Zika virus

Interim guidelines

Health Care workers should screen pregnant women considering traveling to Asia, Central America, South America, Caribbean, Mexico and Puerto Rico as Zika virus have been confirmed in these areas. Pregnant women who have travel to these areas and have symptoms consistent with Zika virus (acute onset of fever, maculopapular rash, arthralgia or conjunctivitis) during or within 2 weeks of travel should have a fetal ultrasound to identify fetal microcephaly or intracranial calcifications. Testing in consultation with local health and state agencies is recommended.  There is no specific antiviral treatment.

How do people get Zika?

Zika virus is transmitted by Aedes aegypti mosquitoes (also known as yellow fever mosquitoes) and by Aedes albopictus mosquitoes (also known as Asian tiger mosquitoes).  In the United States, the states with the highest risk are the states of Southeast United States, Arizona and part of Texas.  However, since 2011 there have been cases of Zika virus in California after mosquito bites.  Zika virus cannot be spread through casual contact such as touching, or kissing a person with the virus, or by breathing in the virus.

Prevention

What can people do to keep from getting Zika?

There is no vaccine to prevent Zika.  However, people need to protect themselves from mosquito bites.  The following preventive measures are recommended:

1. mosquito repellents containing DEET, picaridin, IR3535, and oil of lemon
eucalyptus should be applied to exposed skin and clothing.

2. Using insect repellent is safe and effective.  Pregnant women and women who
are breastfeeding can and should choose an EPA-registered insect repellent
and use it according to the product label.

3. wear long-sleeved shirts and long pants.

San Gabriel Valley at risk?

In the San Gabriel Valley basin, the Aedes aegypti mosquito (yellow mosquito) and Aedes albopictus (tiger mosquito) are found through out the area. However, in South El Monte, the tiger mosquito is prominent with the yellow mosquito found in East Los Angeles and Boyle Heights.

To prevent the breeding of these mosquitoes, clear all water basin and pools to prevent mosquito from thriving. Flower basins are gorgeous but act as a breeding ground for the yellow and tiger mosquito.

Invasive mosquitoes

Anyone who believes they have the yellow or tiger mosquitoes in their backyard, they should take action to remove them. These mosquitoes can be identified by their black and white colorations. They are aggressive biters.
If you need help with control of these mosquitoes, call the greater Los Angeles Vector control District at (562) 944-9656. You can find them on www.glavcd.org

Transmission

Zika virus is transmitted primarily through the bite of an infected mosquito. These are the same mosquitoes that spread dengue fever and chikungunya virus. These virus need standing water to lay their eggs. They prefer to bite people and live indoors and outdoors near people.

Rarely from mother to child
The severe effects of causing microcephaly (small head) is rare but there is limited data on what stage of pregnancy causes the most severe detrimental effects.

Breastfeeding

To date, there is no reports of transmission of the Zika virus through breastfeeding. There has been reports of the Zika virus transmissible through other bodily fluids such as semen and possibly blood, but for now breastfeeding is still recommended.

Prevention

What can people do to keep from getting Zika?

There is no vaccine to prevent Zika.  However, people need to protect themselves from mosquito bites.  The following preventive measures are recommended:

1. mosquito repellents containing DEET, picaridin, IR3535, and oil of lemon
eucalyptus should be applied to exposed skin and clothing.

2. Using insect repellent is safe and effective.  Pregnant women and women who
are breastfeeding can and should choose an EPA-registered insect repellent
and use it according to the product label.

3. wear long-sleeved shirts and long pants.

Blood transfusion

There is currently no literature on Zika virus transmission and blood transfusion. However, since Zika virus is an arbovirus and that other arbovirus have been reported to be transmitted by blood transfusion, the French Polynesia government did an investigation on blood donors and Zika virus detection during their outbreak (Musso_EuroSurveill_2014_19(14) Potential for Zika virus transmission through blood transfusion demonstrated during French Polynesia, November 2013 to February 2014). The investigators detected during their major outbreak from November 2013 to February 2014, that 42/1,505 blood samples were positive (2.8%). It is important, however, to date there are no reported cases of blood transfusion Zika virus transmission but vigilance is important. It is important to adapt blood donation safety procedures to local epidemiological correlation.

Who should get tested

How should be tested for Zika virus?

Testing is recommended for the following situations:

1.  Pregnant women with a history of travel to Zika-affected area AND:
– compatible symptoms (2 or more of the following: fever, maculopapular rash,
arthralgia, or non-purulent conjunctivitis) during or within 2 weeks of
travel
OR
– presence of fetal microcephaly or intracranial calcification on ultrasound

2. Children with microcephaly whose mother were in an affected area during their
pregnancy since the outbreak began in March 2015

3. Infants born to mothers with positive or inconclusive test results for Zika virus
infection

4. Non-pregnant patients with compatible symptoms and history of travel to a Zika
affected area

Testing is recommended for the following situations

a. Patients diagnosed with Guillain-Barre syndrome (GBS) with a history of travel
to a Zika-affected area may be tested. There have been reports of GBS in
patients following suspected Zika virus infection in other countries, however,
the relationship between Zika virus and GBS is uncertain at best