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June 14, 2016

Zika Virus Disease

JAMA. 2016;315(22):2482. doi:10.1001/jama.2016.4741

Zika virus disease is generally a mild illness, but it can cause serious birth defects when it affects pregnant women.

What Is Zika?

Zika virus disease is caused by the Zika virus, which is spread to people by mosquito bites. An estimated 80% of people who get Zika have no symptoms. When symptoms appear, they are usually mild, last a few days to a week, and go away on their own. The most common symptoms are fever, rash, joint pain, and red eyes. Although most Zika infection is spread by mosquito bites, it can also be spread from mother to child in pregnant women and can be sexually transmitted. There is currently no treatment for Zika.

Zika and Birth Defects

The major health concern of Zika is its link to pregnancy loss and birth defects when pregnant women are infected. In particular, maternal Zika infection appears to be linked with a condition called microcephaly (small head size) in infants. It is not known what the chance of microcephaly or other birth defects is after maternal Zika infection. Symptoms of neurological abnormalities have been seen in infants both with and without microcephaly born after maternal Zika infection. It is not known what the extent of neurological abnormalities will be as these infants continue to grow.

Current 2015-2016 Outbreak in Central and South America and the Caribbean

Zika infection was confirmed in Brazil in May 2015, and since then, local transmission has been reported in many countries in South and Central America and the Caribbean. For a full list and map of countries with active Zika transmission, visit www.cdc.gov/zika/geo/active-countries.html.

Who Should Be Tested for Zika?

Recommendations for testing by the Centers for Disease Control and Prevention (CDC) are evolving as more information is gathered. Testing is done by a blood sample taken in the doctor’s office that is then sent to the CDC. The CDC currently recommends that

  • If you are pregnant and have traveled to an area with ongoing Zika transmission while pregnant, you should be tested for Zika, regardless of whether you have had any mosquito bites or symptoms of Zika.

  • Women who are not pregnant do not need to be tested for Zika, even if they have had symptoms of Zika.

  • Men do not need to be tested for Zika, regardless of symptoms.

Preventing Zika

There is currently no medication or vaccine that can prevent Zika. The best way to prevent Zika while traveling in a Zika area is to avoid mosquito bites by wearing appropriate clothing, staying indoors, and using insect repellent. The CDC advises pregnant women to avoid unnecessary travel to areas with active Zika transmission.

For men who have traveled to a Zika area and who have a pregnant partner, abstinence or condom use for the duration of pregnancy is recommended. It is currently not known how long Zika can be sexually transmitted after exposure, as the virus may remain active in semen longer than it does in the bloodstream.

For men and nonpregnant women of childbearing age who travel to a Zika area, delaying pregnancy after travel with any form of contraception can be considered.

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Article Information

Published Online: April 13, 2016. doi:10.1001/jama.2016.4741.

Source: Centers for Disease Control and Prevention

Topic: Infectious Disease