Zika virus infection (synonyms: Zika fever; Zika virus disease; ZIKV; ICD-10 U06: Zika virus disease) is caused by Zika viruses. The virus received its name because it was isolated in 1947 from a captive rhesus monkey at a research station in Zika Forest in Entebbe, Uganda. Zika virus belongs to the flavivirus family (single-stranded RNA viruses). The flavivirus family belongs to the list of arboviruses transmissible to humans by arthropods (arthropods). Pathogen reservoirs are thought to be primates, rodents, and also humans. Occurrence: The virus occurs naturally in tropical Africa (discovered in the Zika Forest, Uganda (1947)). As of 2007, fewer than 20 human infections were known (worldwide). These were detected in Africa (African Zika virus strain) and Southeast Asia (Asian Zika virus strain; Brunei, Indonesia, Malaysia, Maldives, Myanmar, Cambodia, Laos, East Timor, Philippines, Thailand, Vietnam). Meanwhile, the Asian strain of Zika virus is occurring in South America, countries in the Caribbean, South Pacific, and Cape Verde Islands. In 2015, Zika virus infections were documented for the first time in Brazil. It is believed that the virus entered Brazil through the 2014 World Cup. At the end of January 2016, Zika virus infections were reported in 21 Central and South American countries. According to the World Health Organization (WHO), the Zika virus strain found in South America has reached Africa for the first time: since October 2015, 7,557 suspected Zika cases have been counted in Cape Verde.In July 2016, occurrence of Zika cases in Florida and Puerto Rico (USA).Cases with Zika virus infections are also gradually being confirmed in Europe (Denmark, Germany, Great Britain, Italy, Switzerland, Spain) (the first registered Zika sufferer in Europe was in 2013). Sick people have been infected during long-distance travel.WHO sees an increased risk for the spread of the pathogen in the following regions: Madeira Island and Black Sea coast in Georgia and Russia. There is a moderate risk in 18 countries, including many Mediterranean countries such as France, Italy, Spain, Croatia, Greece and Turkey. The German Society for Virology does not expect the Zika virus to establish itself in Germany because the main vector, the mosquito Aedes aegypti (Egyptian tiger mosquito/yellow fever mosquito), does not occur in Germany, or the related species, Aedes albopictus, is very rare. Note: In the Mediterranean region, the Asian tiger mosquito (Aedes albopictus) is widespread. Transmission of the pathogen (route of infection) occurs via the all-day biting mosquitoes of the genus Aedes (main vectors are the Egyptian tiger mosquito (Aedes aegypti) and the Asian tiger mosquito (Aedes albopictus); other mosquitoes are Aedes africanus, Aedes luteocephalus, Aedes vittatus, Aedes furcider)). Transmission through infected semen/sex is also possible. Zika virus survives longer than 6 months in the ejaculate.The possibility of perinatal infection (infection in the period shortly before or after birth) is not excluded. Contaminated blood transfusions can also be considered as carriers. For example, during a Zika virus epidemic in French Polynesia, 3% of all blood samples from asymptomatic donors tested positive.Regarding children infected intrauterine (“in the uterine cavity”) with Zika virus, note: One child continued to excrete the virus in saliva and urine for two months after birth.Thus, it can be assumed that Zika virus infection can occur wherever Aedes mosquitoes live, that is, especially in North and South America (Canada and Chile are exceptions). Human-to-human transmission: Yes. The incubation period (time from infection to onset of disease) is usually 3-7 days. Duration of illness is approximately 2 weeks. Symptoms usually appear 3-12 days after the infectious mosquito bite and last up to a week. The disease leaves lifelong immunity. Course and prognosis: In most cases, the course of Zika virus infection is mild and self-limiting, i.e., ending without external influence. Not every infected person develops symptoms (asymptomatic course). The symptoms disappear after one week at the latest. The infectious disease has become the focus of public interest because there is evidence that infection of pregnant women in the first or second trimester (third trimester) leads to severe brain/skull malformations in fetuses and newborns.Brazil in particular has seen an increase in cases of microcephaly, which has been attributed to infection with Zika virus in pregnant women. It is now known that at least one in ten infections results in malformations.The damage to the fetus has now been grouped under the term congenital ZikV syndrome (CZS). These include miscarriage, intrauterine short stature, microcephaly, enlarged ventricles, lissencephaly (severe brain maldevelopment), and arthrogryposis (congenital joint stiffness)A public health emergency has been declared in Brazil (as of January 2016). Approximately 1.3 million people are already infected. As a precaution, the relevant authorities strongly advise pregnant women not to travel to known Zika virus regions. If this cannot be avoided, adequate mosquito protection must be ensured. Vaccination against Zika virus is expected to be available by 2018. The WHO warns pregnant women not to travel to affected areas. Furthermore, expectant mothers whose sexual partners lived in affected areas should only have protected sexual intercourse during pregnancy.In Germany, there has been an obligation to report arboviruses, which includes the Zika virus, since May 1, 2016, according to the Infection Protection Act (IfSG).
