Zika virus (ZIKV) izoliran je 1947. godine iz majmuna na području šume Zika u Ugandi. Do 2007. godine virus se održavao u enzootskom ciklusu na području Afrike uz sporadične humane slučajeve. Nakon epidemije 2007. godine na mikronezijskom otoku Yap bilježe se epidemije na pacifi čkim otocima, a 2015. godine virus je unesen u Brazil odakle se proširio Srednjom i Južnom Amerikom. U prirodnom se ciklusu ZIKV održava između majmuna i različitih vrsta komaraca roda Aedes. U urbanom su ciklusu rezervoar ljudi, a vektori komarci Ae. aegypti i Ae. albopictus. Interhumani prijenos moguć je transfuzijom krvi, presatkom organa, spolnim putem te sa zaražene majke na dijete transplacentno/tijekom poroda. U većine zaraženih osoba (~80 %), ZIKV infekcija prolazi asimptomatski. Klinički se infekcija u >95 % oboljelih očituje kao blaga bolest praćena subfebrilnom temperaturom, osipom, mialgijom, artralgijom te konjunktivitisom. Infekcija nastala tijekom trudnoće može rezultirati spontanim pobačajem ili kongenitalnim malformacijama (mikrocefalija). Najčešće opisana neurološka komplikacija je Guillain-Barreov sindrom. Dijagnostika se potvrđuje detekcijom ZIKV RNA ili ZIKV protutijela. Zbog mogućih križnih reakcija s ostalim fl avivirusima, inicijalno reaktivne rezultate testa ELISA potrebno je potvrditi neutralizacijskim testovima. Na području Hrvatske do sada je testirano ukupno 106 povratnika iz endemskih područja, od kojih je u tri potvrđena klinički manifestna ZIKV infekcija.Zika virus (ZIKV) was isolated in 1947 from a febrile rhesus monkey in the Zika forest, Uganda, and subsequently (1948) from Aedes africanus mosquitoes in the same region. First human cases were reported in 1952 in Uganda and Tanzania.until 2007, ZIKV was maintained in enzootic cycle within Africa with only sporadic human cases reported. After the outbreak on the Yap Island (Federated States of Micronesia) in 2007, several outbreaks were reported on the Pacifi c Islands (French Polynesia, New Caledonia, Cook Islands, Easter Island). In 2015, ZIKV was introduced in Brazil with further spreading across Central and South America. Comparing the pre-epidemic Asian and African lineage strains with the epidemic ZIKV strains, several amino acid substitutions were only present in the epidemic strains which could be associated with changes in virulence and the rapid spread of the virus. In a sylvatic cycle, ZIKV is transmitted between monkeys and different mosquito species of the genus Aedes. In an urban cycle, the virus is transmitted between humans through the bite of infected Aedes aegypti and less effi cient, Aedes albopictus mosquitoes. Some other modes of inter-human transmission have been demonstrated, including sexual transmission, blood transfusion/organ transplantation, transplacental and perinatal transmission. Although ZIKV RNA has been detected in breastmilk, transmission through breastfeeding has not been reported. The majority of infections (~80%) are asymptomatic. The main symptoms associated with ZIKV infection include fever, rash, myalgia, arthralgia and conjunctivitis. However, meningitis, encephalitis and myelitis have also been reported. Guillain-Barre syndrome is the most commonly reported neurological complication. ZIKV infection during pregnancy can result in spontaneous abortion or congenital ZIKV syndrome. The congenital abnormalities associated with maternal ZIKV
infection include microcephaly, intracerebral calcifi cations, ventriculomegaly and chorioretinal atrophy. Diagnosis of ZIKV includes direct (viral isolation, RT-PCR) and indirect (serology) methods. ZIKV RNA can be detected in blood, urine, saliva, semen and amniotic fl uid. Since cross-reactive antibodies with other fl aviviruses are commonly observed, especially with dengue virus, initially reactive results should be confirmed using neutralization tests. Due to similar clinical symptoms and geographical distribution, dengue and chikungunya should be included in the differential diagnosis of ZIKV infection. Many
importations of ZIKV infections have been reported in European countries since 2013. In Croatia, 106 travelers returning from endemic areas were tested so far. Clinically manifest ZIKV infection was serologically confi rmed in three patients
