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Zika virus infection in Adult
Other Resources UpToDate PubMed

Zika virus infection in Adult

Contributors: Vivian Wong MD, PhD, Lisa Altieri MD, James H. Willig MD, MSPH, Susan Burgin MD
Other Resources UpToDate PubMed


Zika virus (ZIKV) is a mosquito-borne single-stranded RNA virus of the Flaviviridae family, closely related to the dengue virus. Human infection is primarily acquired via bites from infected Aedes aegypti or Aedes albopictus mosquitoes in endemic areas: the tropical regions of Africa, Southeast Asia, and the South Pacific islands and more recently Latin America and the Caribbean. In 2015, Zika virus outbreak was first reported in Brazil, Colombia, and Suriname. Travel-related cases have since been reported in the United States; sexually transmitted cases are suspected to have occurred, and Zika virus has been found in the semen of infected men. Viral shedding has also been documented in vaginal secretions of infected women. A small number of cases of likely local mosquito-borne Zika virus transmission have been reported in Miami, FL, and Brownsville, TX. Since late 2016, Zika virus transmission in the Americas has dropped significantly. There have been rare cases of person-to-person nonsexual transmission. There is no apparent sex or age predilection for Zika virus infection.

After being bitten by an infected mosquito, it takes approximately 3-14 days for symptoms to appear. The diagnostic criteria of Zika virus disease include a widespread morbilliform rash with at least one of the following manifestations: arthralgia, arthritis, and/or conjunctivitis. Other symptoms may include fever, myalgias, headache, sore throat, cough, vomiting, and diarrhea, although up to 80% of patients infected with Zika virus are asymptomatic.

Symptoms are typically mild, short-lasting (2-7 days), and self-limited. In a 2019 review, rash was seen in 90% of 240 cases. Mucocutaneous hemorrhage occurred in around 8%, and conjunctivitis was seen in just over one-third of individuals. While no sequelae are typically seen, Guillain-Barré syndrome and other neurological disorders have been reported in patients after exposure to Zika virus. In addition, viral infection in pregnant patients has been associated with microcephaly in infants (see congenital Zika virus infection). There are also cases of fetal loss in women who were infected with Zika virus. It is thought that these outcomes are the result of congenital infection with Zika virus.

Because the clinical presentation overlaps with those of other arboviruses, such as dengue fever and chikungunya, cases may be mistaken for another arboviral infection.

Zika virus has the potential to cause outbreaks, but cases in travelers returning to nonendemic areas are infrequently reported. While Zika virus is spread by the bite of an infected mosquito, there have been reports of it being spread human to human via sexual transmission as well as via blood transfusion.

CDC Level-2 Travel Alert (Practice Enhanced Precautions): The CDC has issued a travel alert for Mexico, the Caribbean, Central and South America, and the Commonwealth of Puerto Rico:
  • Pregnant patients in any trimester should consider postponing travel to the areas where Zika virus transmission is ongoing. Travel to any area of Mexico below 6500 feet is strongly discouraged. Those who must travel to one of these areas should talk to their doctor or other health care provider first and strictly follow steps to avoid mosquito bites during the trip.
  • Patients trying to become pregnant should consult with their health care provider before traveling and strictly follow steps to prevent mosquito bites during the trip.
Check the CDC website for the latest information and for diagnostic testing information.


A92.8 – Other specified mosquito-borne viral fevers

3928002 – Zika virus disease

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Last Updated:08/04/2021
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Zika virus infection in Adult
A medical illustration showing key findings of Zika virus infection : Fever, Erythema, Widespread distribution, Arthralgia, Mosquito exposure, Smooth papules
Clinical image of Zika virus infection - imageId=7934020. Click to open in gallery.  caption: 'Diffuse erythematous patches and plaques on the thigh.'
Diffuse erythematous patches and plaques on the thigh.
Copyright © 2023 VisualDx®. All rights reserved.