updated RCOG 02/19
Introduction
⚫ The majority of people infected with Zika virus have minimal symptoms
For those with significant symptoms, Zika virus tends to cause a mild, short-lived (2 to 7 days)
illness
⚫ Congenital Zika Syndrome, which encompasses congenital brain abnormalities, including microcephaly.
⚫ Zika virus has also been recognised as a trigger of Guillain-Barré syndrome
Transmission
⚫ Aedes mosquito, most commonly Aedes aegypti
⚫ First symptoms can develop in 3 to 12 days
⚫ Virus is present in breast milk but doesn’t cause disease. So can breast feed
⚫ However, a small number of cases of sexual transmission have been reported
⚫ The virus has been shown to be present in semen, vaginal secretions and menstrual blood
⚫ Zika virus can be transmitted by blood transfusion
Symptoms
⚫ Fever
⚫ Rash
⚫ itching/pruritus
⚫ Headache, retro-orbital pain, conjunctivitis
⚫ Arthralgia/arthritis; myalgia; lower back pain
Congenital Zika Virus Syndrome
A fetus infected in early gestation is more likely to be affected compared to infection later in pregnancy.
Diagnosis
The diagnosis of Zika virus infection should be considered in individuals who experience symptoms
suggestive of acute Zika virus infection
within 2 weeks of leaving an area with risk for Zika virus transmission OR
within 2 weeks of sexual contact with a male sexual partner who has recently travelled within
the previous 3 months to an area with high or moderate risk of Zika virus transmission
⚫ Sperm can carry Zika for 3 months
⚫ Zika shows symptoms within 2 weeks
If Zika virus antibodies are NOT detected in a serum sample collected 4 or more weeks after the last
possible travel-associated or sexual exposure, then recent Zika virus infection can be excluded.
Couples considering pregnancy
⚫ Advised to prevent pregnancy and barrier methods (e.g. condom use)
Use these methods for
○ Both partners travelled or Just Male partner travelled – Use for 3 months
○ Only Female Partner travelled – Use for 2 months
○ If gotten infected with ZIKA – Don’t get pregnant for 2 months.
Pregnant women who have visited a country or area with risk for Zika
virus transmission but had NO symptoms of Zika Virus.
Routine testing of asymptomatic pregnant women is not available on the NHS.
Any pregnant woman with possible exposure to Zika virus, presenting
with fetal ultrasound findings consistent with microcephaly
⚫ Amniocentesis to test for the virus using RT-PCR
Amniocentesis is associated with a small risk of miscarriage or preterm birth and in general should
not be performed before 15 weeks of gestation.
⚫ However, for the purpose of identifying Zika virus, amniocentesis should not usually be performed
before 20 weeks of gestation as fetal urination is not well-established until then (and this is the
source of the virus in the amniotic fluid).
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