Zika Virus - A Review for Family Physicans
Mosquito-borne viruses have been on the rise in recent years. This becomes especially critical when you consider a virus with a particularly harrowing consequence, like the Zika virus (ZIKV) and infant microcephaly. From its obscure history in Africa, ZIKV diverged into an African and Asian strain, the latter strain traveling from Asia to the islands in the Pacific Ocean and ultimately to the Americas, including the United States. ZIKV spread through this immunologically naïve population through mosquito bites, sexual transmission, intrauterine transmission and blood transfusion. Zika symptoms may include fever, joint pain, and maculopapular rash, all of which are common to other mosquito-borne illnesses such as dengue and chikungunya, also seen in similar locations. Awareness of the symptoms, differential diagnosis and the testing algorithm for Zika may improve detection and facilitate early management. Tests for ZIKV include nucleic amplification assays, IgM serology, and the plaque reduction neutralization test, with decision to test determined by symptom status, pregnancy status, and degree of exposure. While the majority of patients with ZIKV are asymptomatic, the most severe complications are Guillain-Barré Syndrome for adults and Congenital Zika Syndrome for infants born to infected mothers. Since the mainstay of management is supportive care and surveillance, preventive strategies are critical in prevention of these complications. Prevention is multimodal including mosquito population control, mosquito bite prevention, and actions to prevent sexual transmission. Through counseling and early detection, the family medicine practitioner has the unique opportunity to prevent the spread of ZIKV and its potential complications.