Latest on Zika in the United States

As the Zika virus continues to spread, the CDC remains the primary source for information regarding updated guidelines on testing for those people who have had potential exposure. Currently in the United States, the only reported cases of mosquito-transmitted cases of Zika have occurred in the state of Florida. In August of this year, mosquito-transmitted Zika was identified in both the Wynwood neighborhood of Miami and a 4.5 square mile area of Miami Beach, Florida. While it has been determined that active Zika virus transmission is no longer ongoing in the Wynwood neighborhood, pregnant women should avoid travel to the identified 4.5-square-mile area of Miami Beach.  Furthermore, pregnant women and partners of pregnant women may consider postponing travel to all parts of Miami-Dade County, including areas without identified active transmission. For areas outside of the U.S. where there is active mosquito-transmission of Zika, please visit the CDC’s website.

Testing is strongly advised for anyone who has traveled to an area with mosquito-transmitted Zika and has developed symptoms. Testing should be done within 14 days of symptom onset. Testing is also recommended for pregnant women without symptoms who have traveled to a country on the Zika list. If no symptoms have developed, testing should be done between 2-12 weeks after leaving the area of potential exposure.

If patients meet the CDC’s testing criteria, Zika Virus testing can be completed through the state’s Viral & Rickettsial Disease Laboratory (VRDL) at no cost to the patient. Blood and/or urine samples are collected in our office and then sent out to the lab. Results are available approximately 4 weeks from the time of specimen collection. Zika Virus testing is now also being offered by several commercial laboratories, such as Lab Corp and Quest Diagnostics. While commercial labs are not able to perform confirmatory testing yet, they do provide a convenient option for qualitative detection of Zika virus IgM antibodies in 2-3 days.  If Zika virus antibodies are detected through a commercial test, they will be sent to the CDC for confirmatory testing.

As discussed in previous blogs, Zika virus is transmitted through the bite of an infected Aedes species mosquito – the same type of mosquito that spreads Dengue and Chikungunya. Common symptoms of Zika include fever, joint pain, conjunctivitis, muscle pain, rash, and headache. However, in some cases no symptoms develop. Zika virus infection during pregnancy is a cause of microcephaly and other severe fetal brain defects and has been linked to problems in infants, including eye defects, hearing loss, and impaired growth. Zika has also been linked to Guillain-Barré syndrome (GBS), which affects the nervous system causing muscle weakness, and sometimes, paralysis

If you meet the testing criteria (or have questions about whether you meet testing criteria), and would like Zika virus testing, please contact me at (415) 831-2198 or by e-mail via our secured patient portal (Judith Ball, OB Coordinator) at your earliest convenience.

 

 

PREGNANT WOMEN COUPLES TRYING TO CONCEIVE ALL TRAVELERS
GUIDANCE Travel to Zika transmission areas should be postponed in all trimesters. Travel to Zika transmission areas should be postponed.
 

 

 

If a pregnant woman has a partner who lives in or has traveled to an area with Zika, she should use a condoms or other barrier protection every time she has sex or should not have sex with that partner for the duration of her pregnancy.

Women (if symptomatic) should wait to attempt conception at least 8 weeks after their symptoms first appeared or last possible date of exposure (if asymptomatic).

 

Men should wait to attempt to get their partner pregnant for at least 6 months from symptom onset (if symptomatic) or last possible exposure (if asymptomatic).

 

All travelers to areas of active Zika transmission should be strictly adhering to mosquito bite precautions (i.e. wearing long-sleeve shirts and long pants, and using EPA-registered insect repellents that contain active ingredients such as DEET or Picaridin).

 

TESTING Symptomatic pregnant women should be tested within 14 days of symptom onset.

Asymptomatic pregnant women with exposure to should be tested within 2-12 weeks after the last date of possible exposure.

The CDC does not recommend Zika virus testing for couples interested in attempting conception in which one or both partner has had possible exposure to Zika virus.

 

***Testing can still be done through commercial labs.***

 

CDC recommends Zika virus testing for all people who may have been exposed to Zika through sex and who have symptoms consistent with Zika virus infection.

 

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