Zika virus is working its way north, raising worries in many states about what to do for mosquito control, contraception for women and how to prevent birth defects. That means pediatricians need up to date information to enable them to counsel patients and explain the disease. Being able to find current information in one place is important, and an overview article published in Pediatrics this month (peds.2016-0621) provides that.
The CDC authors describe the origin of the virus, how it has spread geographically, and the transmission characteristics and the clinical effects it can produce. Most people with Zika virus infection are asymptomatic; symptoms when present are generally mild and include fever, maculopapular rash, arthralgia, and conjunctivitis. Since early 2015, Zika virus has spread rapidly through the Americas with local transmission identified in 31 countries and territories as of February 29th.
The expectation is that endemic transmission will be established in states that have the appropriate vector mosquitoes, mostly commonly Aedes aegyptii and Aedes albopictus. Those species are found in the South, Midwest and Great Plains with some pockets in the Southwest and California. That endemic transmission cycle between mosquitoes and residents can become established quickly; such transmission now exists in Puerto Rica and the US Virgin Islands
The Aedes mosquitoes are daytime biters and preventing bites is considered key to controlling the diseases. That can be difficult because the mosquitoes live in and around human households and are difficult to eradicate. .
All age groups are susceptible to Zika virus infections and maternal-fetal transmission has been documented. The microcephaly that has been reported in Brazil and other countries in Central and South America has gotten a lot of attention, but other manifestations of abnormal brain development are also being investigated. Much remains to be learned about the impact on fetal development and the range of clinical effects.
Clearly the knowledge about Zika virus is expanding rapidly and this article provides a good briefing about this illness and provides links that will be updated as things change.
