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Patient education: Zika virus infection (The Basics)

Written by the doctors and editors at UpToDate

What is Zika? Zika is a type of virus. Infection with Zika can cause fever, rash, joint pain, and red eyes.
Zika virus is spread mainly through mosquito bites. You can also get it by having sex with someone who is
infected, even if they don't have symptoms. Spread is also possible in other ways, including from a pregnant
mother to her unborn baby, and through donated blood or organs.

If you have Zika while you are pregnant, it can cause serious problems for your baby. If you are not pregnant
or planning to get pregnant, Zika is not likely to make you very sick or cause serious problems.

Where is Zika found? Since May of 2015, there has been a Zika outbreak happening. The virus has been
found in Florida and Texas, as well as the United States territories of Puerto Rico, the Virgin Islands, and
American Samoa. Most cases have been in Central and South America, Mexico, the Caribbean, and the
Pacific Islands.

For the most current information about the outbreak, including the latest list of places where mosquitoes carry
Zika, see one of these websites:

United States Centers for Disease Control and Prevention (CDC): www.cdc.gov
World Health Organization (WHO): www.who.int

What are the symptoms of Zika? Many people infected with Zika have no symptoms, or only mild
symptoms. If there are symptoms, they usually happen 2 to 14 days after being infected.

Symptoms might include:

Fever
Rash
Pain in the joints, especially in the hands and feet
Red eyes
Headache

Zika can also lead to serious problems in babies whose mothers have the infection while they are pregnant.

In some areas where there is Zika virus, there have also been more cases of a disease called "Guillain-Barr
syndrome" (or "GBS"). This is a condition that causes muscle weakness, which can sometimes be severe and
even lead to paralysis. (Paralysis means you cannot move some muscles at all.) GBS seems to be caused by
Zika in some cases, although most people who get Zika will not get GBS. Some people with Zika have other
problems with the nerves or brain. But this is also rare.

What if I am pregnant? If you get infected with Zika while you are pregnant, you could pass the infection
on to your baby. If you are pregnant or trying to get pregnant, experts say you should avoid traveling to areas
where there is Zika virus. If you do visit these areas, it's especially important to try to avoid mosquito bites. It's
also important to avoid having unprotected sex with anyone who has Zika virus. (See 'Can Zika be
prevented?' below.)

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Zika can cause serious problems in pregnancy, including miscarriage (when a pregnancy ends on its own
before 20 weeks), stillbirth (when the baby dies before it is born), and birth defects. Babies who are born with
the infection can have a head and brain that are much smaller than normal. Doctors call this "microcephaly."
Babies with microcephaly are at risk of many different issues, including seizures, trouble hearing and seeing
normally, learning problems, and other problems with their growth and development. Babies born with Zika
can also have very stiff joints or muscles that do not bend or stretch normally.

If you are pregnant and were recently in one of the areas where there is Zika, tell your doctor or nurse. Also
tell them if you have had unprotected sex with anyone who has (or might have) Zika. Depending on your
situation, your doctor might want to test you for the virus. He or she can do tests to see if your baby is likely to
have it, too.

What if I want to get pregnant in the future? If you are thinking about having a baby, talk to your doctor.
He or she can help you plan for a healthy pregnancy. If you or your partner live outside the areas where Zika
is found, but have been to any of these areas, read the advice below on how to prevent the spread of Zika
through sex. This includes guidelines about how long to wait before trying to get pregnant. (See 'Can Zika be
prevented?' below.)

Can I get Zika through sex? Yes, it's possible to get Zika through sex. If you or your partner has been to
an area where there is Zika virus, it's a good idea to use a condom for any kind of sex. This includes vaginal,
anal, and oral sex. It is possible for a man to be infected with Zika and pass it on to his partner without even
knowing he has it.

See below for more on preventing the spread of Zika through sex. (See 'Can Zika be prevented?' below.)

Should I see a doctor or nurse? Yes. If you live in (or recently visited) an area where Zika is found, see a
doctor or nurse if you have symptoms or if you are pregnant.

