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Zika virus infection
The Zika virus is a mosquito-borne flavivirus transmitted primarily by Aedes species mosquito (Aedes aegypti and Aedes Albopictus). These mosquitoes that are aggressive biters during the day but also bite at night. An estimated 80% of persons infected with Zika virus have no symptoms.
Symptoms are usually mild and include acute onset of fever, and maculopapular rash, arthralgia, or conjunctivitis for several days to a week. Severe disease requiring hospitalization is uncommon and fatalities are rare. Currently, no vaccine or medication is available to prevent or treat Zika virus infection.
Outbreaks, cases and transmission
Zika outbreaks are occurring in multiple countries. In 2015, the first local Zika virus transmission in the Americas was reported in Brazil and local transmission has now been in several countries or territories in the Americas. (See world map and list of countries.)
Cases in the United States:
As of August 2, 2017 in US Territories, there have been more than 37,007 cases of Zika- the majority were locally acquired from mosquitos. In the US States, there have been 5,381 cases of Zika – the majority were travel-associated cases and 224 cases were locally acquired from mosquitos.
Travelers
Travelers to areas with ongoing Zika virus transmission and outbreaks are at risk of becoming infected and spreading the virus to new areas. The recent cases in Florida were not unexpected because imported cases may result in local spread of the virus in some areas where there are Aedes species mosquito. This happens when people infected with Zika virus infect mosquitoes that bite them and the mosquitos transmit the virus to others.
Clinicians- reporting, lab testing
A blood or urine test can confirm a Zika infection. Healthcare providers are encouraged to report suspected Zika virus disease cases to their state health department to facilitate diagnosis and to mitigate the risk of local transmission. CDC has provided guidance and training materials for clinicians and healthcare providers for evaluation, testing and clinical care of pregnant women, women of childbearing age, infants/children; guidance to prevent sexual transmission; and guidance for diagnostic testing.
Pregnant women
CDC is recommending that pregnant women consider postponing travel to any area where Zika virus transmission is ongoing. Pregnant women who do travel to these areas should talk to their doctors or other healthcare providers first and strictly follow steps to avoid mosquito bites during the trip. Women trying to become pregnant should consult with their healthcare providers before traveling to these areas and strictly follow steps to avoid mosquito bites during the trip and throughout the day, as the Aedes mosquitoes bite mostly during the daytime.
Key resources
Webinars
- 2017 CDC Zika webinar summaries and slide sets
- Zika Virus: Updates to Clinical Guidance and Recommendations for Pregnant Women and Infants July 27, 2017
- Zika Update: Findings from the U.S. Zika Pregnancy Registry and Updated Clinical Guidance May 4, 2017.
- Gearing up for the Travel Season: How clinicians can ensure their patients have knowledge on Zika (Dec 8th, 2016) Summaries and slide sets available
- CDC. Zika in the ED: How Emergency Care Staff can Take Action (on demand from November 1, 2016)
Identifying people at risk, screening protocols, key assessment, interventions and reporting. Audio/slides - Zika Update: Clinical Laboratory Testing and Care of Infants with Congenital Zika Virus Infection (on demand from August 23, 2016)
Call info, audio/slides - CDC. Clinical guidance for Pregnant Women- (on demand from August 9, 2016)
Updated Interim Zika Clinical Guidance for Pregnant Women and Data on Contraceptive Use to Decrease Zika-affected Pregnancies. Call info or audio/slides after call - Zika Virus Disease_ What you need to know (on demand from April 8, 2016)
Speakers Joanne Cono MD- CDC, Jeanne Sheffield MD -Johns Hopkins, Gina Pugliese RN MS Premier Safety Institute discuss epidemiology, lab diagnosis, travel, issues for reproductive age and pregnant women (evaluation, counseling, management, congenital findings) and implications for healthcare personnel
Slides/audio - For other CDC ZIKA webinars on demand, visit emergency.cdc.gov/coca/calls/index.asp.
CDC Health Advisories-Alerts
- CDC: Update: Interim Guidance for Health Care Providers Caring for Pregnant Women with Possible Zika Virus Exposure — United States (7-28-17)
- CDC Guidance for Travel and Testing of Pregnant Women and Women of Reproductive Age for Zika Virus Infection Related to the Investigation for Local Mosquito-borne Zika Virus Transmission in Miami-Dade and Broward Counties, Florida (8-1-16)
Communication
- CDC communication planning guide (3-25-16)
Location of Zika infections
Traveler health precautions
- CDC Guidance for living in or traveling to Florida (8-1-16)
- Travelers’ Health: Practice enhanced precautions (7-27-16)
Prevention
- Prevention – general (8-1-16)
Pregnant women
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CDC Update: Interim Guidance for Health Care Providers Caring for Pregnant Women with Possible Zika Virus Exposure 7-29-16
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CDC. Updated interim pregnancy guidance: Testing and interpretation recommendations for a pregnant woman with possible exposure to Zika virus — United States ALGORITHM 7-28-16
- CDC Guidance for Travel and Testing of Pregnant Women and Women of Reproductive Age for Zika Virus Infection Related to the Investigation for Local Mosquito-borne Zika Virus Transmission in Miami-Dade and Broward Counties, Florida (8-1-16)
- Pregnant women (2-19-16)
- Interim Guidelines for Pregnant Women During a Zika Virus Outbreak (1-22-16)
About Zika virus
- Q and A about Zika (2-12-16)
Prevention of sexual transmission: men and their partners
Mosquito control
Hospital – clinic care settings
- CDC. Key Zika considerations for healthcare settings (8-22-16)
- CDC Labor and Delivery– Preventing transmission in labor and delivery settings with standard precautions (3-22-16)
Testing (blood, urine) and Diagnosis
- CDC. Updated interim pregnancy guidance: Testing and interpretation recommendations for a pregnant woman with possible exposure to Zika virus — United States 7-28-16
- CDC. Testing of blood and urine and diagnosis (6-21-16)
Clinicians – healthcare providers
- OSHA Interim Guidance for Protecting Workers from Occupational Exposure to Zika Virus (4-10-16)
- Clinical Guidance and Testing
- CDC Facts About Microcephaly (2-12-16)
- CDC Interim Guidelines for Pregnant Women During a Zika Virus Outbreak (1-22-16)
- CDC updated interim guidelines for caring for infants and children with possible Zika (2-19-15)
- CDC Interim Guidelines for the Evaluation and Testing of Infants with Possible Congenital Zika Virus Infection – United States, 2016 (1-29-16)
- CDC Questions and Answers for Healthcare Providers Caring for Pregnant Women and Women of Reproductive Age with Possible Zika Virus Exposure (2-9-16)
- CDC Questions and Answers for Pediatric Healthcare Providers: Infants and Zika Virus Infection (2-19-16)
Transmission
Response to Local Transmission
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CDC. Zika Community Action Response Toolkit (8-1-16)
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CDC Interim response plan for local transmission in Continental U.S. and Hawaii, June 2016
Resources
State and local public health laboratories
- Diagnostic testing guidance body fluids, tissue (7-25-16)
Blood Supply
- FDA – Reducing risk for Zika virus blood transmission in the U.S. (2-16-16)