What is the treatment for Zika virus infection?

From the Guidelines

There is no specific antiviral treatment for Zika virus infection, and management focuses on supportive care to relieve symptoms while the body fights the infection. The primary goal is to reduce morbidity, mortality, and improve quality of life. According to the CDC guidelines 1, patients should rest, stay hydrated, and take acetaminophen (Tylenol) for fever and pain at standard doses (325-650 mg every 4-6 hours, not exceeding 3000 mg daily).

Key Considerations

• NSAIDs like ibuprofen should be avoided until dengue fever is ruled out, as they can increase bleeding risk if dengue is present 1.
• Aspirin should be avoided in children due to Reye's syndrome risk.
• Infected individuals should prevent mosquito bites during the first week of illness to avoid transmitting the virus to others by using insect repellent, wearing long sleeves and pants, and staying in screened or air-conditioned areas.
• Pregnant women with Zika require close monitoring with serial ultrasounds to check for fetal abnormalities.

Prevention of Sexual Transmission

• Infected individuals, particularly men, should use condoms or abstain from sex for at least 3 months after symptom onset (if symptomatic) or their last possible Zika virus exposure (if asymptomatic) to minimize their risk for sexual transmission of Zika virus 1.
• Most people recover completely within 7-14 days, but neurological complications like Guillain-Barré syndrome require immediate medical attention.

Special Considerations

• The definition of possible Zika virus exposure includes travel to or residence in an area with risk for Zika virus transmission or sex without a condom with a partner who traveled to or lives in an area with risk for Zika virus transmission 1.
• CDC will continue to update recommendations as new information becomes available 1.

From the Research

Treatment Options for Zika Virus

• There are currently no licensed vaccines or drugs to prevent or treat Zika virus infection 2.
• Treatment for Zika virus infection is primarily focused on relieving symptoms, as the infection is typically self-limiting 3.
• Several nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin, ibuprofen, and acetaminophen, have been shown to inhibit the replication of Zika virus in cell cultures 4.
• These NSAIDs exert their inhibitory effect by reducing the expression of AXL, the entry cofactor of Zika virus, and inducing its degradation 4.
• Other potential anti-Zika virus agents are being tested in preclinical and clinical trials, including drugs that target virus or host factors 5, 6.

Challenges in Developing Treatments for Zika Virus

• The development of effective countermeasures against Zika virus is challenging due to the need for drugs to be safe in pregnant women 2.
• Cross-reactions between Zika virus and other flaviviruses, as well as the impact of Zika virus vaccination on subsequent flavivirus infections, are unknown 2.
• The evaluation of the efficacy of vaccines and drugs against Zika virus in clinical trials is complicated due to the decline of Zika virus circulation 2.

Potential Antiviral Agents for Zika Virus

• Several anti-Zika virus candidates are being developed, including drugs that target both the virus (structural proteins and enzymes) and cellular elements 6.
• Knowledge-driven drug repurposing, structure-based discovery, RNA interference, long noncoding RNAs, miRNAs, and peptide inhibitors may pave the way for the discovery of novel anti-Zika virus agents 5.