Zika virus infection medical therapy: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Zika virus}} | {{Zika virus}} | ||
{{CMG}}; {{AE}} {{YD}} | {{CMG}}; {{AE}} {{YD}}, {{NRM}}, {{SSK}} | ||
==Overview== | ==Overview== | ||
The mainstay of therapy for Zika virus infection is supportive care. Supportive care includes includes rest, adequate fluids intake, and administration of antipyretics and analgesics. Aspirin and other NSAIDs should be avoided until [[Dengue fever]] is ruled out | The mainstay of therapy for Zika virus infection is supportive care. Supportive care includes includes rest, adequate fluids intake, and administration of [[antipyretics]] and [[analgesics]]. [[Aspirin]] and other [[NSAIDs]] should be avoided until [[Dengue fever]] is ruled out, as [[NSAIDs]] may increase the risk of [[hemorrhage]] in patients with [[Dengue fever]]. Antiviral treatment is not recommended for the management of Zika virus infection. The general principles of medical therapy for the management of Zika virus apply to pregnant women. Treatment of congenital Zika virus infection is supportive and should address specific medical and neurodevelopmental issues for the infant’s particular needs. Mothers are encouraged to breastfeed infants even in areas where Zika virus is found, as available evidence indicates the benefits of breastfeeding outweigh any theoretical risks associated with Zika virus infection transmission through breast milk.<ref name="pmid24721538">{{cite journal| author=Besnard M, Lastere S, Teissier A, Cao-Lormeau V, Musso D| title=Evidence of perinatal transmission of Zika virus, French Polynesia, December 2013 and February 2014. | journal=Euro Surveill | year= 2014 | volume= 19 | issue= 13 | pages= | pmid=24721538 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24721538 }} </ref><ref name="pmid15687461">{{cite journal| author=Gartner LM, Morton J, Lawrence RA, Naylor AJ, O'Hare D, Schanler RJ et al.| title=Breastfeeding and the use of human milk. | journal=Pediatrics | year= 2005 | volume= 115 | issue= 2 | pages= 496-506 | pmid=15687461 | doi=10.1542/peds.2004-2491 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15687461 }} </ref> | ||
==Medical Therapy== | ==Medical Therapy== | ||
| Line 10: | Line 10: | ||
:*Rest | :*Rest | ||
:*Adequate fluid intake | :*Adequate fluid intake | ||
:*Pharmacologic therapy (i.e. antipyretic agents and/or analgesics) | :*Pharmacologic therapy (i.e., antipyretic agents and/or [[analgesics]]) | ||
::*Note: Aspirin and other NSAIDs should be avoided until [[Dengue fever]] is ruled out (NSAIDs may increase the risk of hemorrhage in Dengue fever).<ref name= “Zika Medicaltherapy”> Zika virus. Center for Disease Control and Prevention for Medical Professionals. http://www.cdc.gov/zika/hc-providers/clinicalevaluation.html Accessed on December 14, 2015</ref> | ::*Note: Aspirin and other NSAIDs should be avoided until [[Dengue fever]] is ruled out ([[NSAIDs]] may increase the risk of [[hemorrhage]] in Dengue fever).<ref name= “Zika Medicaltherapy”> Zika virus. Center for Disease Control and Prevention for Medical Professionals. http://www.cdc.gov/zika/hc-providers/clinicalevaluation.html Accessed on December 14, 2015</ref> | ||
*Antiviral treatment is not recommended for the management of Zika virus infection. | *Antiviral treatment is not recommended for the management of Zika virus infection. | ||
*There is no vaccine or medicine for Zika virus infection.<ref name= “Zika Medicaltherapy”> Zika virus. Center for Disease Control and Prevention for Medical Professionals. https://www.cdc.gov/zika/about/index.html(2016) Accessed on September 14, 2016</ref> | *There is no [[vaccine]] or medicine for Zika virus infection.<ref name= “Zika Medicaltherapy”> Zika virus. Center for Disease Control and Prevention for Medical Professionals. https://www.cdc.gov/zika/about/index.html(2016) Accessed on September 14, 2016</ref> | ||
==Special Considerations== | ==Special Considerations== | ||
===Management of Pregnant Women=== | ===Management of Pregnant Women=== | ||
*The general principles of medical therapy for the management of Zika virus apply to pregnant women (i.e. rest, fluids, acetaminophen antipyretic therapy if needed, avoid aspirin and NSAIDS). | *The general principles of medical therapy for the management of Zika virus apply to pregnant women (i.e., rest, fluids, [[acetaminophen]] antipyretic therapy if needed, avoid aspirin and NSAIDS). | ||
*In a pregnant woman with laboratory evidence of Zika virus in serum or amniotic fluid, serial ultrasounds should be considered to monitor fetal anatomy and growth every 3–4 weeks. | *In a pregnant woman with laboratory evidence of Zika virus in serum or amniotic fluid, serial ultrasounds should be considered to monitor fetal anatomy and growth every 3–4 weeks. | ||
*Referral to a maternal-fetal medicine or infectious disease specialist with expertise in pregnancy management is recommended. | *Referral to a maternal-fetal medicine or infectious disease specialist with expertise in pregnancy management is recommended. | ||
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*Treatment of congenital Zika virus infection is supportive and should address specific medical and neurodevelopmental issues for the infant’s particular needs; investigations are ongoing to better understand what services will be most effective for these children as they grow. | *Treatment of congenital Zika virus infection is supportive and should address specific medical and neurodevelopmental issues for the infant’s particular needs; investigations are ongoing to better understand what services will be most effective for these children as they grow. | ||
