Zika virus: What does a physician caring for children in Canada need to know? Flashcards Preview

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Flashcards in Zika virus: What does a physician caring for children in Canada need to know? Deck (14):

What is the zika virus?

RNA virus member of flavivirus family


Where is zika prevalent?

1. South America
2. Caribbean
3. Mexico
4. United States in Florida and Texas only


How is Zika spread?

Aedes aegypti mosquitoes
Less commonly Aedes albopictus


What is the estimated incubation period?



What percentage of infections are asymptomatic?



What are common features of symptomatic zika?

1. Maculopapular rash (usu. pruritic, starting proximally and spreading to limbs with assoc. edema)
2. Low grade fever
3. Arthralgias (esp. small joints in hands and feet)
4. Myalgias
5. Headache
6. Non-purulent conjunctivitis


What is the usual recovery time?



What are some unusual features of zika?

1. Myelitis
2. Encephalitis
3. Hearing loss
4. GU symptoms
5. Hematospermia
6. Hypotension
7. Thrombotic thrombocytopenia
8. Death
9. GBS


What is congenital zika virus syndrome (CZS)?

(1) severe microcephaly with partially collapsed skull;
(2) thin cerebral cortices with subcortical calcifications;
(3) macular scarring and focal pigmentary retinal mottling;
(4) congenital contractures; (5) marked early hypertonia and symptoms of extrapyramidal involvement


What is the estimated risk of zika virus infection during pregnancy?

1-13% risk


How is the diagnosis made?

1. Serology (Immunoglobulin M [IgM] or Immunoglobulin G [IgG] or neutralizing antibody) or
2. Detection of ZIKV RNA by polymerase reaction (PCR) testing.

PCR positive in first 4d
IgM positive at 7d post symptoms and persists about 3 months
IgG positive at 10d post symptoms and persisted for life


What are prevention or treatment for zika virus?

1. No treatment
2. Use personal protective measures to avoid germs
3. Avoid travel to affected areas if pregnant
4. Consider breastfeeding with caution during acute zika infections


What populations should be investigated for congenital Zika syndrome?

1. >2016 birth
2. Unexplained microcephaly
3. Intracranial calcifications
4. Ventriculomegaly
5. Major structural CNS abnormalities
6. Maternal history:
a) travel to ZIKV endemic country during pregnancy
b) sexual contact during pregnancy with a male who travelled to a ZIKV endemic country in the preceding 6m


See figures in text for details re: screening?

See CPS statement

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