Understanding Pathogenesis, Clinical Features, Complications, and Diagnostic Methods of Zika Virus: A Review

Abstract

The Zika virus (ZIKV) is a mosquito-borne illness originally identified in Uganda in 1947. It remained relatively unnoticed until 2015, when many outbreaks in the Americas raised global alarms. Unlike cases earlier isolated, the fast spread of ZIKV was associated with severe health complications, such as congenital microcephaly and Guillain-Barré Syndrome (GBS), prompting the World Health Organization to declare it a Public Health Emergency of global Concern. The basic mode of transmission is through Aedes aegypti mosquitoes, although the virus can also spread by sexual contact, mother to child, and through blood. ZIKV infects numerous host cells and replicates within the endoplasmic reticulum, disrupting the body’s immune signaling and inducing cell death.  ZIKV infection typically presents mild symptoms similar to those of the flu, including fever, rash, joint pain, and conjunctivitis (also known as pink eye). These symptoms generally develop 3 to 14 days after being bitten by an infected mosquito and typically subside within a week. However, some people remain asymptomatic. In rare instances, Zika virus infection can cause serious complications, such as Guillain-Barré syndrome or microcephaly in babies born to infected mothers, as well as other significant fetal health problems. Diagnosis of ZIKV relies on molecular tests like RT-PCR and serological tests such as ELISA. However, the sensitivity and specificity of these tests are often influenced by cross-reactive antibodies from other flaviviruses and low levels of the virus in the blood. Current advancements in rapid diagnostics have enhanced accessibility, but ensuring standardization and validation across diverse populations remains a significant challenge. This review offers a comprehensive overview of ZIKV pathogenesis, clinical features, neurological syndrome, and diagnostic methods, emphasizing the need for innovative strategies to enhance early detection and improve public health responses to future outbreaks.