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Zika Virus

The Zika virus is spread mostly by the bite of an infected Aedes species mosquito (Ae.aegypti and Ae.albopictus). These mosquitoes are aggressive daytime biters, but can also bite at night.

Zika virus can be transmitted from a pregnant woman to her fetus. Infection during pregnancy can cause certain birth defects such as microcephaly and other severe fetal brain defects.

Zika virus can also be transmitted through sexual contact, through laboratory exposure, and possibly by blood transfusion. To date, there are no reports of infants getting Zika virus through breastfeeding.

Local transmission of Zika virus has been documented in one U.S. state, Florida and three U.S. territories. The majority of the cases in the Continental U.S. have been in people who have traveled to areas with Zika and have brought back the virus with them.

There is no vaccine or medicine for Zika virus.

Women

For women who are pregnant, the U.S. Centers for Disease Control and Prevention (CDC) recommend not traveling to areas with Zika. http://www.cdc.gov/zika/geo/index.html

The CDC also recommends women who are trying to become pregnant avoid travelling to these areas. If they must travel to an area with Zika, women should wait at least 8 weeks after returning before trying to get pregnant.

It’s important for women who are thinking about getting pregnant, to talk to their healthcare provider about their decision, and the steps she can take to increase her chance of having a healthy pregnancy and baby. If traveling to an area with active Zika cases, pregnancy planning becomes essential.

BEFORE traveling to an area with Zika, talk with your healthcare provider about:

This table shows how long to wait after possible exposure to Zika before trying to get pregnant.

Suggested Timeframe to Wait Before Trying to Get Pregnant
Possible exposure via recent travel or sex without a condom with a partner infected with Zika:
  Women Men
  Wait at least 8 weeks after symptoms start or last possible exposure. Wait at least 6 months after symptoms start or last possible exposure.
People living in or frequently traveling to areas with Zika:
  Women Men
Positive Zika Test Wait at least 8 weeks after symptoms start. Wait at least 6 months after symptoms start.
No testing performed or negative test Talk with doctor or healthcare provider. Talk with doctor or healthcare provider.


If you are not thinking about getting pregnant or you decide that now is not the right time for a pregnancy, discuss ways to prevent unintended pregnancy with your healthcare provider, including all your birth control options. For a complete list of birth control options, click here.

Additional information about preconception health:

Men

Men have an equal say and responsibility in pregnancy planning. A man’s overall health, lifestyle choices and environmental toxins can affect his fertility and possible health of his future children. We know that a man with Zika, with or without symptoms, can pass the virus onto his female partner during sex putting a pregnancy at risk for birth defects.

Men who will be traveling, or who have traveled, to an area where Zika can be found, should talk to their healthcare provider about their risk of getting and spreading the virus to their female partner BEFORE trying to conceive. During this appointment, you will also want to discuss:

This table shows how long to wait after possible exposure to Zika before trying to conceive.

Suggested Timeframe to Wait Before Trying to Get Pregnant
Possible exposure via recent travel or sex without a condom with a partner infected with Zika:
  Women Men
  Wait at least 8 weeks after symptoms start or last possible exposure. Wait at least 6 months after symptoms start or last possible exposure.
People living in or frequently traveling to areas with Zika:
  Women Men
Positive Zika Test Wait at least 8 weeks after symptoms start. Wait at least 6 months after symptoms start.
No testing performed or negative test Talk with doctor or healthcare provider. Talk with doctor or healthcare provider.


We do not have a vaccine for the Zika virus, so men need to practice some basic prevention measures to protect themselves and their partners. These include:

  • Using condoms to reduce the chance of getting/spreading Zika from sexual activity. To be effective, condoms must be used correctly from start to finish, every time you have sex.
  • Take steps to prevent mosquito bites while in an area with Zika. This protects the couple and prevents further spread of the virus.
  • Even if they do not feel sick, travelers returning to the United States from an area with Zika should take steps to prevent mosquito bites for 3 weeks so they do not pass Zika to uninfected mosquitoes.
  • Additional information: Preconception Health for Men: www.cdc.gov/preconception/men.html

Providers

Zika virus continues to spread in multiple countries and territories. Local transmission of Zika virus from mosquitoes has been documented in the continental U.S., but the majority of cases have been confirmed in travelers returning from Zika-affected areas and in their sexual partners. Consequently, healthcare providers should be prepared to handle possible cases of the virus and advise patients' accordingly.

Zika virus disease is an emerging public health threat, and there are still things we don't know about the disease. For the average American who is not travelling to an affected area, Zika virus infection isn't a high risk. Based on current knowledge, the greatest risk for complications from Zika virus infection is to a pregnant woman's fetus. If a pregnant woman is infected with Zika virus, she can pass the virus to her fetus. Zika has been linked to cases of microcephaly and to other adverse pregnancy outcomes, including miscarriage and stillbirth.