*Mothers are encouraged to breastfeed infants even in areas where Zika virus is found, as available evidence indicates the benefits of breastfeeding outweigh any theoretical risks associated with Zika virus infection transmission through breast milk.<ref name="pmid24721538">{{cite journal| author=Besnard M, Lastere S, Teissier A, Cao-Lormeau V, Musso D| title=Evidence of perinatal transmission of Zika virus, French Polynesia, December 2013 and February 2014. | journal=Euro Surveill | year= 2014 | volume= 19 | issue= 13 | pages= | pmid=24721538 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24721538 }} </ref><ref name="pmid15687461">{{cite journal| author=Gartner LM, Morton J, Lawrence RA, Naylor AJ, O'Hare D, Schanler RJ et al.| title=Breastfeeding and the use of human milk. | journal=Pediatrics | year= 2005 | volume= 115 | issue= 2 | pages= 496-506 | pmid=15687461 | doi=10.1542/peds.2004-2491 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15687461 }} </ref> | *Mothers are encouraged to breastfeed infants even in areas where Zika virus is found, as available evidence indicates the benefits of breastfeeding outweigh any theoretical risks associated with Zika virus infection transmission through breast milk.<ref name="pmid24721538">{{cite journal| author=Besnard M, Lastere S, Teissier A, Cao-Lormeau V, Musso D| title=Evidence of perinatal transmission of Zika virus, French Polynesia, December 2013 and February 2014. | journal=Euro Surveill | year= 2014 | volume= 19 | issue= 13 | pages= | pmid=24721538 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24721538 }} </ref><ref name="pmid15687461">{{cite journal| author=Gartner LM, Morton J, Lawrence RA, Naylor AJ, O'Hare D, Schanler RJ et al.| title=Breastfeeding and the use of human milk. | journal=Pediatrics | year= 2005 | volume= 115 | issue= 2 | pages= 496-506 | pmid=15687461 | doi=10.1542/peds.2004-2491 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15687461 }} </ref> | ||
*Developmental monitoring and screening during the first year of life is recommended for all children with congenital Zika virus infection. | *Developmental monitoring and screening during the first year of life is recommended for all children with [[congenital]] Zika virus infection. | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Emergency mdicine]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Infectious disease]] | [[Category:Infectious disease]] | ||
[[Category:Dermatology]] | |||
[[Category:Pulmonology]] | |||
[[Category:Gastroenterology]] | |||
[[Category:Neurology]] | |||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yazan Daaboul, M.D., Nate Michalak, B.A., Serge Korjian M.D.
Overview
The mainstay of therapy for Zika virus infection is supportive care. Supportive care includes includes rest, adequate fluids intake, and administration of antipyretics and analgesics. Aspirin and other NSAIDs should be avoided until Dengue fever is ruled out, as NSAIDs may increase the risk of hemorrhage in patients with Dengue fever. Antiviral treatment is not recommended for the management of Zika virus infection. The general principles of medical therapy for the management of Zika virus apply to pregnant women. Treatment of congenital Zika virus infection is supportive and should address specific medical and neurodevelopmental issues for the infant’s particular needs. Mothers are encouraged to breastfeed infants even in areas where Zika virus is found, as available evidence indicates the benefits of breastfeeding outweigh any theoretical risks associated with Zika virus infection transmission through breast milk.[1][2]
Medical Therapy
- The mainstay of therapy for Zika virus infection is supportive care:
- Rest
- Adequate fluid intake
- Pharmacologic therapy (i.e., antipyretic agents and/or analgesics)
- Note: Aspirin and other NSAIDs should be avoided until Dengue fever is ruled out (NSAIDs may increase the risk of hemorrhage in Dengue fever).[3]
- Antiviral treatment is not recommended for the management of Zika virus infection.
- There is no vaccine or medicine for Zika virus infection.[3]
Special Considerations
Management of Pregnant Women
- The general principles of medical therapy for the management of Zika virus apply to pregnant women (i.e., rest, fluids, acetaminophen antipyretic therapy if needed, avoid aspirin and NSAIDS).
- In a pregnant woman with laboratory evidence of Zika virus in serum or amniotic fluid, serial ultrasounds should be considered to monitor fetal anatomy and growth every 3–4 weeks.
- Referral to a maternal-fetal medicine or infectious disease specialist with expertise in pregnancy management is recommended.
Management of Congenital Zika Virus Infection
- No specific antiviral treatment is available for Zika virus infections.
- Treatment of congenital Zika virus infection is supportive and should address specific medical and neurodevelopmental issues for the infant’s particular needs; investigations are ongoing to better understand what services will be most effective for these children as they grow.
- Mothers are encouraged to breastfeed infants even in areas where Zika virus is found, as available evidence indicates the benefits of breastfeeding outweigh any theoretical risks associated with Zika virus infection transmission through breast milk.[1][2]
- Developmental monitoring and screening during the first year of life is recommended for all children with congenital Zika virus infection.
References
- ↑ 1.0 1.1 Besnard M, Lastere S, Teissier A, Cao-Lormeau V, Musso D (2014). "Evidence of perinatal transmission of Zika virus, French Polynesia, December 2013 and February 2014". Euro Surveill. 19 (13). PMID 24721538.
- ↑ 2.0 2.1 Gartner LM, Morton J, Lawrence RA, Naylor AJ, O'Hare D, Schanler RJ; et al. (2005). "Breastfeeding and the use of human milk". Pediatrics. 115 (2): 496–506. doi:10.1542/peds.2004-2491. PMID 15687461.
- ↑ 3.0 3.1 Zika virus. Center for Disease Control and Prevention for Medical Professionals. http://www.cdc.gov/zika/hc-providers/clinicalevaluation.html Accessed on December 14, 2015