Symptoms and Diagnosis of Zika Virus Infection

Zika virus is spread to people through mosquito bites. The most common symptoms of Zika virus disease are fever, rash, joint pain, and conjunctivitis (red eyes). The illness is usually mild with symptoms lasting from several days to a week. Severe disease requiring hospitalization is uncommon.

 
Symptoms and Diagnosis of Zika Virus Infection
Symptoms

  • About 1 in 5 people infected with Zika virus become ill (i.e., develop Zika).
  • The most common symptoms of Zika are fever, rash, joint pain, or conjunctivitis (red eyes). Other common symptoms include muscle pain and headache. The incubation period (the time from exposure to symptoms) for Zika virus disease is not known, but is likely to be a few days to a week.
  • The illness is usually mild with symptoms lasting for several days to a week.
  • Zika virus usually remains in the blood of an infected person for a few days but it can be found longer in some people.
  • Severe disease requiring hospitalization is uncommon.
  • Deaths are rare.

Diagnosis
Clinical illness is consistent with Zika virus disease if two or more symptoms (acute onset of fever, maculopapular rash, arthralgia, or conjunctivitis) are present.

  • The symptoms of Zika are similar to those of dengue and chikungunya, diseases spread through the same mosquitoes that transmit Zika.
  • See your healthcare provider if you develop the symptoms described above and have visited an area where Zika is found.
  • If you have recently traveled, tell your healthcare provider when and where you traveled.
  • Your healthcare provider may order blood tests to look for Zika or other similar viruses like dengue or chikungunya.
Laboratory
  • Availability of Zika virus testing is limited; consult your state or local health department to facilitate testing. Tests include Zika virus reverse transcription–polymerase chain reaction (RT-PCR) and Zika virus immunoglobulin M (IgM) and neutralizing antibodies on serum specimens. Given the overlap of symptoms and endemic areas with other viral illnesses, evaluate for possible dengue or chikungunya virus infection.
  • Laboratory evidence of maternal Zika virus infection: 1) Zika virus RNA detected by RT-PCR in any clinical specimen; or 2) positive Zika virus IgM with confirmatory neutralizing antibody titers that are >/=4-fold higher than dengue virus neutralizing antibody titers in serum. Testing would be considered inconclusive if Zika virus neutralizing antibody titers are <4-fold higher than dengue virus neutralizing antibody titers.
  • Amniocentesis is not recommended until after 15 weeks of gestation. Amniotic fluid should be tested for Zika virus RNA by RT-PCR.

 
 
References:

  1. Staples JE, Dziuban EJ, Fischer M, Cragan JD, Rasmussen SA, Cannon MJ, Frey MT, Renquist CM, Lanciotti RS, Muñoz JL, Powers AM, Honein MA, Moore CA. Interim Guidelines for the Evaluation and Testing of Infants with Possible Congenital Zika Virus Infection – United States, 2016. MMWR Morb Mortal Wkly Rep. 2016 Jan 29;65(3):63-67. [Medline]
  2. Bogoch II, Brady OJ, Kraemer MU, German M, Creatore MI, Kulkarni MA, Brownstein JS, Mekaru SR, Hay SI, Groot E, Watts A, Khan K. Anticipating the international spread of Zika virus from Brazil. Lancet. 2016 Jan 14. pii: S0140-6736(16)00080-5. [Medline]

Created Jan 29, 2016.

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