follow the full course of treatment prescribed by your healthcare provider. In addition:

• Let your child rest if he or she is tired.
• Give acetaminophen for fever, headache, or muscle aches. Acetaminophen may cause liver damage or other problems. Read the label carefully and give your child the correct dose as directed. Do not give more doses than directed. To make sure you don’t give your child too much, check other medicines your child takes to see if they also contain acetaminophen. Unless recommended by your healthcare provider, your child should not take this medicine for more than 5 days.
• Do not give nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin without your healthcare provider’s approval. If your child has the dengue virus instead of Zika virus, these medicines may cause serious or life-threatening bleeding.
• Make sure that your child drinks a lot of clear liquids. Water, broth, juice, electrolyte solutions, and noncaffeinated drinks are best. When your child has a high fever, the body needs more liquid because it loses more water through the breath and skin.

Ask your provider:

• How and when you will get your child’s test results
• How long it will take for your child to recover
• If there are activities your child should avoid and when your child can return to normal activities
• How to take care of your child at home
• What symptoms or problems you should watch for and what to do if your child has them

Make sure you know when your child should come back for a checkup.

How can I help prevent Zika virus?

Zika virus infections in pregnant women can infect the baby and cause serious birth defects. The Centers for Disease Control and Prevention (CDC) recommends that women who are pregnant, or who might become pregnant, should NOT travel to areas where Zika virus has been reported.

If you are pregnant and live in or must travel to areas with risk of Zika, use condoms from start to finish every time you have oral, vaginal, or anal sex, or do not have sex during your entire pregnancy. Also, protect yourself from mosquito bites.

Take these precautions to avoid mosquito bites:

• If you are planning to travel:
  • Schedule travel to tropical areas during seasons when mosquitoes are less active.
  • Stay in places that are clean, insect free, and have air conditioning, window screens, or mosquito nets.
• Don’t use perfume or other scented products on your child’s skin because they can attract mosquitoes.
• Make sure that your child wears long pants and long-sleeved shirts.
• Use an insect repellent whenever your child is outdoors. Don't use more repellent than recommended in the package directions. Don't put repellent on open wounds or rashes. Don’t put it near your child’s eyes or mouth. When using sprays for the skin, don’t spray the repellent directly on your child’s face. Spray the repellent on your hands first and then put it on your child’s face. Children older than 2 months can use repellents with no more than 30% DEET. DEET should be applied just once a day. Wash it off your child’s body when your child goes back indoors.
  • Picaridin may irritate the skin less than DEET and appears to be just as effective.
  • Spray clothes with repellents because mosquitoes may bite through thin clothing. Products containing permethrin are recommended for use on clothing, shoes, bed nets, and camping gear. Permethrin-treated clothing repels and kills ticks, mosquitoes, and other insects and can keep working after laundering. Permethrin should be reapplied to clothing according to the instructions on the product label. Some commercial products are available pretreated with permethrin. Permethrin does not work as a repellent when it is put on the skin.
  • In some studies, oil of lemon eucalyptus, a plant-based repellent, provided as much protection as repellents with low concentrations of DEET, but it hasn't been as well tested as DEET. Oil of lemon eucalyptus should not be used on children under age 3.
  • Some repellents can make children ill if they put it in their mouth or swallow it. Never let young children play with or put repellent on themselves. Adults should put repellent on their own hands, and then put the repellent on the child’s body.
• Install or repair window and door screens so it is harder for mosquitoes to get indoors.
• Mosquitoes lay eggs in water. To reduce mosquito breeding, drain standing water. Routinely empty water from flowerpots, pet bowls, clogged rain gutters, swimming pool covers, buckets, barrels, cans, and other items that collect water.

To prevent sexually transmitted disease, advise your older child not to have sex, or to use latex or polyurethane condoms during foreplay and every time he or she has vaginal, oral, or anal sex for at least 6 months after last possible exposure.

Zika virus has been shown to live in a male’s semen longer than in other body fluids. If a male has been diagnosed or has had symptoms of Zika virus, he should continue to use condoms for at least 6 months.

You can get more information from:

• World Health Organization
  http://www.who.int/csr/don/en/index.html
• The Centers for Disease Control and Prevention
  800-232-4636
  https://www.cdc.gov