# Zika Virus Disease - Category: acute - Review status: reviewed (every claim checked against a document named on this page) - Sources: MSF Essential Drugs 2024 - paracetamol (oral) - Verified date: 2026-08 ## Verified against - MSF Essential Drugs 2024 - paracetamol (oral) - Zika Virus - disease-level clinical article (zika-virus-disease-clinical.txt) ## Treatment metadata - Paracetamol — 500 mg — oral.solid - Referral & safety-netting (no drug therapy) ## Complete treatment card ```text ZIKA VIRUS DISEASE Sources: MSF Essential Drugs 2024 - paracetamol (oral) Review status: REVIEWED against MSF Essential Drugs 2024 - paracetamol (oral), Zika Virus - disease- level clinical article (zika-virus-disease-clinical.txt) (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (4) - Most infections are silent or only mildly symptomatic - Rash, conjunctivitis, fever, and headache are the most common features, each seen in roughly half or more of patients [fever · headache · rash] - Joint pain, muscle pain, and pain behind the eyes are also common [joint pain · muscle pain] - Less often there is swelling, vomiting, and abdominal pain [abdominal pain · vomiting] SIGNS - what you find (5) - Conjunctivitis and a rash favor Zika over dengue or chikungunya, which share many other features [rash] - The rash has a flat-and-bumpy (maculopapular) pattern, and any fever tends to be mild and brief [fever · rash] - A full neurologic exam is recommended because Zika is a suspected trigger of Guillain-Barre syndrome - Inflammation of the spinal cord or brain has also turned up as a rare complication - Infection during pregnancy can cause congenital problems including microcephaly [dysmorphic features] TESTS (7) - Routine labs are usually normal, though white cells, platelets, and liver enzymes may be mildly affected - Testing is recommended for anyone with Zika exposure who has symptoms - Pregnant women with Zika exposure should be tested even without symptoms - An abnormal fetal ultrasound suggestive of Zika effects is also an indication to test - Zika testing is built into routine prenatal visits at booking and again in the second trimester for exposed women - Test choice depends on how long symptoms have lasted (under or over 14 days) and on pregnancy status - PCR and antibody testing are used to detect the infection IF NOT THIS - what else fits (4) - Dengue is a key differential given the overlapping symptoms - Chikungunya virus infection presents similarly - Malaria should be excluded, especially with a relevant travel history - Yellow fever is also on the differential Source StatPearls "Zika Virus" - disease-level clinical article Status traced to the source above 1. PARACETAMOL [1st line] Adult 1 g three or four times daily, maximum 4 g in 24 hours - As needed for pain or fever Peds 15 mg/kg/dose [child max 500 mg] (Child 1 month and over: 15 mg/kg per dose, 3 or 4 times daily, maximum 60 mg/kg daily. Child under 1 month: 10 mg/kg per dose, 3 or 4 times daily, maximum 40 mg/kg daily. MSF's own weight table gives one 500 mg tablet three times daily from 30 kg to under 50 kg, so 500 mg is the per-dose ceiling; the 60 mg/kg daily total still applies.) 3kg -> 45 mg/dose 4kg -> 60 mg/dose 5kg -> 75 mg/dose 6kg -> 90 mg/dose 7kg -> 105 mg/dose 8kg -> 120 mg/dose 9kg -> 135 mg/dose 10kg -> 150 mg/dose 11kg -> 165 mg/dose 12kg -> 180 mg/dose 13kg -> 195 mg/dose 14kg -> 210 mg/dose 15kg -> 225 mg/dose 16kg -> 240 mg/dose 17kg -> 255 mg/dose 18kg -> 270 mg/dose 19kg -> 285 mg/dose 20kg -> 300 mg/dose 21kg -> 315 mg/dose 22kg -> 330 mg/dose 23kg -> 345 mg/dose 24kg -> 360 mg/dose 25kg -> 375 mg/dose 26kg -> 390 mg/dose 27kg -> 405 mg/dose 28kg -> 420 mg/dose 29kg -> 435 mg/dose 30kg -> 450 mg/dose 31kg -> 465 mg/dose 32kg -> 480 mg/dose 33kg -> 495 mg/dose 34kg -> 500 mg/dose (capped) 35kg -> 500 mg/dose (capped) 36kg -> 500 mg/dose (capped) 37kg -> 500 mg/dose (capped) 38kg -> 500 mg/dose (capped) 39kg -> 500 mg/dose (capped) 40kg -> 500 mg/dose (capped) 41kg -> 500 mg/dose (capped) 42kg -> 500 mg/dose (capped) 43kg -> 500 mg/dose (capped) 44kg -> 500 mg/dose (capped) 45kg -> 500 mg/dose (capped) 46kg -> 500 mg/dose (capped) 47kg -> 500 mg/dose (capped) 48kg -> 500 mg/dose (capped) 49kg -> 500 mg/dose (capped) 50kg -> 500 mg/dose (capped) Source MSF Essential Drugs 2024 - paracetamol (oral) Why Symptomatic relief of the pain and fever only. It does not treat the cause, and the dose is the same whatever the cause is. Caution Not endemic in Egypt. Relevant to a returning traveller; check the travel history. Relief only - it does not treat what is causing the pain or fever. Check every other product the patient is taking for paracetamol; combination cold and flu preparations are the usual route to an accidental overdose. Reduce the dose in significant liver disease, chronic alcohol use, or low body weight. RED FLAG - A pregnant patient with possible exposure needs urgent referral because of the fetal microcephaly risk; high fever with a bleeding tendency means excluding dengue or chikungunya before assuming Zika; and limb weakness after the illness suggests Guillain-Barre syndrome. Egypt FEBRIMOL 500 MG 20 TAB. PHARCO 3.50 EGP (0.17/unit) CETAMOL 500 MG 20 TABS. MEMPHIS 8.00 EGP (0.40/unit) PARACETAMOL-MUP 500MG B.P. 20 TABS. MUP 13.00 EGP (0.65/unit) CETAL 500 MG 20 TABS. EIPICO 24.00 EGP (1.20/unit) ARKADOLOW 500 MG 30 F.C. TABS. UTOPIA 42.00 EGP (1.40/unit) PARAMOL 500MG 20 TAB. MISR 38.00 EGP (1.90/unit) ADOL 500MG 24 CAPLETS JULPHAR 32.00 EGP AUGICETAMIDE 500 MG 20 SACHETS AUG PHARMA 50.00 EGP FEBRIMOL ORAL DROPS 20 ML PHARCO 4.00 EGP -> ? strength differs, ? different route - not oral solid THERA-LO 3.2G/100ML ORAL SUSP. 100 ML PHAROPHARMA 5.00 EGP -> ? strength differs, ? different route - not oral solid 2. REFERRAL & SAFETY-NETTING (NO DRUG THERAPY) [1st line] Adult Source Zika Virus - disease-level clinical article (zika-virus-disease-clinical.txt) Why Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen. Caution RED FLAG - Aspirin and NSAIDs are explicitly advised against if dengue fever is a possible differential due to hemorrhage and Reye syndrome risk. RED FLAG - Pregnancy complications (congenital Zika syndrome, microcephaly, brain and ocular malformations) require specialized care. Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)