Zika virus: What does a physician caring for children in Canada need to know? Flashcards

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1
Q

What is the zika virus?

A

RNA virus member of flavivirus family

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2
Q

Where is zika prevalent?

A
  1. South America
  2. Caribbean
  3. Mexico
  4. United States in Florida and Texas only
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3
Q

How is Zika spread?

A

Aedes aegypti mosquitoes

Less commonly Aedes albopictus

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4
Q

What is the estimated incubation period?

A

3-12d

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5
Q

What percentage of infections are asymptomatic?

A

75-80%

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6
Q

What are common features of symptomatic zika?

A
  1. Maculopapular rash (usu. pruritic, starting proximally and spreading to limbs with assoc. edema)
  2. Low grade fever
  3. Arthralgias (esp. small joints in hands and feet)
  4. Myalgias
  5. Headache
  6. Non-purulent conjunctivitis
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7
Q

What is the usual recovery time?

A

3-14d

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8
Q

What are some unusual features of zika?

A
  1. Myelitis
  2. Encephalitis
  3. Hearing loss
  4. GU symptoms
  5. Hematospermia
  6. Hypotension
  7. Thrombotic thrombocytopenia
  8. Death
  9. GBS
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9
Q

What is congenital zika virus syndrome (CZS)?

A

(1) severe microcephaly with partially collapsed skull;
(2) thin cerebral cortices with subcortical calcifications;
(3) macular scarring and focal pigmentary retinal mottling;
(4) congenital contractures; (5) marked early hypertonia and symptoms of extrapyramidal involvement

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10
Q

What is the estimated risk of zika virus infection during pregnancy?

A

1-13% risk

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11
Q

How is the diagnosis made?

A
  1. Serology (Immunoglobulin M [IgM] or Immunoglobulin G [IgG] or neutralizing antibody) or
  2. Detection of ZIKV RNA by polymerase reaction (PCR) testing.

PCR positive in first 4d
IgM positive at 7d post symptoms and persists about 3 months
IgG positive at 10d post symptoms and persisted for life

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12
Q

What are prevention or treatment for zika virus?

A
  1. No treatment
  2. Use personal protective measures to avoid germs
  3. Avoid travel to affected areas if pregnant
  4. Consider breastfeeding with caution during acute zika infections
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13
Q

What populations should be investigated for congenital Zika syndrome?

A
  1. > 2016 birth
  2. Unexplained microcephaly
  3. Intracranial calcifications
  4. Ventriculomegaly
  5. Major structural CNS abnormalities
  6. Maternal history:
    a) travel to ZIKV endemic country during pregnancy
    b) sexual contact during pregnancy with a male who travelled to a ZIKV endemic country in the preceding 6m
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14
Q

See figures in text for details re: screening?

A

See CPS statement

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