Is there a test for Zika? Yes. If your doctor or nurse thinks you might have Zika, he or she can order tests
to look for the virus. He or she might also do tests for other diseases that have similar symptoms.

If you are pregnant, and you have been to an area where there is Zika while pregnant, you should get tested
even if you don't have any symptoms.

How is Zika treated? There is no specific treatment for Zika virus infection. If your symptoms bother you,
you should rest and drink plenty of fluids. You can also take acetaminophen (sample brand name: Tylenol) to
relieve fever and aches.

Do not take aspirin or NSAIDs, such as ibuprofen (sample brand names: Advil, Motrin) or naproxen (sample
brand name: Aleve), unless your doctor or nurse says it's okay. That's because they can cause bleeding in
people who have a disease that is similar to Zika, called "dengue fever." Blood tests can tell your doctor or
nurse if you have dengue fever, Zika, or something else.

Never give aspirin or medicines that contain aspirin to children younger than 18 years. In children, aspirin can
cause a serious problem called Reye syndrome.

Can Zika be prevented? Yes. The best way to prevent Zika virus infection is to avoid the mosquitoes that
carry it. Not all countries where Zika is common control mosquitoes well. But you can lower your chances of
getting the infection if you live or travel there. The table has some tips for avoiding mosquitoes (table 1).

It's also important to try to avoid mosquito bites if you have already gotten Zika. That's because during the

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first week of having it, the virus can be found in your blood. If a mosquito bites you, and then bites another
person, that person could then get Zika too.

Zika can be spread through sex, too. It's important to avoid unprotected sex if you or your partner might have
been exposed to the virus. "Exposed" means living in or traveling to an area where there is Zika, or having
unprotected sex with someone who has.

Some experts suggest the following guidelines, which are especially important for people who could get
pregnant (and their partners). These guidelines are for people who do not live in areas with Zika virus:

Men who might have been exposed to Zika should use condoms, or not have sex, for at least 6 months.
The 6 months should begin after symptoms start (if the man has symptoms) or after the last possible
exposure (if he doesn't).

Women who might have been exposed to Zika should use condoms, or not have sex, for at least 8
weeks. The 8 weeks should begin after symptoms start (if the woman has symptoms) or after the last
possible exposure (if she doesn't).

Men and women who might have been exposed to Zika and whose partner is pregnant should use
condoms, or not have sex, for the rest of the partner's pregnancy. This is especially important, even if the
person does not have symptoms.

For people who live in areas where there is Zika, experts suggest continuing to use condoms for as long as
the outbreak is happening.

Another way Zika can be spread is through donated blood or tissues. If you want to donate blood, stem cells,
eggs, or sperm, and have been to an area where there is Zika virus or had sexual contact with someone who
has, tell the donation center staff. Then they can decide how long you should wait before donating.

There is no vaccine for Zika virus infection.

More on this topic

Patient education: Staying healthy when you travel (The Basics)

Patient education: Dengue fever (The Basics)
Patient education: How to plan and prepare for a healthy pregnancy (The Basics)
Patient education: Guillain-Barr syndrome (The Basics)

Patient education: General travel advice (Beyond the Basics)

All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Aug 19, 2017.

The content on the UpToDate website is not intended nor recommended as a substitute for medical advice,
diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care
professional regarding any medical questions or conditions. The use of UpToDate content is governed by
the UpToDate Terms of Use. 2017 UpToDate, Inc. All rights reserved.

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GRAPHICS

Tips for avoiding the mosquitoes that carry the Zika virus

Stay inside when the mosquitoes are most active. They bite mostly during the daytime and at twilight (the very
early morning, and the few hours before sunset). Buildings with screens and air conditioning are safest.

Wear shoes, long-sleeved shirts, long pants, and a hat when you go outside.

Wear bug spray or cream that contains DEET or a chemical called "picaridin." Check the label to make sure. Do
not use DEET on babies younger than 2 months.

On your clothes and gear, use bug repellents that have a chemical called "permethrin."

Drain any standing water if possible, such as wading pools, buckets, and potted plants with saucers. Mosquitoes
breed in standing water.

Graphic 109261 Version 1.0

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