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Friday, February 26, 2016

Zika virus, updates from Center for Disease Control (CDC)

Questions About Zika: The CDC Answers

(One of the best articles about how to control the dengue fever and the mosquito that carries Zika is in this article:
"The Mosquito Solution" by Michael Spectre
Denise Jamieson, MD, MPH
I've cut and pasted here because many of us have young granddaughters. I hope this information from Centers for Disease Control (CDC) is helpful.
Zika Virus
What Is Zika Virus?
Zika is a disease caused by Zika virus, which is spread to humans primarily through the bite of an infected Aedes species mosquito. The Zika virus is closely related to dengue, yellow fever, Japanese encephalitis, and West Nile viruses.
Other Than Through Mosquito Bites, How Can Zika Virus Be Transmitted?
Although Zika virus is primarily transmitted through the bite of infected Aedes mosquitoes, there are several other modes of transmission: maternal/fetal, intrauterine, perinatal, blood transfusions, organ donations and sexual transmissions

Where Did the Zika Virus Come From?
In 1947, Zika virus was first found in a monkey in Uganda. Before 2007, only sporadic human disease cases were reported in Africa and Southeast Asia, although additional cases were likely to have occurred and were not reported. In 2007, the first outbreak of Zika was reported on Yap island, Federated States of Micronesia. A subsequent outbreak occurred in French Polynesia in 2013-2014, with more than 28,000 suspected Zika virus infections reported.

Brazil reported the first Zika case in the Americas in 2015. Since that time, the virus has spread, and outbreaks are currently occurring in many countries and territories in the Americas, including the Commonwealth of Puerto Rico and the US Virgin islands.

What Are the Symptoms and Diagnosis of Zika?
About 1 in 5 people infected with Zika virus will get sick. For those who are symptomatic, symptoms are typically mild and self-resolving; for this reason, most people will not realize they have been infected.

The most common symptoms of Zika virus are fever, rash, joint pain, or conjunctivitis. Symptoms typically begin 2 -7 days after being bitten by an infected mosquito.

Severe disease requiring hospitalization is uncommon. Fatalities caused by Zika virus are rare.

Zika virus usually remains in the blood of an infected person for about a week, but it can be found longer in some people. During the first week after onset of symptoms, Zika virus disease can often be diagnosed by performing reverse-transcriptase polymerase chain reaction (RT-PCR) on serum (aka "blood test").

Currently, no vaccine or medication exists to prevent to treat Zika virus infection.  There are no commercially available diagnostic tests for Zika virus disease.

What Can People Do to Prevent Becoming Infected With Zika?There is no vaccine to prevent or medicine to treat Zika. Educate patients who will be traveling to endemic areas.

The best way to prevent disease spread by mosquitoes is to adhere to the recommendations below.

Recommendations for Adult Men and Women

  1. Wear long-sleeved shirts and long pants.
  2. Stay in places with air conditioning or that use window and door screens to keep mosquitoes outside.
  3. Sleep under a mosquito bed net if temperature-controlled or screened rooms are not available or if sleeping outdoors.
  4. Use Insect Repellents
When used as directed, insect repellents are proven safe and effective even for pregnant and breastfeeding women. A list of Environmental Protection Agency (EPA)-registered products is available online.
Always follow the product label instructions.
Reapply insect repellent as directed.
Do not spray repellent on the skin under clothing.
If you are also using sunscreen, apply sunscreen before applying insect repellent.

If You Have a Baby or Child
  • Do not use insect repellent on babies younger than 2 months of age.
  • Dress your child in clothing that covers arms and legs, or
  • Cover crib, stroller, and baby carrier with mosquito netting.
  • Do not apply insect repellent onto a child's hands, eyes, mouth, and cut or irritated skin.
  • Adults: Spray insect repellent onto your hands and then apply to a child's face.
  • Treat Clothing and Gear With Permethrin, or Buy Permethrin (insecticide)-Treated Items
Treated clothing remains protective after multiple washings. See product information to learn how long the protection will last.
If treating items yourself, follow the product instructions carefully.
Do NOT use permethrin products directly on skin. They are intended to treat clothing.

Does Zika Virus Infection in Pregnant Women Cause Birth Defects?
There have been multiple reports of microcephaly and other poor pregnancy outcomes in babies of mothers who were infected with Zika virus while pregnant. Knowledge of the link between Zika and these outcomes is evolving, but until more is known, CDC recommends special precautions for the following groups:
  1. Pregnant women (in any trimester)
  2. Counsel pregnant women to consider postponing travel to any area where Zika virus transmission is ongoing.
  3. If pregnant women must travel to one of these areas, advise them to strictly follow steps to prevent mosquito bites during the trip.
  4. If a woman has a male partner who lives in or has traveled to an area where Zika is spreading, advise her to either abstain from sex or use condoms consistently and correctly for the duration of the pregnancy.
Women who are trying to become pregnant
  1. Talk to your female patients about their plans to become pregnant and the risk for Zika virus infection.
  2. Advise women and their male partners to strictly follow steps to prevent mosquito bites.
Recommendations for Pregnant Women Considering Travel to an Area of Zika Virus Transmission

Counsel pregnant women to:
Postpone travel to areas where Zika virus transmission is ongoing
Strictly follow steps to avoid mosquito bites

No specific antiviral treatment is available for Zika virus disease. Treatment is generally supportive and can include rest, fluids, and use of analgesics and antipyretics. Because of similar geographic distribution and symptoms, patients with suspected Zika virus infections also should be evaluated and managed for possible dengue or chikungunya virus infection.

Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) should be avoideduntil dengue can be ruled out, to reduce the risk for hemorrhage. People infected with Zika, chikungunya, or dengue virus should be protected from further mosquito exposure during the first few days of illness to prevent other mosquitoes from becoming infected and reduce the risk for local transmission.

Diagnosis and Reporting
Preliminary diagnosis is based on the patient's clinical features, places and dates of travel, and activities. Laboratory diagnosis is generally accomplished by testing serum or plasma to detect virus, viral nucleic acid, or virus-specific immunoglobulin M and neutralizing antibodies

As an arboviral disease, Zika virus is a nationally notifiable condition. Healthcare providers are encouraged to report suspected cases to their state or local health departments to facilitate diagnosis and mitigate the risk for local transmission. State or local health departments are encouraged to report laboratory-confirmed cases to CDC through ArboNET, the national surveillance system for arboviral disease.

What Is CDC Doing About Zika?
CDC has been aware of Zika for some time and has been preparing for its possible introduction into the United States.Laboratories in many countries have been trained to test for chikungunya and dengue. These skills have prepared these laboratories for Zika testing.

CDC is working with international public health partners and with state health departments to

  • Alert healthcare providers and the public about Zika;
  • Post travel notices and other travel-related guidance;
  • Provide state health laboratories with diagnostic tests; and
  • Detect and report cases, which will help prevent further spread.
The arrival of Zika in the Americas demonstrates the risks posed by this and other exotic viruses. CDC's health security plans are designed to effectively monitor for disease, equip diagnostic laboratories, and support mosquito control programs both in the United States and around the world.

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