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Chan JFW, Choi GKY et al. J Infect 2016; 72: 507–524

Zika was discovered in Uganda almost 60 years ago. Then there was a massive epidemic in the Pacific islands between 2007 and 2013. There is now the outbreak in Latin America. This latest occurrence maybe associated with the congenital Zika syndrome. Zika fever is usually low grade fever with a generalised, erythematous, maculopapular rash that spreads downward from the face to the limbs. It usually resolves within 3-7 days. But sometimes the symptoms are severe with digestive tract (including aphthous [-like] ulcers), genito-urinary symptoms and severe neurological complication (Guillain-Barré syndrome). Congenital Zika syndrome may comprise a host of different conditions such as microcephaly and resulting redundant scalp skin, neurological abnormalities, including absence of swallowing, and ophthalmological defects, including cataracts and asymmetrical eye sizes. But there is no large-scale prospective cohort or case control study demonstrating a causal link between the presence of ZIKV in the foetus and congenital anomalies, after exclusion of other infectious conditions such as rubella and herpes simplex (TORCH infections), and possibly even a larvicide.