How to Treat Zika Virus

Treatment is focused on the management of symptoms and complications

The Zika virus can be frightening since you will often have no idea that you’ve been infected until complications appear. These may include miscarriage and birth defects. In rare instances, a Zika infection can lead to Guillain-Barré syndrome, a nerve disorder that can lead to the loss of motor control.

Unfortunately, there are no medications or vaccines to treat or prevent an infection. Treatment, therefore, is based solely on the management of symptoms and complications.

Uncomplicated Infections

In as many as 80 percent of Zika infections, there will be no symptoms whatsoever. If symptoms do appear they tend to be mild and flu-like, including headaches, muscle and joint pain, mild fever, and conjunctivitisamong others.

In most people, the immune system will able to control and clear the infection within a week or two. During that time, Tylenol (acetaminophen), bed rest, and plenty of fluids may be all you need to see you through the illness.

On the other hand, you should avoid nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, Aleve (naproxen), or Advil (ibuprofen) until dengue fever, a viral infection closely related to Zika, can be ruled out. These drugs may cause severe gastrointestinal bleeding.

Similarly, aspirin should also not be used in children with a viral infection as this can lead to a potentially life-threatening condition known as Reyes syndrome.

Conjunctivitis Treatment

Viral conjunctivitis is typically not treated; drops or ointment will do little, in anything, to help. Artificial tears and a cooled soaked cloth may help relieve some of the grittiness and discomfort.

If you wear contact lenses, you may want to switch to glasses until you are better able to give your eyes a rest. You should also avoid rubbing your eyes, as this can transfer the virus from one eye to the next. The same applies to the sharing of eye makeup, hand towels, or eye drops.

In rare cases, Zika-associated conjunctivitis may lead to uveitis (inflammation of the middle layer of the eye). This can be improved with a short course of corticosteroid eye drops.

Guillain-Barré Syndrome

Guillain-Barré syndrome (GBS) is an uncommon disorder of the nervous system in which the immune system attacks its own nerve cells, causing muscle weakness, loss of muscle control, and, on rare occasion, paralysis.

Zika-associated GBS has, thus far, been constrained to a relatively small handful of cases in 13 countries (Brazil, Colombia, the Dominican Republic, El Salvador, French Guiana, French Polynesia, Haiti, Honduras, Martinique, Panama, Puerto Rico, Suriname, and Venezuela).

The underlying cause of GBS is not well understood but is almost always preceded by an infection of some sort. Beside the Zika virus, other common causes are cytomegalovirus and Campylobacter jejuni.

Treatment may include the use of intravenous immunoglobulins (IVIg) commonly used to treat autoimmune diseases and plasmapheresis, a form of blood dialysis that removes harmful immune cells from the blood. Respiratory support and physical rehabilitation may also be needed.

Congenital Zika

If a mother is infected with Zika during or just prior to pregnancy, there is really nothing that can be done to prevent passing the virus to her baby. With that being said, even if a transmission does occur, the risk of a severe complication is only around 2.3 percent, according to research published in the International Journal of Molecular Medicine.

In the aftermath of the 2016 outbreak, 51 cases of Zika-related birth defects—collectively referred to as congenital Zika virus syndrome—were reported in the United States, say investigators from the Center for Disease Control and Prevention. Moreover, 77 miscarriages were directly linked to confirmed infections.

Management of Complications

Congenital Zika virus syndrome is characterized by symptoms that can vary in number and range in severity from mild to life-threatening. Chief among them is a potentially catastrophic birth defect known as microcephaly, in which the baby is born with an abnormally small head and brain.

Other congenital complications may include spasticity and seizures, intellectual deficits, retinal eye damage, and physical deformities such as clubfoot or arthrogryposis (contracted and fixed joints).

Treatment, as such, wouldn’t be focused on the Zika infection but rather the aftermath of the infection. Among the options:

  • Microcephaly treatment is mainly supportive. While some children will not have any symptoms other than a decreased head size, others may require lifelong care from a multidisciplinary team of specialists, including neurologists, psychiatrists, physical therapists, and speech therapists.
  • Spasticity and seizures may be treated with antiepileptic medications.
  • Retinal injuries, including macular scarring and chorioretinal atrophy, may require surgery to prevent vision loss and blindness.
  • Physical deformities such as clubfoot or arthrogryposis may be treated with braces, occupational therapy, medical procedures (such as serial stretching and casting), and surgeries like Achilles tenotomy.

Vaccine Development

With no medications to treat a Zika infection or prevent transmission from mother to child, increasing focus has been placed on accelerating vaccine research.

While there are currently no vaccines available to prevent Zika, a Phase II human trial was approved in March 2017 to test a genetically engineered vaccine based on the same model used to develop the West Nile virus vaccine. If the initial results are positive, larger phase III may be launched as early as 2020.

Preventing Zika When Pregnant or Traveling
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