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What is Zika Virus Disease?

Zika virus is a mosquito-borne disease that is a member of the flavivirus group. This group includes several other viruses that cause serious, sometimes life-threatening diseases such as yellow fever, dengue fever, West Nile and Japanese encephalitis.

Zika virus has been known for decades to circulate in Africa and Asia and more recently in the Pacific Islands, but very few cases of human disease were documented before 2007. In May of 2015, the first infections were confirmed in Brazil. Since then, the Brazilian government estimates that more than 1.5 million people have been infected with Zika virus. Zika is now confirmed to be circulating in several countries and territories in the Americas including Mexico and is probably present in even more. The list of countries where Zika virus has been identified can change with new cases identified. 

Cases have been reported in people who have recently traveled to an affected region. Given the widespread recent outbreaks and spring vacation travel season, more Americans will likely contract Zika virus disease in this way.

It is likely that cases of Zika virus disease will occur in regions of the US inhabited by the mosquito believed to be responsible for spreading the virus in most parts of Latin America and the Caribbean, Aedes aegypti. The southern US is infested with this mosquito and therefore is at risk for local transmission of Zika virus disease in a manner similar to dengue and chikungunya viruses. Aedes albopictus has also been implicated in Zika virus transmission in Africa and occurs further north in the eastern US. 

What are the symptoms of Zika virus? 

In children and adults, Zika virus infection is generally mild - some develop flu-like symptoms, joint pain, eye inflammation and red rashes, while other people may not have any symptoms. In some cases, infection is associated with serious complications, including Guillain-Barre syndrome, a disorder where the immune system attacks the peripheral nerves and eventually causes paralysis. There is currently no vaccine to prevent Zika virus disease nor are there any treatments to resolve disease symptoms. 

Concerning the possibility of the Zika virus being transmitted in semen, a few suspected cases have been identified but it remains unclear how often this occurs or how long the virus persists in infected men. 

What is the link between Zika virus and microcephaly? 

Microcephaly is a neurological condition where a baby is born with an abnormally small head because its brain did not develop correctly. These children almost always have lifelong mental retardation and many die young.  

There have been reports in Brazil of microcephaly in babies of mothers who had been exposed to the Zika virus, and Zika virus has been detected in the amniotic fluid and tissues of several fetuses. However, more research is needed to confirm the causal link. Nonetheless, the CDC suggests that pregnant women in any trimester should consider postponing travel to regions where the Zika virus is active. And women trying to become pregnant should consult with their doctor or health care provider before travel to those regions. 

So far, the majority of babies born with microcephaly cases have not been confirmed with laboratory tests to be linked with Zika. Therefore, in most cases experts cannot say for sure with certainty that this condition was caused by the virus. More definitive case-control and prospective cohort epidemiological studies are underway to provide more definitive information.

However, the overall evidence that Zika is responsible for the vast majority of these cases is strengthening: 

  • Between 2010 and 2014 in Brazil, 139-175 babies were born with microcephaly each year. In 2015, there were more than 3,500 cases of this disease, coincident with the arrival of Zika virus. 
  • The Zika virus has been found in the placenta of a few babies born with microcephaly, which has prompted Brazilian doctors to warn women not to become pregnant if possible, for the time being. Some of the hardest hit areas have declared a state of emergency.  
  • The virus's genetic material (RNA) has been detected in the tissues of some of the babies with microcephaly whose mothers were confirmed to have Zika during pregnancy.
  • The CDC has identified the Zika virus in the tissues of babies who died from Brazil from microcephaly. 

What is recommended for pregnant women at risk of Zika?

Women who are pregnant or are considering becoming pregnant should talk to their obstetrician and make sure they are familiar with the latest guidance from the CDC. This is particularly important if there has been recent travel to countries affected by Zika virus. Keep in mind that the virus is spreading rapidly so the list of countries affected may not reflect the current distribution due to the inherent lag in diagnostic testing and reporting. 

You can find CDC guidance for pregnant women here

Click here for the CDC's current information on travel to affected countries. 

What can people do to minimize their risk of becoming infected with Zika virus?

Currently no vaccine exists to prevent Zika virus disease. The best prevention is avoiding mosquito bites. If you or someone you know plans on traveling to countries where Zika virus (see map) or other viruses spread by mosquitoes are found, take the following steps:

  • Use insect repellents
  • When used as directed, insect repellents are safe and effective for everyone, including pregnant and nursing     women.
  • Most insect repellents can be used on children in proper concentrations. Do not use products containing oil of lemon eucalyptus in children under the age of three years.
  • Repellents containing DEET, picaridin, IR3535, and some oil of lemon eucalyptus and para-menthane-diol products provide long lasting protection.
  • If you use both sunscreen and insect repellent, apply the sunscreen first and then the repellent.
  • Do not spray insect repellent on the skin under your clothing
  • Treat clothing with permethrin or purchase permethrin-impregnated clothing.
  • Always follow the label instructions when using insect repellent or sunscreen and especially note recommendations for use on children.
  • When weather permits, wear long-sleeved shirts and long pants.
  • Use air conditioning or window/door screens to keep mosquitoes out of your home, hotel room or place of work. Remember that the mosquitoes believed to transmit Zika virus bite during the daytime as well as early morning and evening.
  • Help reduce the number of mosquitoes inside and outside your home or hotel room by emptying standing water from containers such as flowerpots or buckets.
  • If you live in areas inhabited by A. aegypti or A. albopictus, eliminate sources of standing water near your home to reduce populations of these mosquitoes and lower the risk of local Zika virus circulation if you or another traveler returns infected.

