Zika Virus Infection: Causes, Symptoms & Treatment

Due to a rapid spread of the Zika virus, the World Health Organization (WHO) has declared a global health emergency. Zika virus infection, which has been known since 1947, is transmitted by mosquitoes. This viral disease initially occurred in Africa, Southeast Asia and the Pacific Islands. Recently, people in Central and especially South American countries are increasingly infected by the pathogen.

Zika virus infection

The virus was first discovered in a monkey near the Ugandan capital of Kampala. It got its name from the name of a forest area near Kampala. According to WHO, the first case of the disease was in a human in 1968. Zika virus is classified in the Flaviviridae family. The viral infection is transmitted by mosquitoes. These include the Asian tiger mosquito Aedes albopictus and the yellow fever mosquito Aedes aegypti. It is suspected that there is also a possibility of infection from person to person, for example through sexual intercourse. However, there is as yet no scientific proof of this. The consequences of the viral disease are harmless in large numbers. If symptoms and complaints are noticeable at all, they are similar to those of a mild flu. In individual cases, however, there are suspicions of severe damage caused by the virus in newborns. Experts already consider it very likely, without scientific proof, that the Zika virus causes malformation of the head in fetuses. The disease cannot yet be cured by medication. It is only possible to alleviate the symptoms that occur. A vaccine is not available.

Causes

The reason for the frequency of virus transmission and the extremely rapid spread over large areas is the large number as well as the survivability of the mosquito species. The ease of transmission also plays a role. When biting people already infected with the Zika virus, the mosquitoes pick up the virus and can thus spread the pathogen further. In addition, the eggs of the yellow fever mosquito are particularly resistant. Eggs laid in means of transport such as airplanes, ships or trucks can survive for a long time even with small amounts of liquid. It is significant that the diseases only occur on a massive scale in areas where the mosquitoes are also widespread. In 21 countries in North, South and Central America, illnesses with the Zika virus have already been detected. Brazil and Colombia are particularly affected, as are many Caribbean countries. For Brazil, host country of the next Summer Olympics in 2017, an increase in the number of cases to 1.5 million people is prognosis. One thing in particular is causing great concern: the Zika virus is also considered to be the cause of an increasing number of illnesses in newborns with irreparable, in exceptional cases even fatal, effects. In Polynesia, moreover, the Zika virus has also been suspected, as yet unproven, to have been causative of some cases of Guillain-Barré syndrome (nerve disease).

Symptoms, complaints, and signs

When the viral disease becomes apparent in an infected person, which is not always the case, symptoms similar to those of a mild flu occur. These include mild fever, headache, and skin rash with redness and itching. In individual cases, however, more dangerous developments can also occur via the transmission route through pregnant women. In fetuses and newborns, severe changes can occur in the head area. In Brazil, 3893 cases of microcephaly (malformation due to a significantly reduced skull circumference) were recently registered. In the previous year, only a total of 147 cases of this particular condition were detected in Brazil. Of the nearly 4000 new cases, 50 affected children have already died if there is a causal link to the malformation. In addition, severe mental disabilities have occurred in numerous cases as consequences of Zika virus infection. Guillain-Barré syndrome, which occurs in Polynesia at the same time as the viral disease, has not yet occurred in other countries affected by the Zika virus. Nevertheless, without laboratory results to date, scientists and physicians believe it is possible that there may be a connection with the Zika virus. The symptoms of the disease of the nerve tracts are predominantly paralysis and sensory disturbances.In bad cases, problems for breathing or heart function can also occur.

Diagnosis and course of the disease

Due to the Zika virus infection often not perceived by the affected person, in many cases also no examination takes place. When the flu-like symptoms occur, a medical examination is often also waived. This is due to the less severe symptoms and the short duration of the disease. As a rule, the impairments such as mild fever or headache and aching limbs are no longer present after only a few days. A reliable determination of the Zika virus infection can only be made by means of a blood test. The course of the disease in microcephaly shows mental and physical developmental disorders. In exceptions, however, unimpaired development is also possible despite the too small head circumference. The malformation can be detected for the first time by ultrasound during pregnancy. A confirmatory diagnosis is made by computed tomography.

Complications

In the worst case, Zika virus infection can lead to the death of the affected person and for this reason must always be treated. If left untreated, this can also lead to long-term complications and symptoms that can no longer be readily treated. The affected person primarily suffers from high fever and headache, sometimes a skin rash appears. This is associated with redness or itching and also has a negative effect on the aesthetics of the affected person. If the affected person is pregnant and becomes ill with a Zika virus infection, the child may be affected by malformations or other disabilities. In the worst case, this can also lead to stillbirth. In this case, the parents and the relatives also suffer from severe psychological discomfort and therefore need psychological treatment to avoid depression. In the further course of the Zika virus infection, those affected often also suffer from sensory disturbances or paralysis. The heart function or breathing can also be negatively affected by the disease. Treatment of Zika virus infection is usually symptomatic and can limit most symptoms. Specific complications usually do not occur.

