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Quiz: Do You Know the Zika Virus Guidelines?
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Quiz: Do You Know the Zika Virus Guidelines?

Michael Stuart Bronze, MD

|January 27, 2016

A mosquito-borne illness, Zika virus has been in the news due to a suspected relationship between infection in pregnant women and birth defects, including microcephaly. Previously seen in Africa, Southeast Asia, and the Pacific Islands, the virus recently arrived in Brazil and spread rapidly through Latin America. Several cases have been found in the United States, prompting the Centers for Disease Control and Prevention (CDC) to issue interim guidelines. How much do you know about this newsworthy condition? Test yourself with our short quiz.

Which of the following has been associated with Zika virus infection?
Guillain-Barré syndrome
Vasculitic neuropathy
Myasthenia gravis
Cauda equina syndrome
857714-figure-1.jpg

Guillain-Barré syndrome has been associated with Zika virus infection. The first case was reported during a co-epidemic of Zika virus and type 1 and type 3 dengue fever in French Polynesia.

For more on Guillain-Barré syndrome, read here.

Which of the following is recommended in pregnant women with a history of travel to an area with an ongoing Zika virus outbreak?
Agglutination testing of maternal serum
Enzyme-linked immunosorbent assay (ELISA) screening of maternal serum
Western blot testing of maternal serum
Reverse transcription-polymerase chain reaction (RT-PCR) testing of maternal serum
857714-figure-3.jpg

RT-PCR testing is indicated in pregnant patients whose symptoms began the previous week. Specimens collected 4 or more days after the patient became symptomatic should be subjected to immunoglobulin M (IgM) and neutralizing antibody testing. Distinguishing Zika virus from other flavivirus infections may be difficult.

For more on RT-PCR testing, read here.

Which of the following is the first step indicated by the testing algorithm provided by the CDC for pregnant women with history of travel to an area with Zika virus who are asymptomatic 2 weeks after travel?
Fetal ultrasonography
RT-PCR testing
Amniocentesis
IgM testing
857714-figure-5.jpg

According to the testing algorithm, fetal ultrasonography is indicated to detect microcephaly or intracranial calcifications. If either finding is present, the patient should be tested for infection, and amniocentesis should be considered. If neither finding is present, consider serial ultrasonography to monitor for development of microcephaly or intracranial calcifications.

For more on microcephaly, read here.

Which of the following is not recommended in women with suspected Zika virus infection?
Testing of cord serum for Zika and dengue virus IgM and neutralizing antibodies
Early amniocentesis (≤ 14 weeks of gestation)
Testing of frozen placental tissue and cord tissue
Histopathologic examination of the placenta and umbilical cord
857714-figure-2.jpg

Amniocentesis performed at 15 weeks of gestation or beyond has lower complication rates. Amniocentesis is not recommended before such time. In cases of live birth with evidence of maternal or fetal Zika virus infection, testing of frozen placental tissue and cord tissue, testing of cord serum, and histopathologic examination of the placenta and umbilical cord are indicated.

For more on amniocentesis, read here.

Which of the following is recommended in the treatment of pregnant women with laboratory evidence of Zika virus?
Analgesics and antipyretics
Aspirin
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Zika virus-specific antiviral treatment
857714-figure-4.jpg

Unfortunately, no specific antiviral treatment has been established. Treatment is often supportive, including rest, fluids, and use of analgesics and antipyretics, with fever treated with acetaminophen. Until dengue can be ruled out, aspirin and NSAIDs should be avoided. They are not typically used during pregnancy.

For the complete CDC guidelines, read here.

Also, take our reader poll, "Are You Prepared for the Zika Virus?" here.

 

Medscape © 2016  WebMD, LLC

Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.

Cite this article: Michael Stuart Bronze. Quiz: Do You Know the Zika Virus Guidelines? Medscape. Jan 27, 2016.



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Frozen Sucks!

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I've been following this story. Very devastating. And the virus is sexually transmitted so one person is infected by a mosquito and passes it on to his partner who becomes pregnant. We, the US, have to keep this out of the Country and give time to figure the solution out.

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