There is no vaccine to prevent Zika virus infection or specific antiviral treatment available. However, there are some steps that healthcare providers can recommend to pregnant women and their partners or women who are planning pregnancy to reduce the possibility of infection.

What should I tell my patients about Zika virus?

  • Healthcare providers should know and discuss the transmission, signs, symptoms and possible complications of Zika virus infection with their patients.
  • Ask patients and their partners (especially pregnant women or women planning pregnancy) about their travel history or travel plans.
  • Advise pregnant women or women planning pregnancy to avoid areas with active Zika virus transmission. If they must travel, counsel them to strictly follow steps to avoid mosquito bites and prevent sexual transmission during and after the trip.
  • Advise pregnant women with a sex partner who has traveled to or lives in an area with active Zika virus transmission to use condoms or abstain from sex for the duration of the pregnancy to prevent Zika infection.
  • Healthcare providers should participate in the U.S. Zika Pregnancy Registry if the pregnant woman has laboratory evidence of Zika virus and also participate in the Utah Birth Defects Registry if delivering babies born with birth defects as a result of Zika virus infection.

Who should be evaluated for Zika virus testing?

  • All pregnant women in the U.S. and U.S. territories should be assessed for possible Zika virus exposure at each prenatal care visit.
  • Symptomatic Pregnant Women: Pregnant women who report signs or symptoms consistent with Zika virus disease (acute onset of fever, rash, arthralgia, conjunctivitis) should be tested for Zika virus infection.
  • Asymptomatic Pregnant Women: Testing recommendations for asymptomatic pregnant women with possible Zika virus exposure differ based on the circumstances of possible exposure (i.e., ongoing versus limited exposure) and the elapsed interval since the last possible Zika virus exposure).
  • Symptomatic and asymptomatic pregnant women who seek care >12 weeks after symptom onset or possible Zika virus exposure.
  • Differential diagnosis should also include dengue and chikungunya virus for patients with symptoms consistent with Zika virus disease.
  • Clinical Guidance for Healthcare Providers Caring for Pregnant Women (11/16/2016)
    http://www.cdc.gov/zika/hc-providers/pregnant-woman.html
  • Zika Screening Tool for Pregnant Women (11/16/2016)
    http://www.cdc.gov/zika/pdfs/zikapreg_screeningtool.pdf
  • Interactive Pregnancy & Zika Clinical Algorithm Available (12/10/2016)
    http://www.cdc.gov/zika/hc-providers/testing-for-zikavirus.html

What type of testing is recommended?

What type of testing/specimen collection is recommended at time of birth?

  • Testing of infants with possible congenital Zika virus infection who were born to mothers with possible exposure to Zika virus should be guided by 1) whether the infant had microcephaly or intracranial calcifications detected at birth and 2) the mother’s Zika virus testing results.
    • Possible exposure to Zika virus is defined by travel to or residence in an area of active Zika virus transmission or sex without a condom with a partner who traveled to or resided in an area of active transmission.
  • Diagnostic testing of infant serum, cord blood, placenta and/or umbilical cord specimens collected at birth is performed to identify cases of Zika virus infection and provide information for clinical care and management. Click here for Specimen Collection Requirements.
  • Visit, http://health.utah.gov/epi/diseases/zika/ for detailed information.

Where do I send the tests?

Zika virus testing for Utah residents is available through the Utah Public Health Laboratory and some commercial laboratories.

If testing is recommended and sent to the Utah Public Health Laboratory, please submit the Zika Test Request Form for UPHL.

For detailed information on testing:

Clinical Information

The Centers for Disease Control and Prevention recommend that healthcare systems (including urgent care, hospitals, physician offices, etc.) prepare for patients seeking a diagnosis and/or symptom management.

Zika Hospital Information Packet

Zika Provider Information Packet

Provider Toolkit for Pediatricians

Provider Toolkit for Obstetricians

Healthcare Exposure to Zika and Infection Control
https://www.cdc.gov/zika/hc-providers/infection-control.html

Measuring Infant Head Circumference: An Instructional Video for Healthcare Providers
https://www.youtube.com/watch?v=HWV1JdAhsSo

Congenital Zika Infection: Assessment and Follow up of Infant Hearing
https://www.cdc.gov/zika/hc-providers/infants-children/congenital-zika-infection.html

Zika Training for Healthcare Providers
View recorded webinars and on-demand trainings.
https://www.cdc.gov/zika/hc-providers/training/training.html

FAQs

For questions about Zika please refer to the following links:

CDC Website
http://www.cdc.gov/zika/about/questions.html

UDOH Epidemiology Website
http://health.utah.gov/epi/diseases/zika/

Zika and Sexual Transmission (pdf)

Resources

The Utah Birth Defect Network offers resources for Zika Virus Infection. Resources include materials from the Utah Zika Summit, MMWR Zika reports, educational materials, and the latest developments, updates and articles of interest.

