Clinical and laboratory diagnosis of Zika fever: an update

ABSTRACT Zika fever can be defined as an acute febrile viral illness, mainly transmitted by the mosquito of the genus Aedes. It makes a differential diagnosis from diseases caused by other flaviviruses, such as chikungunya and dengue fever. Many people with Zika virus (ZIKV) infection will not have symptoms or will only have mild clinical symptoms. The clinical conditions are nonspecific and characterized by low-grade fever, pruritic erythematous maculopapular rash, non-purulent conjunctival hyperemia without pruritus, arthralgia, myalgia, and headache. It is a benign, self-limiting and short-duration condition. Complications such as Guillain-Barr é syndrome (GBS), spontaneous abortion and fetal malformations, mainly microcephaly and retinal lesions, may occur. The laboratory investigation is more important in cases suspected of ZIKV infection that have evolved with neurological complications, in pregnant women, abortion or congenital malfor mations, and is a key part for diagnostic definition. Real-time polymerase chain reaction (RT-PCR) can detect the virus in blood samples about four to seven days after the onset of symptoms. In urine, it is possible to identify viral ribonucleic acid (RNA) up to 15 days after clinical onset, even if viremia has ceased, and it is an alternative for late diagnosis. Serological tests may also be performed, while there may be cross-reactivity with other flaviviruses. Immunoglobulin class M (IgM) can be screened between the 2nd and 12th week...
Source: Jornal Brasileiro de Patologia e Medicina Laboratorial - Category: Pathology Source Type: research