Zika virus disease

Symptoms Of Zika Virus Disease

The incubation period (the time from exposure to symptoms) of Zika virus disease is 3 to 14 days. Symptoms are usually indistinguishable from other diseases such as dengue & chikungunya and persist for 2 to 7 days. The symptoms include: 

• Fever 
• Rash
• Conjunctivitis
• Muscle pain
• Joint pain
• Malaise
• Headache

Patients might also experience some other symptoms such as: 

• Abdominal pain
• Diarrhoea
• Constipation
• Photophobia
• Small ulcers on the oral mucosa
• Hearing impairment
• Vomiting

Causes Of Zika Virus Disease

Most people contract the Zika infection through mosquito bites. 

The virus is primarily spread by the bite of an infected Aedes aegypti and Aedes albopictus mosquito, which breed in or near stagnant water. These mosquitoes usually bite during the day, peaking in the early morning and late afternoon/evening.

Listen to our expert discuss diseases commonly spread by mosquitoes.

Risk Factors For Zika Virus Disease

The factors that increase the risk of Zika virus disease include: 

• Residing in the Zika-infected area
• Not taking adequate precautions to prevent mosquito bites.
• Travelling to the areas where there are Zika outbreaks
• Having unprotected sex with with a person having Zika virus disease
• Transfusion of blood and blood products
• From mother to foetus during pregnancy

Diagnosis Of Zika Virus Disease

Zika virus disease is usually advised to be diagnosed within a week of developing symptoms or in case you or your partner have recently travelled to a contaminated area. 

The most common testing methods include: 

1. Reverse transcription polymerase chain reaction (RT-PCR)

This method detects the Zika virus's RNA (genetic material). It is a rapid, sensitive, and specific method for early detection. The test can be done with urine, saliva, and blood samples and can detect the virus during the first 3 to 5 days after the onset of infection. 

This test helps to differentiate between similar infections such as dengue fever or chikungunya infection.

2. Serology

The method can detect the presence of antibodies after four days of illness. Antibody(IGM) levels are variable but generally become positive starting in the first week after the onset of symptoms and continuing for up to 12 weeks post-symptom onset or exposure, but may persist for months to years.

This test is not generally recommended as it cannot differentiate from other viral infections, such as dengue, chikungunya, and yellow fever.

3. Plaque reduction neutralisation tests (PRNT)

This is a quantitative assay that measures virus-specific neutralising antibody titers. PRNTs can resolve false-positive IgM antibodies.
This test is commonly acknowledged as the gold standard, However it has limitations in terms of time, cost and resources. 

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Examination during pregnancy

During pregnancy, several tests can be done to identify congenital Zika virus infection. These include:

1. Ultrasound
Serial ultrasounds (every 3 to 4 weeks) are recommended for Zika-infected (or suspected) pregnant women. The test can detect various brain-related abnormalities of the foetus, such as microcephaly. 

2. Amniocentesis
This procedure, which involves testing the amniotic fluid for possible Zika virus infection, is a proactive step that can be taken after 15 weeks of gestation. Early detection significantly increases the chances of managing the infection, empowering you to take control of your health and your baby's well-being.

Several tests such as anemia, diabetes, hepatitis B and C, and HIV conducted during pregnancy can minimise or prevent various health threats.

Learn about some of the basic tests and their importance during pregnancy. 
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Prevention Of Zika Virus Disease

Zika virus disease is preventable. By taking the following simple steps to reduce mosquito bites, you can significantly lower your risk:

I. Prevent mosquito bites

1. Use mosquito repellents
These are available in patches, bands, creams, and lotions. Mosquito repellants protect against mosquitoes both indoors and outdoors. They can be chemical-based or natural.

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Tips to follow while using repellants

• Avoid spraying the repellant on the skin under clothing.

• Apply sunscreen first, if you are applying it with a repellant.

• Read complete instructions to avoid any reaction.

• Do not apply insect repellent to a child’s hands, eyes, mouth, cuts, or irritated skin.

Learn more about applying mosquito repellants correctly.
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2. Avoid stagnant water
Mosquitoes lay eggs in and around standing water. The following measures can be taken to avoid standing water.

• Drain out water from buckets and mugs after washing & bathing.

• Cover up water storage containers with tight lids.

• Remove standing water from flower pots, AC trays, and coolers. 

• Clean roof gutters, home coolers and swimming pools regularly.

• Keep native larvivorous fishes in the pools as they feed on mosquitoes.

3. Restrict entry of mosquitoes from outdoors 
The infected mosquitoes breeding eggs outside in the trash containers can enter the house. The best way is to prevent their entry. This can be done by taking the following measures: 

• Use nets and screens for doors and windows.

• Keep windows and doors close.

• Fix all the holes of doors and windows, if any.

• Cover baby carriers with net.

4. Cover yourself 
One can avoid the mosquito bite by wearing protective clothing. While you are dressing up, follow the measures such as: 

• Wear full sleeve clothes and pants
• Wash clothing & gear such as shoes, pants, socks, etc with insecticide 
• Wear light-coloured clothes
• Allow the clothes to dry completely before wearing

5. Sleep under mosquito nets
It is one of the conventional and effective ways to prevent mosquito bites. These nets can be mounted on your bed. The fine mesh of the nets restricts the entry of mosquitoes. 

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II. Follow safe sexual practices

Zika virus disease can be transmitted through vaginal, oral & anal sex. Sharing of sex toys can also pass the virus to other people. 

