Fast Five Quiz: Mosquito-Borne Diseases

Michael Stuart Bronze, MD

Disclosures

May 06, 2020

In most cases, Zika virus infection causes a mild, self-limiting illness. The incubation period is probably 3-12 days. Owing to the mild nature of the disease, more than 80% of Zika virus infection cases may go unnoticed. The spectrum of Zika virus disease overlaps with that of other arboviral infections, but rash (maculopapular and probably immune-mediated) typically predominates. The rash in Zika virus infection is usually a fine maculopapular rash that is diffusely distributed. It can involve the face, trunk, and extremities, including palms and soles. Occasionally, the rash may be pruritic. The rash, along with other symptoms, usually occurs within 2 weeks after travel to a Zika virus–affected area. Zika virus rash usually occurs within the first week of illness, with the illness itself lasting from several days to weeks.

Diagnosis of Zika virus infection is typically based on serologic testing, although CDC now recommends urine testing. CDC has issued interim guidance on Zika virus antibody testing and result interpretation. Urine can be tested via real-time RT-PCR using samples collected less than 2 weeks following symptom onset. Urine should be tested in conjunction with serum if specimens were obtained less than 1 week following symptom onset. A positive result on either test confirms Zika virus infection. The viral level may be higher in urine and for a longer duration than in serum.

Additional interim guidance from CDC suggests that men with possible Zika virus exposure who are planning to conceive with their partner should wait at least 3 months after symptom onset or after their last possible Zika virus exposure before engaging in unprotected sex. This is also intended to prevent sexual transmission of Zika virus.

Read more about guidelines for Zika virus.

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