Zika virus infection differential diagnosis
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yazan Daaboul, M.D.; Luke Rusowicz-Orazem, B.S.; Serge Korjian M.D.; Yamuna Kondapally, M.B.B.S[2]
Overview
The broad-ranging clinical symptoms associated with Zika virus infection commonly cause it to be misdiagnosed with multiple similar diseases that are also from the Flaviviridae virus family. Zika virus infection has similar clinical presentation to dengue fever, yellow fever, West Nile virus, and Japanese encephalitis. Zika virus infection is distinct in its milder clinical manifestations and shorter length of infection. The association between Zika virus infection and complications that include congenital anomalies and neurological syndromes is also distinctive. Of note, patients bitten by mosquitoes may be concomitantly infected with Zika virus and other mosquito-borne infections, and co-infection should always be considered.
Differentiating Zika Virus Infection from Other Diseases
- Zika virus infection manifests through a broad range of clinical symptoms shared with multiple different diseases from the Flaviviridae virus family, causing misdiagnosis to be common with the following diseases:[1]
- Of note, patients bitten by mosquitoes may be concomitantly infected with Zika virus and other mosquito-borne infections, and co-infection should always be considered.
- Zika virus infection is clinically distinct from similar diseases by its typically mild symptoms and short length, with symptoms typically lasting 4-7 days total and not requiring hospitalization.[2]
- Zika virus infection-related complications, such as microcephaly and Guillain-Barré syndrome, distinguish Zika virus infection from other Flaviviridae Virus diseases.[3]
Differentiating Zika Fever from Dengue Fever
The following table summarizes the distinguishing and common features between Zika fever and Dengue fever, both of which are transmitted by the Aedes mosquito:
| Dengue Fever | Zika Fever | |
| Common Clinical Features | Biphasic fever pattern, maculopapular rash, arthralgia, headache, and signs of hemorrhage | Fever, maculopapular rash, conjunctivitis, and headache |
| Hemorrhage Common? | Yes | No |
| Symptom Severity | May be severe | Usually mild |
| Symptom Duration | 2 to 7 days | 4 to 7 days |
| Incubation Period | 4 to 10 days | 3 to 12 days |
| Endemicity | Americas, Africa, Southeast Asia | Americas, Africa, Southeast Asia |
| Vector | Aedes mosquito | Aedes mosquito |
| Laboratory Findings | Leucopenia, rising hematocrit (suggestive of impending hemorrhage), thrombocytopenia, elevated liver function tests | Leucopenia but normal hematocrit, platelet count, and liver function tests |
| Diagnosis | RT-PCR or ELISA | RT-PCR or ELISA |
| Treatment | Supportive care, avoid aspirin and other NSAIDs | Supportive care |
References
- ↑ Zika virus. Center for Disease Control and Prevention for Medical Professionals. http://www.cdc.gov/zika/hc-providers/clinicalevaluation.html Accessed on December 10, 2015
- ↑ Outbreak of Exanthematous Illness Associated with Zika, Chikungunya, and Dengue Viruses, Salvador, Brazil. Emerging Infectious Diseases; Center for Disease Control. http://wwwnc.cdc.gov/eid/pdfs/vol21no12_pdf-version.pdf Accessed on December 16, 2015
- ↑ “Epidemiological Alert: Neurological Syndromes, Congenital Malformations, and Zika Virus Infection. Implications for Public Health in the Americas”. Pan American Health Organization. Pan American Health Organization. December 1, 2015. Retrieved December 11, 2015.
© 2026 MyEClinic – IFTM Institut für Telematik in der Medizin GmbH