Zika virus is a flavivirus spread by the bite of the Aedes mosquito and is related to denque, yellow fever and West Nile viruses.
Originally reported in Uganda, the virus has now spread to many parts of the world including the United States (See Figures).
Incubation is 2-12 days and only 20% of patients bitten develop symptoms. Transmission between humans can occur via blood transfusion or sexual activity. Symptoms include fever, rash, conjunctivitis, joint pain, headache, and generalized weakness.
One of the most publicized complications is microcephaly in babies born of women infected with the virus during pregnancy (generally in the first trimester of pregnancy). Greater than 4000 cases have been reported in Brazil and now in other areas of the world.
Treatment of the disease is symptomatic meaning treating the fever and symptoms with acetaminophen (Tylenol) and other supportive care such as IV fluids if dehydrated. Ibuprofen (Motrin) should be avoided as co-infections with dengue do occur and use of nonsteroidal anti-inflammatory agents, such as ibuprofen, may increase risk of progression to hemorrhagic fever.
Testing for the virus can occur from blood, urine or cerebrospinal fluid specimens sent to local health departments. http://www.cdc.gov/zika/hc-providers/index.html
EMS providers should use universal precautions or standard infectious disease precautions (gloves and mask) when evaluating and transporting these patients to the emergency department. Exposure to blood or bodily fluids should be reported per normal guidelines and no additional precautions are necessary. Questions regarding exposures can first be directed to the Medical Alert Center who can contact Public Health.
- United States Center for Disease Control and Prevention http://www.cdc.gov/zika accessed 7-11-16.
- Los Angeles County Department of Public Health http://publichealth.lacounty.gov/acd/vectorzika.htm accessed 7-11-16.
- Los Angeles County Department of Public Heath http://publichealth.lacounty.gov/acd/docs/ZikaCDRoundsMay201