Zika fever A92.5

Dick et al 1952

Zika fever is caused by the Zika virus, a human pathogenic enveloped positive-stranded RNA virus of the Flaviviridae family, which is mainly transmitted by mosquitoes (Aedes). Occasionally, there have also been reports of cases where the viruses were transmitted via sexual intercourse. The Zika virus shows tropism for skin and neural stem cells (Carod-Artal FJ 2016).

The pathogen was first discovered in 1947 in the Zika forest in Uganda, hence the name. In just a few months the Zika virus spread to 26 countries in South America. There is no danger of infection in Germany. It is considered a so-called "emerging pathogen" (i.e. it is a newly emerging pathogen that has the potential to spread to many countries around the world). In some countries (Brazil, French Polynesia, El Salvador, Venezuela, Colombia and Suriname) an increase in microcephaly in newborns and the occurrence of Guillian-Barré syndrome in adults have been linked to Zika virus infection (de Oliveira WK et al. 2017).

The WHO warns especially pregnant women and their sexual partners against travelling to countries with elevated Zika virus.

Most infections are mild. Some of the infections go completely unnoticed and without symptoms. Typically, a maculopapular exanthema, enanthema, fever, headache, conjunctivitis, and arthralgias and myalgias are seen (Carod-Artal FJ 2016). The exanthema persists for an average of six days, and the disease symptoms persist for an average of 3-7 days.

In late 2015, cases of disease occurred in pregnant women with suspected cranial malformations of the embryos. The result was microcephaly and mental retardation.

Dengue fever, measles, rubella, parvovirus B19 infections. Bacterial infections such as: rickettsiosis, leptospirosis; malaria; drug reactions.

A specific therapy is not available. Travel returnees, especially those with chronic diseases, should rule out infection with the Zika virus if fever symptoms occur. Non-specific complaints such as fever, headache, fatigue, muscle and joint pain and skin rashes occurring within 3 weeks after returning from a trip may indicate infection with the Zika virus. This fact is important for pregnant women returning from travel or partners of pregnant women returning from travel. In both cases a blood test for Zika virus is recommended.

Mosquito protection measures are considered the most important protection. Travellers should therefore always wear skin-covering clothing, use mosquito nets at the place where they sleep and, especially on free skin areas, protect themselves regularly - day and night - with mosquito repellent creams or lotions.

Since May 2016 the disease is notifiable

1. Carod-Artal FJ (2016) Epidemiology and neurological complications of infection by the Zika virus: a new emerging neurotropic virus. Rev Neurol 62:317 328.
2. de Laval F et al (2016) Zika virus infections. Med Sante Trop 26:145-150.
3. de Oliveira WK et al. (2017) Infection-related microcephaly after the 2015 and 2016 Zika virus outbreaks in Brazil: a surveillance-based analysis. Lancet 390(10097):861-870.
4. Eppes C et al (2017) Testing for Zika virus infection in pregnancy: key concepts to dealwith an emerging epidemic. On J Obstet Gynecol 216:209 225.
5. Shirley DT et al (2017) Zika virus infection. Pediatr Clin North Am 64:937-951.