Summary
Definition
History and exam
Key diagnostic factors
- residence in/travel from endemic area
- fever
- maculopapular rash
- arthralgia
- conjunctivitis
- features of congenital Zika syndrome (infants)
- features of Guillain-Barre syndrome
Other diagnostic factors
- other constitutional symptoms
- gastrointestinal symptoms
- retro-orbital pain
- edema of lower limbs
- transient hearing loss in adults
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
Diagnostic tests
1st tests to order
- reverse transcriptase-polymerase chain reaction (RT-PCR)
- serology
- testing for other arboviruses
Tests to consider
- prenatal ultrasound
- amniocentesis
- head circumference measurement (newborn)
- newborn further evaluation
- CT/MRI head (newborn)
- tests for Guillain-Barre syndrome
Treatment algorithm
symptomatic: nonpregnant
pregnant: with possible mosquito-borne or sexual exposure
congenital Zika syndrome
Zika-associated Guillain-Barre syndrome
Contributors
Authors
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.
Acknowledgements
Dr Adriana Scavuzzi would like to gratefully acknowledge Dr Geraldo Furtado, a previous contributor to this topic.
Disclosures
GF is an author of references cited in this topic.
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.
References
Key articles
Adebanjo T, Godfred-Cato S, Viens L, et al. Update: interim guidance for the diagnosis, evaluation, and management of infants with possible congenital Zika virus infection - United States, October 2017. MMWR Morb Mortal Wkly Rep. 2017 Oct 20;66(41):1089-99.Full text Abstract
Pan American Health Organization; World Health Organization. Provisional remarks on Zika virus infection in pregnant women: document for health care professionals. Jan 2016 [internet publication].Full text
World Health Organization. Zika virus fact sheet. Dec 2022 [internet publication].Full text
Centers for Disease Control and Prevention. Zika virus: clinical testing and diagnosis for Zika virus disease. May 2024 [internet publication].Full text
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Dengue fever
- Chikungunya virus
- West Nile virus
More DifferentialsGuidelines
- Clinical testing and diagnosis for Zika virus disease
- Zika outbreak toolbox
More GuidelinesPatient information
Zika virus
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