UTMB Zika experts:

Scott Weaver

Scott Weaver, globally recognized for his expertise in mosquito-borne diseases, is the director of the UTMB Institute for Human Infections and Immunity and scientific director of the Galveston National Laboratory. His work has been widely published and he holds nine patents in vaccine development. 

Weaver was presented the 2014 Walter Reed Medal in recognition of his distinguished accomplishments in the field of tropical medicine, especially in understanding the emergence of mosquito-borne viral diseases such as dengue, chikungunya and Zika. 

He is the co-chairman for the Global Virus Network's Chikungunya Task Force, which formed to speed the process to creating vaccines and much-needed diagnostic tools for this virus, as well as to advocate for research efforts.

Pei-Yong Shi 

Pei-Yong Shi is the I.H. Kempner Professor of Human Genetics at UTMB and is an adjunct professor of emerging infectious diseases at the Duke - NUS Graduate Medical School in Singapore. Shi came to UTMB after spending seven years serving as the Dengue Head Unit and Executive Director to lead drug discovery at the Novartis Institute for Tropical Diseases. 

Shi is internationally renowned for his work on flaviviruses that integrates both his academic and industrial expertise. 

Shi and his team discovered a new approach to developing vaccines for flaviviruses, including Zika, which employs a certain type of mutant virus. The mutant virus-based vaccine is similar enough to the parent virus that when the vaccine is given to a person, they will develop immunity to the disease without ever developing the disease itself. These vaccines are currently under development and are not yet available to the public.

Nikos Vasilakis

Nikos Vasilakis is an associate professor in the UTMB department of pathology. He has extensive experience in mosquito-borne disease vaccine development, genetics and evolution. Vasilakis spent several years directing and coordinating research programs while at Wyeth Vaccine Research, giving him a deep understanding of both academic preclinical and pharmaceutical perspectives. 

Vasilakis and his laboratory are studying the evolution and pathogenesis of arthropod-borne viruses, virus-mosquito and virus-host interactions using sylvatic dengue as a model, for which a study has been developed with Malaysian collaborators in Borneo. Additionally, as part of the World Reference Center for Emerging Viruses and Arboviruses, he utilizes Next Generation Sequencing to discover, characterize and annotate new and novel viruses that could lead to the development of successful countermeasures for a number of veterinary and human diseases which is quite useful when a virus is establishing itself in a new environment as Zika is doing in the Americas. 

In December 2015 at the behest of FioCruz of the Brazilian state of Bahia, Vasilakis and his colleague Shannan Rossi travelled to Salvador, Brazil to set up improved diagnostics for Zika, chikungunya and dengue in collaboration with the the FioCruz Foundation. While there, they had the opportunity to visit affected areas in poor regions and the Geral Roberto Santos Hospital where our collaborators have established a cohort of infant microcephaly. 

Zika Virus Disease - Full Video

Weaver presents an overview of the current outbreak - Media Clips

Zika Overview

How to Protect Against Zika

How UTMB is Working to Understand and Eliminate Zika

World Class Research Centers

UTMB's infectious disease research is coordinated through the Institute for Human Infections and Immunity, home to more than 120 faculty actively engaged in research. The IHII's premiere research facility is the Galveston National Laboratory, which includes the largest fully operational Biosafety Level Four laboratory on an academic campus in the U.S.

UTMB is home to The World Reference Center for Emerging Viruses and Arboviruses, a collection of more than 6,000 virus strains that accepts any virus suspected of being transmitted by animals or insects for identification and characterization. Most of the existing samples of Zika virus globally are housed in this Reference Center. A number of visiting scientists each year spend time in the Reference Center, learning classical and serologic techniques as well as newer molecular methods for mosquito-borne virus identification and testing. 

The IHII includes the Sealy Center for Vaccine Development, one of the most comprehensive vaccine development centers in the world, whose researchers are investigating new ways to treat infectious diseases of every type, from new strains of influenza to emerging diseases from every corner of the globe.

UTMB has been designated a World Health Organization Collaborating Center for Vaccine Research, only the second in the Western Hemisphere. 

UTMB is also home to the National Biocontainment Training Center, which is dedicated to preparing the worldwide community of infectious disease scientists to work safely in high-containment research laboratories. This unique training opportunity is unmatched nationally or internationally and fills a critical role in the development and training of a cadre of skilled scientists, engineers and staff dedicated to combatting the infectious diseases affecting global health. 

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