Do I have Zika?

Do I have Zika? 

A patient in Jamaica asked: 4 days ago had a sore throat. Lost voice for a day. Coughing. Now , 5 days later both eyes are red and watery. No other symptoms. Could it be Zika?

Zika virus (ZIKV) is a mosquito-borne flavivirus (positive, single-stranded, enveloped RNA viruses), first discovered in the Zika forest of Uganda in 1947, and was first isolated from a human in 1952.

The most common symptoms in this outbreak were rash, fever, arthritis or arthralgia, and nonpurulent conjunctivitis. The absence of reported symptoms in many individuals with evidence of acute infection suggested a predominance of asymptomatic ZIKV infections (perhaps 80%).

Zika is usually mild with symptoms lasting for several days to a week. People usually don’t get sick enough to go to MD and very rarely die of Zika. Thus many don’t realize they have been infected. 

The key first symptoms are:
1. Fever
2. Rash, 
3. Joint pain: arthritis and arthralgia
4. Non purulent Conjunctivitis (red eyes without much discharge)
5. Muscle pain
6. Headache
7. Pain behind the eyes
8. Vomiting

If you have coughing, it is unlikely to be Zika and likely another virus.
For help with the cough, see

Sandra Lora Cremers, MD, FACS

Of note, people who are infected with Zika can develop Guillain-Barré Syndrome, which a friend and MD I know had: it can be deadly so be aware of this connection.

 2016 Nov 2;95(5):1161-1165. Epub 2016 Oct 17.

Guillain-Barré Syndrome Associated with Zika Virus Infection in a Traveler Returning from Guyana.


Zika virus (ZIKV) is a mosquito-borne flavivirus with a significant public health impact highlighted by the ongoing epidemic in the Americas. We describe a 44-year-old male presenting to our tropical medicine center with complaints of fever, headache, joint pain, and rash after recent travel to Guyana. The patient subsequently developed gait imbalance and lower extremity weakness with clinical examination, cerebrospinal fluid studies, and magnetic resonance imaging of the spine consistent with a diagnosis of Guillain-Barré syndrome (GBS). ZIKV infection was confirmed via detection of ZIKV RNA in urine by polymerase chain reaction. The patient was treated with intravenous immunoglobulin and experienced near-complete neurologic recovery, reporting ongoing mild paresthesia up to 2 months later. This case highlights the diagnostic challenges posed by ZIKV and underscores the need for clinician awareness of the potential for neurological complications such as GBS with ZIKV infection.
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