The most important thing first: for most people Zika is very mild — according to CDC, about 80% of those infected have no symptoms at all. But if the person infected is pregnant, the virus can cause microcephaly and brain damage in the baby. So this article is written for two people: anyone who is pregnant or planning a pregnancy — and anyone who could pass it to them.
Recognising it: four signs — and most people have none
According to CDC, the time from a mosquito bite to symptoms is usually 3 to 14 days, and symptoms last from a few days to a week. Because most people infected do not know they are infected, the worrying part of Zika lies in how it SPREADS, not in how it is treated.
- Fever, usually only mild.
- A rash on the skin, widespread and spreading.
- Joint pain and aching; there may be a headache with it.
- RED EYES, like conjunctivitis, with no pus.
- But do NOT use this set of signs to settle the diagnosis yourself: CDC lists dengue among the illnesses that must be told apart from Zika — nobody can tell them apart reliably by eye, only a test can settle it.
Not just mosquitoes: three routes of transmission
- MOSQUITO bites. According to CDC the illness is carried by Aedes mosquitoes — the same species that carries dengue — and these mosquitoes bite during the day as well as at night. According to CDC, Zika is present in Vietnam.
- SEX. According to CDC, a person who is infected can pass Zika on through sex EVEN WHEN they have no symptoms at all.
- FROM A PREGNANT PERSON TO THE BABY, during pregnancy.
Why pregnancy is the heart of this
According to CDC, Zika infection during pregnancy can cause severe birth defects, and is linked with pregnancy loss, stillbirth and preterm birth. The defect mentioned most often is microcephaly — a head smaller than usual because the brain has not grown enough. It also has to be said accurately: not every person infected while pregnant goes on to have a baby with a problem.
But that cannot be read off from home. According to CDC, if you are pregnant or planning a pregnancy, talk to your doctor about your risk of Zika infection, about the possible effects on the baby, and about how to protect yourself.
What to do now
- Write down on paper the FIRST DAY of the fever or the rash, and where you have just travelled. These are exactly the points a doctor will ask about.
- Pregnant, or your wife or partner is pregnant: ring the obstetrician the same day, do not wait to see whether the rash fades.
- According to CDC, managing the symptoms means plenty of rest, drinking enough fluids, and an over-the-counter fever and pain medicine such as paracetamol (acetaminophen) — the dose is for a doctor or pharmacist to decide.
- Just back from an area with Zika: according to CDC, prevent mosquito bites for 3 weeks even if you are not ill, so that you do not pass the virus to mosquitoes where you live.
Things you must NOT do
- Do NOT use aspirin or other non-steroidal anti-inflammatory drugs, ibuprofen among them, until dengue has been ruled out — according to CDC, to reduce the risk of bleeding. Many over-the-counter cold remedies contain them, so read the label or ask a pharmacist.
- Do NOT conclude “it is only Zika, it is mild” and then stop watching. Until there has been a test, dengue has not been ruled out — and that illness can turn severe just as the fever settles.
- Do NOT take “no symptoms” to mean “not infectious”: according to CDC, someone with no symptoms can still pass it on through sex.
- Do NOT buy antibiotics yourself, because this is a virus; do NOT use coin rubbing, skin pricking or cupping; do NOT set up a drip at home.
When you must go to hospital
GO TO EMERGENCY CARE or call 115 (the emergency number in Vietnam) NOW if: weakness in both legs spreading up to the arms and face, especially with difficulty breathing, difficulty swallowing or difficulty speaking; seizures; drowsy and hard to wake, confused; a severe headache with projectile vomiting, a stiff neck, dislike of light; rapid breathing, difficulty breathing, blue lips; bleeding gums or a nosebleed, vomiting blood, black stools, bruising in several places; severe abdominal pain, or pain that keeps increasing; constant vomiting with nothing staying down; cold clammy pale skin, no urine passed for hours. — BE SEEN WITHIN 24–72 HOURS if: you are pregnant and have a fever, a rash, joint pain or red eyes; you are pregnant or planning a pregnancy and either you or your partner has just been in an area with Zika, even with no signs at all; a fever into its third day with no clear cause. — If you are unsure, ring and ask before deciding on your own.
The item about weakness spreading up the legs is there to help you recognise Guillain-Barré syndrome — according to CDC, Zika rarely causes this syndrome. According to NHS, the weakness usually starts in the feet and spreads upwards, on both sides at the same time.
Prevention: block the two routes
- According to CDC there is no vaccine or medicine that prevents Zika; prevention means not being bitten: use insect repellent, wear long sleeves and long trousers, fit screens on the windows, sleep under a net — by day as well as by night.
- Block the sexual route: according to CDC, use condoms or do not have sex — for men at least 3 months, for women at least 2 months from the date of return.
- According to CDC, anyone who is pregnant should avoid travelling to an area under a Zika travel notice.
To be clear about scope: Y Te Xanh (GreenCare) does not provide obstetric care. Zika in pregnancy is a matter for an obstetrician: every decision about the pregnancy is made there, nothing at home can assess or manage it instead, and we are not a substitute for your obstetrician. Two things we can do: a remote consultation by video call so you can decide between being seen now and being able to wait, and a doctor coming to the house to take a history and examine you. With a sign in the box above, go in first and ring afterwards.
The symptoms, the routes of transmission, the periods for preventing sexual transmission and the warning about aspirin and NSAIDs follow the public materials of the US CDC; the pattern of weakness in Guillain-Barré follows NHS. This article passes those on and does not replace being examined. Citing CDC here does not imply that CDC endorses Y Te Xanh or our services.
Need personalised advice for your loved one? Call our hotline 094 368 81 15 (24/7) — calling to ask a question or to book costs nothing. GreenCare has doctors who come to examine, nurses who carry out doctor's orders (injections, infusions, dressing changes), remote consultation by video call, and a review of the medicines you are taking; an in-depth remote consultation, or any one after the first, is a paid service. For children we take examination and acute care only — not long-term care at home, and not newborns or expectant mothers. We confirm we have staff in your area and provide transparent pricing before we begin.
Sources
- CDC — About Zika Virus
- NHS — Guillain-Barré syndrome
