Zika virus infection

Last reviewed: 26 Apr 2022
Last updated: 22 Mar 2022

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • fever
  • maculopapular rash
  • arthralgia
  • conjunctivitis
  • features of congenital Zika syndrome (infants)
  • features of Guillain-Barre syndrome
More key diagnostic factors

Other diagnostic factors

  • other constitutional symptoms
  • gastrointestinal symptoms
  • retro-orbital pain
  • oedema of lower limbs
  • transient hearing loss in adults
Other diagnostic factors

Risk factors

  • residence in/travel from endemic area
  • mosquito bites in endemic area
  • unprotected sexual contact with infected individual
  • blood transfusion from infected individual
  • sperm donation from infected individual
  • exposure to other infected body fluids
  • exposure to infected human cells/tissues
More risk factors

Diagnostic investigations

1st investigations to order

  • reverse transcriptase-polymerase chain reaction (RT-PCR)
  • serology
  • testing for other arboviruses
More 1st investigations to order

Investigations to consider

  • antenatal ultrasound
  • amniocentesis
  • head circumference measurement (newborn)
  • newborn further evaluation
  • CT/MRI head (newborn)
  • tests for Guillain-Barre syndrome
More investigations to consider

Treatment algorithm

ACUTE

symptomatic: non-pregnant

pregnant: with possible mosquito-borne or sexual exposure

congenital Zika syndrome

Zika-associated Guillain-Barre syndrome

Contributors

Authors

Geraldo Furtado, MD, MSc

Clinical Director

Microcephaly Working Group

Instituto de Medicina Integral Professor Fernando Figueira (IMIP)

Recife

Brazil

Disclosures

GF is an author of a reference cited in this topic.

Adriana Scavuzzi, MD, MSc, PhD

Coordinator Obstetrics/Gynecology

Microcephaly Working Group

Instituto de Medicina Integral Professor Fernando Figueira (IMIP)

Recife

Brazil

Disclosures

AS declares that she has no competing interests.

Peer reviewers

William A. Petri, Jr., MD, PhD

Chief

Division of Infectious Diseases and International Health

University of Virginia

Charlottesville

VA

Disclosures

WAP declares that he has no competing interests.

Dominic Dwyer, BSc (Med), MBBS, MD, FRACP, FRCPA

Director

Institute of Clinical Pathology and Medical Research

Pathology West

Westmead Hospital

Sydney

Australia

Disclosures

DD is a member of Advisory Boards for bioCSL and GSK in antivirals and vaccines.

Chad Achenbach, MD, MPH

Assistant Professor

Division of Infectious Diseases

Northwestern University Feinberg School of Medicine

Chicago

IL

Disclosures

CA declares that he has no competing interests.

Henry Wu, MD, DTM&H

Assistant Professor of Medicine

TravelWell Center

Division of Infectious Diseases

Atlanta

GA

Disclosures

HW declares that he has no competing interests.

  • Zika virus infection images
  • Differentials

    • Dengue fever
    • Chikungunya virus
    • West Nile virus
    More Differentials
  • Guidelines

    • Infant feeding in areas of Zika virus transmission, 2nd edition
    • Prevention of sexual transmission of Zika virus
    More Guidelines
  • Patient leaflets

    Zika virus

    More Patient leaflets
  • padlock-lockedLog in or subscribe to access all of BMJ Best Practice

Use of this content is subject to our disclaimer