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The mainstays of management are bed rest and supportive care. When multiple arboviruses are cocirculating, specific viral diagnosis, if available, can be important in anticipating, preventing, and managing complications. For example, in dengue, aspirin use should be avoided and patients should be monitored for a rising hematocrit predictive of impending hemorrhagic fever, so that potentially lifesaving treatment can be instituted promptly. Patients with chikungunya virus infection should be monitored and treated for acute arthralgias and postinfectious chronic arthritis.

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5. European Centre for Disease Prevention and Control. Microcephaly in Brazil potentially linked to the Zika virus epidemic: ECDC assesses the risk. Solna, Sweden: European Centre for Disease Prevention and Control, November 25, 2015 ().

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There are a number of reasons why these treatments are gaining some momentum now: for one, there's a big need for antibiotics. In September, the World Health Organization warned that the .

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In a “pure” Zika epidemic, a diagnosis can be made reliably on clinical grounds. Unfortunately, the fact that dengue and chikungunya, which result in similar clinical pictures, have both been epidemic in the Americas confounds clinical diagnoses. Specific tests for dengue and chikungunya are not always available, and commercial tests for Zika have not yet been developed. Moreover, because Zika is closely related to dengue, serologic samples may cross-react in tests for either virus. Gene-detection tests such as the polymerase-chain-reaction assay can reliably distinguish the three viruses, but Zika-specific tests are not yet widely available.

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The ongoing pandemic confirms that Zika is predominantly a mild or asymptomatic denguelike disease. However, data from French Polynesia documented a concomitant epidemic of 73 cases of Guillain–Barré syndrome and other neurologic conditions in a population of approximately 270,000, which may represent complications of Zika. Of greater concern is the explosive Brazilian epidemic of microcephaly, manifested by an apparent 20-fold increase in incidence from 2014 to 2015, which some public health officials believe is caused by Zika virus infections in pregnant women. Although no other flavivirus is known to have teratogenic effects, the microcephaly epidemic has not yet been linked to any other cause, such as increased diagnosis or reporting, increased ultrasound examinations of pregnant women, or other infectious or environmental agents. Despite the lack of definitive proof of any causal relationship, some health authorities in afflicted regions are recommending that pregnant women take meticulous precautions to avoid mosquito bites and even to delay pregnancy. It is critically important to confirm or dispel a causal link between Zika infection of pregnant women and the occurrence of microcephaly by doing intensive investigative research, including careful case–control and other epidemiologic studies as well as attempts to duplicate this phenomenon in animal models.

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There are no Zika vaccines in advanced development, although a number of existing flavivirus vaccine platforms could presumably be adapted, including flavivirus chimera or glycoprotein subunit technologies. Zika vaccines would, however, face the same problem as vaccines for chikungunya, West Nile, St. Louis encephalitis, and other arboviruses: since epidemics appear sporadically and unpredictably, preemptively vaccinating large populations in anticipation of outbreaks may be prohibitively expensive and not cost-effective, yet vaccine stockpiling followed by rapid deployment may be too slow to counter sudden explosive epidemics. Although yellow fever has historically been prevented entirely by aggressive mosquito control, in the modern era vector control has been problematic because of expense, logistics, public resistance, and problems posed by inner-city crowding and poor sanitation. Among the best preventive measures against Zika virus are house screens, air-conditioning, and removal of yard and household debris and containers that provide mosquito-breeding sites, luxuries often unavailable to impoverished residents of crowded urban locales where such epidemics hit hardest.

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Through early epidemiologic surveillance and human challenge studies, Zika was characterized as a mild or inapparent denguelike disease with fever, muscle aches, eye pain, prostration, and maculopapular rash. In more than 60 years of observation, Zika has not been noted to cause hemorrhagic fever or death. There is in vitro evidence that Zika virus mediates antibody-dependent enhancement of infection, a phenomenon observed in dengue hemorrhagic fever; however, the clinical significance of that finding is uncertain.