Zika: Acute Signs and Symptoms
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Symptoms in 1,112 PCR Positive Patients
- Fever (83%)
- Rash (69%; maculopapular)
- Conjunctivitis (39%)
- Myalgia and/or arthralgia (39%)
- Headache (21%)
- Nausea and vomiting (~5%)
62% of asymptomatic Zika patients had a viral load of less than 103 and 100% of patients with a viral load of 105 were symptomatic.
Courtesy of the Zika Foundation and Rescue Medicine, 2016.
24 year old Japanese traveler to Yap developed conjunctivitis at day 3 of fever, day 2 of headache. Other symptoms included mild nausea and GI discomfort. Viral load unknown.
19 year old anglo male develops blanching rash at day 2 of fever. Viral load was 104 ml
154 ill Zika patients from Brazil and Columbia (in press).
All patients had a viral load of less than 104
- AST >1.25X ALT ratio (41/154)
- Thrombocytopenia (43/154)
- Elevated d-dimer (19/154)
- LDH > 4x ULN (20/154)
- Lactate >2.0 (12/154)
Treatment and Risk Assessment
- Oral fluids with electrolytes
- Fever and pain: use acetaminophen, 500-1000mg Q8h
- Avoid NSAIDs due to bleeding
- Severe pain: Tremadol can be used with caution
- Woman: pregnancy test, if positive counseling and ultrasound
- Men: correct use of condoms for 90 days after return followed by physician history and exam and PCR testing if high-risk travel exposure
- Keep patient from being bitten by local mosquitos (thus preventing spread of infection to new areas)