20 things we now know for certain about the Zika virus

Zika virus exploded into the news with striking images of children born with small heads in Brazil. This was at a time the country was struggling to plan for the Rio Olympics, and also embroiled in political turmoil. These all helped to embed the virus firmly in the public’s mind.

rio-1512643_1920

Events have unfolded very rapidly, with shifting certainties and swirling speculations. The storm is however now settling, and a clearer picture emerging. And neurology is right at the centre of this viral catastrophe. What is the current state of play? Here are 20 things we now know about the Zika virus.

1. Zika is an arbovirus of the family Flaviviridae

By Manuel Almagro Rivas - Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=47941048
By Manuel Almagro RivasOwn work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=47941048

2. Zika was first identified in Uganda in 1947

 

By User TShilo12 on en.wikipedia, Public Domain, https://commons.wikimedia.org/w/index.php?curid=1155428
By User TShilo12 on en.wikipedia, Public Domain, https://commons.wikimedia.org/w/index.php?curid=1155428

3. Zika was first isolated from a Rhesus macaque monkey

Rhesus Macaque. Robert Martinez on Flikr. https://www.flickr.com/photos/madrerik/16328787935
Rhesus Macaque. Robert Martinez on Flikr. https://www.flickr.com/photos/madrerik/16328787935

4. The first human cases were reported from Nigeria

Nigeria flag. Global Panorama on Flikr. https://www.flickr.com/photos/121483302@N02/13777960823
Nigeria flag. Global Panorama on Flikr. https://www.flickr.com/photos/121483302@N02/13777960823

5. Outbreaks of Zika have ocurred in BrazilMicronesia, and French Polynesia

French Polynesia Grunge Flag. Nicholas Raymond on Flikr. https://www.flickr.com/photos/80497449@N04/7384286938
French Polynesia Grunge Flag. Nicholas Raymond on Flikr. https://www.flickr.com/photos/80497449@N04/7384286938

 

6. Zika is mainly transmitted by Aedes mosquitoes

By Rafaelgilo - Praca własna, Domena publiczna, https://commons.wikimedia.org/w/index.php?curid=40189440
By RafaelgiloPraca własna, Domena publiczna, https://commons.wikimedia.org/w/index.php?curid=40189440

7. Zika virus is transmitted perinatally

By Øyvind Holmstad - Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=34796811
By Øyvind HolmstadOwn work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=34796811

The Centre for Disease Control (CDC) recommendations for pregnant women are

  • To avoid travel to affected countries
  • To be tested if they travel to affected countries
  • To have 3–4 weekly foetal ultrasound if they test positive for the virus
  • To have their babies tested at birth if they were infected

8. Zika virus is also sexually transmitted 

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9. Zika virus is most likely transmissible through the skin

223 [Pocari Sweat]. Evan Blaser on Flikr. https://www.flickr.com/photos/evanblaser/6032270876
223 [Pocari Sweat]. Evan Blaser on Flikr. https://www.flickr.com/photos/evanblaser/6032270876
  • fatal case report of Zika infection from the New England Journal of Medicine strongly suggests Zika may be transmitted through sweat or tears

10. Zika virus primarily infects neural stem cells

Adult neural stem cells. California Institute for Regenerative Medicine on Flikr. https://www.flickr.com/photos/cirm/3289062760
Adult neural stem cells. California Institute for Regenerative Medicine on Flikr. https://www.flickr.com/photos/cirm/3289062760

11. Zika infection usually only causes mild and self-limiting symptoms

By Beth.herlin - Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=46867814
By Beth.herlinOwn work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=46867814

The typical symptoms of Zika virus infection are

  • Fever
  • Skin rash
  • Conjunctivitis
  • Joint pains
  • Muscle aches
  • Headache

12. Microcephaly is the striking feature of congenital Zika

By Centers for Disease Control and Prevention - http://www.cdc.gov/ncbddd/birthdefects/images/microcephaly-comparison-500px.jpg, Public Domain, https://commons.wikimedia.org/w/index.php?curid=46674502
By Centers for Disease Control and Prevention – http://www.cdc.gov/ncbddd/birthdefects/images/microcephaly-comparison-500px.jpg, Public Domain, https://commons.wikimedia.org/w/index.php?curid=46674502

 

13. Zika infection causes several other brain abnormalities

By Ralphelg - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=16057859
By RalphelgOwn work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=16057859

Brain abnormalities with congenital Zika infection include:

  • Calcification of the brain’s white matter
  • Cerebellar dysgenesis: abnormal development of the cerebellum
  • Craniosynostosis: premature closure of the bones of the brain
  • Lissencephaly: an abnormal shape of the brain 
  • Ventriculomegaly: enlargement of the brain’s fluid-containing spaces

These abnormalities may be seen on brain imaging

14. Adult Zika infection causes Guillain Barre syndrome (GBS)

 

By Doctor Jana - http://docjana.com/#/gbs; http://www.patreon.com/posts/guillain-barre-4374004, CC BY 4.0, https://commons.wikimedia.org/w/index.php?curid=46847816
By Doctor Jana – http://docjana.com/#/gbs; http://www.patreon.com/posts/guillain-barre-4374004, CC BY 4.0, https://commons.wikimedia.org/w/index.php?curid=46847816

15. Zika virus infection causes other neurological diseases

Knitted Neurology. estonia76 on Flikr. https://www.flickr.com/photos/estonia76/6453525355
Knitted Neurology. estonia76 on Flikr. https://www.flickr.com/photos/estonia76/6453525355

There are other neurological diseases associated with Zika virus such as

 

16. Zika virus infection causes many eye abnormalities

By JDrewes - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=3117810
By JDrewesOwn work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=3117810

Eye abnormalities reported with Zika virus infection include

  • Mottling and atrophy of the retina
  • Abnormalities of the optic nerve
  • Coloboma (defects) of the iris
  • Subluxation (dislocation) of the lens

 

17. Zika virus may cause impairments in other organ systems

By Mikael Häggström - Image:Respiratory system complete numbered.svg (Public domain licence), Public Domain, https://commons.wikimedia.org/w/index.php?curid=5806243
By Mikael HäggströmImage:Respiratory system complete numbered.svg (Public domain licence), Public Domain, https://commons.wikimedia.org/w/index.php?curid=5806243

Other organs affected by Zika virus lead to disorders such as

  • Pulmonary hypoplasia, or underdeveloped lungs
  • Severe thrombocytopaenia, or low platelet counts
  • Urinary and genital symptoms

18. Zika virus infection is confirmed by laboratory tests

CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=340018
CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=340018
  • rRT-PCR (real time reverse transcriptase polymerase chain reaction) is the best test for the Zika virus
  • This is done on urine and blood samples collected within 2 weeks of infection

19. There is an experimental human vaccine trial for the Zika virus

 

 

 

20. There are promising antiviral treatments for Zika virus

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