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PubMed This is a summary of 24 peer-reviewed journal articles Updated
Infectious Disease · Zika Virus

Zika Symptoms and Potential Complications

At a Glance

Zika virus often causes mild symptoms like a slight fever, joint pain, red eyes, and a spotted rash. However, it can lead to severe neurological complications, including Guillain-Barré syndrome in adults and microcephaly or other severe brain defects in infants if a pregnant person is infected.

While many people infected with the Zika virus will have no symptoms at all, for others, the infection can lead to specific physical signs or, in rarer cases, more serious neurological and developmental conditions.

The Acute Phase: What to Expect

If you do develop symptoms after being bitten by an infected mosquito, they are usually mild and last for several days to a week [1]. Symptoms typically appear within two weeks of exposure [2].

The “classic” presentation of Zika includes:

  • Low-Grade Fever: A mild elevation in temperature [1].
  • Maculopapular Rash: A red rash characterized by both flat spots (macules) and small raised bumps (papules) [1].
  • Arthralgia: Pain in the joints, particularly in the small joints of the hands and feet [1][3].
  • Conjunctivitis: Redness of the eyes, often described as “pink eye” without the discharge or “goop” usually associated with bacterial infections [1].

Because these symptoms are very similar to other tropical viruses like Dengue and Chikungunya, laboratory testing is the only way to confirm a Zika diagnosis [4][5].

Guillain-Barré Syndrome (GBS)

In a small number of adults, Zika can trigger Guillain-Barré Syndrome (GBS) [6]. This is a rare but serious neurological condition where the body’s immune system mistakenly attacks its own nerves [7].

Researchers believe this happens through molecular mimicry, where the immune system confuses parts of the virus with parts of the nervous system [8][9].

  • Presentation: GBS usually starts as a tingling sensation or weakness in the legs that can spread upward to the arms and upper body [10].
  • Severity: In some cases, it can cause difficulty swallowing or breathing, requiring hospital care [10][11].
  • Risk: While the risk is low, older individuals may have a slightly higher chance of developing GBS following a Zika infection [6].

Congenital Zika Syndrome (CZS)

When Zika is passed from a pregnant person to a fetus, it can cause Congenital Zika Syndrome (CZS) [12]. This is a specific pattern of birth defects that occurs because the virus is neurotropic, meaning it specifically seeks out and attacks nerve tissue [13][14].

How Zika Affects the Developing Brain

The virus specifically targets the “seed cells” that are supposed to divide and grow to form the baby’s brain [15]. Zika interferes in two main ways:

  1. It causes these critical cells to die prematurely before they can form brain tissue [16][17].
  2. It stops the remaining cells from growing into mature, functioning nerve cells [16][18].

The Result: Microcephaly and Beyond

The most well-known sign of CZS is microcephaly, where a baby’s head is significantly smaller than expected because the brain did not grow properly during pregnancy [19][20]. However, CZS involves more than just head size. Other features include:

  • Intracranial Calcifications: Hardened calcium deposits in the brain tissue where the virus caused damage [21][22].
  • Brain Atrophy: A loss of brain volume or “shrinking” of the brain structure [22].
  • Ocular Abnormalities: Damage to the retina or optic nerve that can cause permanent vision loss [23][24].
  • Hypertonia: Excessive muscle tension that makes it difficult for the baby to move their limbs [22].

For more on managing these conditions, see Medical Management and Long-Term Care.

Common questions in this guide

What are the early signs of a Zika infection?
Early signs of Zika are usually mild and appear within two weeks of exposure. They frequently include a low-grade fever, a red rash with flat spots and raised bumps, joint pain, and red eyes without discharge.
How can I tell if I have Zika, Dengue, or Chikungunya?
Because the symptoms of Zika, Dengue, and Chikungunya are very similar, you cannot tell the difference based on symptoms alone. Laboratory testing is the only way to confirm exactly which virus is causing your illness.
Can Zika virus cause Guillain-Barré Syndrome?
Yes, in a small number of adults, Zika can trigger Guillain-Barré Syndrome (GBS). This rare neurological condition happens when the immune system mistakenly attacks the body's nerves, often starting as a tingling sensation or weakness in the legs that spreads upward.
How does Zika affect a developing baby during pregnancy?
If passed to a fetus during pregnancy, the Zika virus can cause Congenital Zika Syndrome (CZS). The virus specifically attacks developing brain cells, which can lead to microcephaly (a smaller than expected head size), vision loss, and other severe neurological abnormalities.

Questions to Ask Your Doctor

Curated prompts to bring to your next appointment.

  1. 1.If I developed symptoms after traveling, what are the chances this is Dengue or Chikungunya instead of Zika?
  2. 2.What specific signs of Guillain-Barré Syndrome should I be watching for in the coming weeks?
  3. 3.Can you explain how we will monitor my baby's brain development throughout the pregnancy?

Questions For You

Tap a prompt to share your answer — we'll use it plus this page's context to start a tailored conversation.

References

References (24)
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    Postnatally Acquired Zika Virus Disease Among Children, United States, 2016-2017.

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    Travel-Associated Zika Virus Disease Cases Among U.S. Residents--United States, January 2015-February 2016.

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This page provides information on Zika virus symptoms and complications for educational purposes only. Always consult a healthcare provider for an accurate diagnosis, especially if you experience neurological symptoms or are pregnant.

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