Zika virus: A global public health menace: A comprehensive update

Abstract

Zika virus (ZIKV) is a RNA virus and belongs to genus Flavivirus and family Flaviviridae . The virus was first discovered from a febrile primate from the Zika forests of Uganda in 1947 and the first human case was documented in 1954. The nonspecific clinical manifestations of ZIKV pose diagnostic dilemmas and delays early and effective treatment. Dental professionals should have a thorough knowledge about the virus and should follow standard infection control measures as the virus has been demonstrated in various body secretions (including salivary secretions). The disease is managed by symptomatic and supportive care and no vaccine exist till date. Recent ZIKV outbreaks and increase association of microcephaly with congenital ZIKV and neurological complications (Guillain-Barré syndrome) has drawn global public health attention. The World Health Organization declared it a public health emergency of international concern in 2016. This review article provides a detailed overview on ZIKV; it is clinical and oral manifestations, diagnostic aids, differential diagnosis, preventive aspects, and management protocol.

Emerging and Re-emerging Viruses

“…ZIKV RNA ayrıca anne sütünde, amniyon sıvısı ve fetal dokularda tanımlanmıştır (91,92) . Bununla birlikte, bu yollardan yayılan ZIKV kanıtı şimdiye dek henüz rapor edilmemiştir (93) .…”

Zika Virus in Africa: Epidemiology and Determinants

“…Clinically, Patients with ZIKV infection often are asymptomatic in initial stages, with about 20% [80] showing clinical symptoms after 3 to 10 days of infection [81]. Patients usually present with fever, maculopapular rash, arthralgia, myalgia, conjunctivitis, headache, retroorbital pain, and emesis, as seen in Cabo Verde [52], but these can often be misunderstood for chikungunya virus (CHIKV) or dengue virus (DENV) [3,4].…”

“…For laboratory confirmation of ZIKV, various specimens can be used, such as; serum, saliva, tissues, urine, and whole blood [80], while in pregnant women, amniotic fluid can be used for diagnosis [4,83]. Some investigations found the detection of ZIKV RNA within a week in saliva and thus recommend both blood and saliva for better sensitivity in acute stages and use urine for later stages of the disease [6].…”

“…Using the specimens above, ZIKV can then be confirmed through laboratory investigations of ZIKV RNA or antigen or IgM and IgG antibodies [6,82,84]. To detect ZIKVRNA, viral proteins (NSI) and live virus, Reverse transcription polymerase chain reaction (RTPCR), IgMcapture enzymelinked immunosorbent assay (MACELISA), and virus isolation can be used respectively [80,85]. These methods are used for both mosquito surveillance and the diagnosis of the patient.…”

“…In countries with advanced laboratory capacities, a ZIKV RTPCR assay should be the firstline test due to its high specificity and sensitivity even in the early stages of infection [84,85]. Since the timing of infection is hard to establish, a negative RTPCR does not exclude infection [80]. However, it is the most accurate and rapid test used worldwide.…”