When should you see a doctor?

Before a stay abroad, the affected person should inform himself in detail about the health conditions of his destination. In particular, local risk factors should be brought to light. In many cases, the German Foreign Office or tour operators will help answer questions about local illnesses as well as the possibilities of medical care. This process can be done without the cooperation of a physician. If the destination is in a region where there may be a risk of infection from various diseases, discuss with a physician the extent to which precautions can be taken. In many cases, vaccinations or other medical preparations help to provide sufficient protection. If the person concerned suffers health impairments at his or her travel destination, consultation with a physician is generally recommended. Pregnant women in particular should initiate a check-up with a doctor at the first signs of irregularities. If symptoms such as fever, headache or changes in the appearance of the skin occur after being bitten by an insect, there is cause for concern. Disturbances in perceptions, numbness of the skin or sensory disturbances should be presented to a physician. In case of a rash or discoloration of the skin, a doctor should also be consulted. Any increase in adverse health effects should be investigated and treated as soon as possible. Without medical care, Zika virus infection can lead to a fatal outcome.

Treatment and therapy

It is not currently possible to cure Zika disease with specific medications. Treatment of the symptoms that occur is carried out in the context of a disease caused by the Zika virus according to the symptoms. In the case of painful accompanying symptoms, generally effective painkillers can be taken. In case of recognizable skin defects, soothing, disinfecting rubs of the affected areas help. If necessary, this can also be an itch-relieving medicine. Fever causes the body to lose a lot of fluid, especially in warmer areas. To avoid weakening the state of health, it is therefore advisable to refrain from major exertion.In this case, bed rest and increased fluid intake are beneficial. Therapy for malformations of the head may be warranted for the psychological stability of both the child and the mother. Therapies to treat physical problems such as mobility or strength deficits are also conceivable. In the rare case of concurrent disease with Guillain-Barré syndrome, there is a need for treatment. Due to the disease of the nerve tracts, muscle weaknesses ascending from the legs may occur. Under certain circumstances, this can lead to complete paralysis of the limbs. In extreme cases, it is even possible that the paralysis symptoms dangerously affect breathing. In addition, the disease, which can be painful, can trigger cardiac arrhythmias. If breathing or heart is affected, emergency medical measures should be initiated immediately.

Prevention

Preventive vaccination against Zika virus is not currently available. Therefore, preventive measures must focus on protection against mosquitoes as vectors. This includes wearing clothing that covers the body. Technical aids such as mosquito nets are also advantageous. Suitable mosquito repellents in the form of lotions, creams or sprays can also be helpful. Particularly for bathing holidaymakers in the areas primarily at risk, comprehensive protection is not possible. It is also problematic that yellow fever mosquitoes in particular are attracted not only by bodies of water, but also by sweet drinks and food.

Aftercare

Zika virus infection usually takes a mild course and does not recur. Follow-up care focuses on clarifying the typical symptoms of the febrile illness and treating them as necessary. The patient must be informed about the symptoms of possible secondary diseases so that he or she can consult a physician early on in the event of complications. As part of follow-up care, the cause of the Zika virus infection must also be determined to prevent re-infection. The doctor can provide tips on how to avoid contact with the pests and what to do in the event of re-infection. In a chronic course, follow-up care for a Zika virus infection can extend for months or even years. Permanent treatment may be necessary, with affected patients primarily requiring drug therapy. Pain medications and antibiotics must be precisely dosed and adjusted to the particular symptoms of Zika virus infection. For pregnant women suffering from a Zika virus infection, a counseling session is part of the follow-up care, during which the possible consequences of the disease on the unborn child are pointed out. If necessary, the patient can then be given further points of contact and tips.

What you can do yourself

So far, Zika virus infection can only be treated symptomatically. The most important self-help measure is physical rest. Pain-relieving medicines may be taken. It is important to observe the symptoms carefully and to note any abnormalities in a diary. If the fever becomes more severe or another health problem occurs, a visit to the family doctor is recommended. It is important to get enough sleep and follow a suitable diet. Affected individuals should also drink enough water and limit contact with other people. The condition should be cured after a few days. The doctor can clarify the symptoms and give further tips. Since Zika virus infection is a typical infectious disease, various time-honored countermeasures such as warm compresses, moderate exercise and avoiding stress are recommended. The fever should be taken several times a day and the body temperature noted. If there are any abnormalities, medical advice is required. In addition, sick people must inform themselves independently about the many symptoms. Sick pregnant women and women who wish to have children expose themselves to the risk of miscarriage. They should talk to their gynecologist and quickly cure the infectious disease.