Prevention and Treatment Options for Zika Virus Infection
The primary prevention strategies for Zika virus include avoiding mosquito bites, preventing sexual transmission, and taking special precautions during pregnancy, while no specific treatment currently exists beyond supportive care. 1
Transmission Routes
- Zika virus is primarily transmitted through the bite of infected Aedes aegypti mosquitoes, but can also spread through sexual contact and from mother to fetus during pregnancy 1, 2
- Sexual transmission has been documented from men to women, men to men, and women to men, with 52 confirmed cases of sexual transmission reported in the United States by July 2018 1, 3
- The virus can cross the placental barrier from mother to fetus, potentially causing severe birth defects including microcephaly 2, 4
Prevention Strategies
Mosquito Bite Prevention
- Use air conditioning, screens, or nets when indoors 4
- Wear long sleeves and pants when outdoors 4
- Apply EPA-registered insect repellents according to product labels (safe for pregnant and lactating women) 4
- Use permethrin-treated clothing and gear for additional protection 4
Sexual Transmission Prevention
- For men with possible Zika virus exposure who are planning to conceive with their partner:
- Wait at least 3 months after symptom onset (if symptomatic) or last possible exposure (if asymptomatic) before engaging in unprotected sex 1
- For couples not trying to conceive:
- Men should consider using condoms or abstaining from sex for at least 3 months after symptom onset or last possible exposure 1
- For men whose partner is pregnant:
Travel Recommendations
- Pregnant women should avoid travel to areas with active Zika virus transmission 2
- Individuals living in or traveling to areas with Zika transmission should take strict precautions against mosquito bites 2, 5
Special Considerations for Pregnancy
- Risk of structural birth defects among infants born to mothers with confirmed or suspected Zika infection during pregnancy ranges from 5-10% 2
- First-trimester infections carry higher risk of adverse fetal outcomes 2
- Neurodevelopmental effects can occur even in infants who appear normal at birth 2
- All pregnant women with possible exposure should be monitored closely 4
Treatment Options
- Currently, no specific medication or vaccine exists to prevent or treat Zika virus infection 6, 5
- Treatment is supportive and focused on symptom management 6
- According to WHO estimates from 2018, a vaccine is not likely to be available until at least 2020 6
Clinical Presentation
- Zika virus infection is asymptomatic in approximately 80% of cases 5
- When symptomatic, illness is typically mild and self-limited 5
- Symptoms are similar to dengue fever and chikungunya, making clinical diagnosis challenging 6
- Potential complications include Guillain-Barré syndrome in adults and congenital abnormalities in fetuses 2, 5
Common Pitfalls and Caveats
- Relying solely on symptoms for diagnosis is problematic due to similarity with other arboviral infections and high rate of asymptomatic cases 6, 5
- Underestimating the persistence of Zika virus in semen (can be detected for months after infection) 1
- Failing to counsel patients about both mosquito bite prevention AND sexual transmission prevention 1, 2
- Not recognizing that neurodevelopmental effects can manifest later in infants who appear normal at birth 2