The virus can stay in semen (viral persistence in testes can last up to 160 days) and vaginal secretions for a longer time than any other body fluids (urine & blood). The following preventive measures can be taken to reduce the chances of infection: 

• Use condoms while having vaginal, oral, and anal sex 
• Avoid sharing of sex toys
• Use dental dams while having oral sex

Condoms can not only act as an effective contraceptive but also protect you from a wide range of sexually transmitted diseases.
But, are you using condoms in the right way?
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Specialist To Visit

In most cases, the symptoms of Zika infection are usually mild and often go away on their own. However, visiting a clinician and early intervention may lead to slow progression and early disease resolution.
The specialists who can help treat this infection include:

• General Physician
• Infectious disease specialist
• Gynecologist

In case of pregnancy, women should visit their obstetrician-gynaecologist as the Zika infection is known to cause several complications in the foetus.

If you're experiencing any symptoms, we strongly advise seeking guidance from our team of world-class medical professionals.

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Treatment Of Zika Virus Disease

There is no specific treatment or vaccine available for Zika virus disease. The treatment is usually aimed to reduce the symptoms. Most of the patients usually recover on their own by taking proper rest & supportive care. 

• To prevent dehydration, people are advised to drink plenty of fluids, such as water and coconut water. 
• Patients must prioritise rest because the infection can lead to tiredness and fever. This is vital to the treatment process and can significantly aid their recovery.
• In case of body pain and fever, Paracetamol can be taken. 
• Pregnant women living in the areas of active Zika transmission or having symptoms should immediately consult their doctors. 

Note: It's important to note that Non-steroidal anti-inflammatory drugs (NSAIDs) such as Ibuprofen or Aspirin should be avoided until your doctor confirms the absence of dengue fever. This precaution can help prevent potential complications.

Home care For Zika Virus Disease

Once you have Zika virus, there are very few chances that you will experience any symptoms. Symptoms are usually mild and rarely require hospitalisation. However, it is essential to take care of the following points:

• Consume plenty of water and other fluids like coconut water, soups, etc.
• Take adequate rest. 
• Regularly sanitise your surroundings. This is an essential step in preventing the spread of Zika virus.
• Control mosquitoes both inside and outside your home. 
• Abstain from any sexual activity as it may transmit the infection to your partner. 
• Do not plan to conceive for at least 2 to 3 months after the recovery.
• Pregnant women should regularly meet their gynaecologist to screen for any foetal abnormalities.

Dietary Inclusions

You can also include the following in your diet to boost your immunity to fight against the infection:

Garlic (Lehsun): With its anti-inflammatory properties, garlic is a powerful ally in fighting infections. Allicin, a key ingredient in garlic, boosts immunity and reduces muscle pain and fever. The best part? It's easy to include in your diet, whether raw, cooked, or powdered, making it a simple yet practical addition to your health routine.  

Papaya (Papita): Papaya enhances immunity which helps in fighting infections. It also acts as an antioxidant. 

Note: Papaya should not be consumed during pregnancy. 

Vitamin C: Foods rich in Vitamin C, such as oranges, strawberries & kiwi, are known to enhance immunity and can aid in faster recovery. 

You can also take Vitamin C supplements to fill any gaps in your diet.
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Tips for caregivers

When caring for a Zika-infected patient, it's crucial to follow these precautionary measures. They play a key role in reducing the risk of transmission, ensuring your safety and that of others. 

• Do not touch blood or body fluids such as urine or vomit of the infected person
• Wash hands properly after meeting with the infected person
• Remove and wash clothes timely and immediately if they are exposed to any blood or other fluids
• Sanitise the person's environment and belongings daily
• Take necessary steps to avoid mosquito bites
• Keep doors and windows close
• Use mosquito nets for babies 

Complications Of Zika Virus Disease

People suffering from Zika virus disease usually recover on their own. The disease is mild and rarely requires hospitalisation. But, in some cases, the diseases can cause several complications. Pregnant women are at high risk of developing complications. 

Congenital Zika syndrome

There is a strong link between Zika virus infection during pregnancy & birth defects in children. An infected pregnant woman can pass the virus to her developing baby. It can cause a group of birth defects in the child known as congenital Zika syndrome. It can affect the growth & development of the developing baby. The possible abnormalities include: 

• Smaller brain and collapsed skull (microcephaly)
• Decreased brain tissue
• Scarring at the back of eye
• Reduced mobility of the joints
• Reduced movement of the body immediately after the birth
• Epilepsy
• Intellectual disability
• Respiratory infection
• Dysphagia
• Neural tube defects
• Cerebral palsy
• Low birth weight
• Vision problems
  
  

Guillain-Barré syndrome (GBS)

Zika virus disease can rarely cause Guillain-Barre Syndrome(GBS). It is a neurological disorder in which the immune system damages nerve cells. It can lead to muscle weakness. In advanced stages, muscles that control breathing can also be affected. 

Usually, patients recover from GBS within several months. Rarely, it causes permanent damage.

Other neurological disorders

Zika virus disease can also lead to some central nervous system-related disorders, such as neuropathy (nerve damage) & myelitis (inflammation of the spinal cord). 

• Encephalitis  (Inflammation of the brain)
• Meningoencephalitis (inflammation of both the brain and its surrounding membranes)
• Retinopathies  (Damage to the retina of the eye)

Thrombocytopenia

Very rarely, Zika virus disease can cause thrombocytopenia. People with this disorder have less number of platelets which can result in bleeding, bruising and slow blood clotting.

Pregnancy loss

The infection of Zika virus in pregnant women increases the chances of miscarriages, preterm birth & still birth.