Zika in the Clinical Setting

The Centers for Disease Control and Prevention recommend that healthcare systems (including urgent care, hospitals, physician offices, etc.) prepare for patients seeking a diagnosis and/or symptom management.

Zika Hospital Information Packet

Zika Provider Information Packet

Provider Toolkit for Pediatricians

Provider Toolkit for Obstetricians

Interactive Pregnancy & Zika Clinical Algorithm Available (12/10/2016)
http://www.cdc.gov/zika/hc-providers/testing-for-zikavirus.html

The American College of Obstetricians and Gynecologists Zika Tool Kit
http://www.acog.org/About-ACOG/ACOG-Departments/Zika-Virus/Zika-Toolkit

Healthcare Exposure to Zika and Infection Control
https://www.cdc.gov/zika/hc-providers/infection-control.html

Measuring Infant Head Circumference: An Instructional Video for Healthcare Providers
https://www.youtube.com/watch?v=HWV1JdAhsSo

Congenital Zika Infection: Assessment and Follow up of Infant Hearing
https://www.cdc.gov/zika/hc-providers/infants-children/congenital-zika-infection.html

Zika Training for Healthcare Providers
View recorded webinars and on-demand trainings.
https://www.cdc.gov/zika/hc-providers/training/training.html

Educational Materials

The Centers for Disease Control and Prevention recommend that healthcare systems (including urgent care, hospitals, physician offices, etc.) prepare for patients seeking a diagnosis and/or symptom management.

Utah Indian Health Advisory Board
Protect the Circle of Life!
Mosquito Prevention Starts with You

Mosquito Prevention and Protection use DEET
DEET Mosquito Card

Morbidity and Mortality Weekly Report (MMWR)

MMWR Zika Reports

The Centers for Disease Control and Prevention publishes weekly information containing data on specific diseases as reported by state and territorial health departments and reports on infectious and chronic diseases, environmental hazards, natural or human-generated disasters, occupational diseases and injuries, and intentional and unintentional injuries. Also included are reports on topics of international interest and notices of events of interest to the public health community.

http://www.cdc.gov/mmwr/zika_reports.html

What's New

Updates

Keep Up with What’s New from CDC Updates on Zika Virus
https://www.cdc.gov/zika/

Articles of Interest

December 18, 2016
Hard Time for Puerto Rico family of child with Zika defect
http://www.heraldextra.com/news/world/hard-times-for-puerto-rico-family-of-child-with-zika/article_da5c0238-27ba-515a-8d80-241b972f636c.html

December 7, 2016
Zika is no longer a global health emergency – it’s worse
http://www.undispatch.com/zika-no-longer-global-health-emergency-worse/

December 7, 2016
More data show Zika viremia in mothers, fetal infection link
http://www.cidrap.umn.edu/news-perspective/2016/12/more-data-show-zika-viremia-mothers-fetal-infection-link

December 6, 2016
Life After Zika: A Young Family Struggles to Care for Their Daughter
http://nymag.com/thecut/2016/12/after-zika-raising-baby-with-microcephaly.html

December 5, 2016
A Zika vaccine is being developed at warp speed, but will there be a market for it?
https://www.statnews.com/2016/12/05/zika-vaccine-development-market/

December 5, 2016
Fighting Zika 24-7
http://www.cdc.gov/zika/about/whatcdcisdoing.html

November 28, 2016
Zika Virus Arrives in South Texas
http://www.nbcnews.com/storyline/zika-virus-outbreak/zika-virus-arrives-south-texas-n689226

November 22, 2016
CDC, US and Brazilian researchers find evidence of onset of Zika-associated microcephaly and other neurologic complications after birth
https://www.cdc.gov/media/releases/2016/s1122-microcephaly-onset-after-birth.html

November 22, 2016
Antibody protects mice from Zika infection
https://www.nih.gov/news-events/nih-research-matters/antibody-protects-mice-zika-infection

November 14, 2016
Zika Infection in the U.S. Is Still Rare So Far, Blood Donations Indicate
http://www.nytimes.com/2016/11/15/health/zika-blood-bank-tests.html?WT.mc_id=SmartBriefs-Newsletter&WT.mc_ev=click&ad-keywords=smartbriefsnl&_r=1

November 8, 2016
Could Zika Virus Have Lasting Impact on Male Fertility?
https://directorsblog.nih.gov/2016/11/08/could-zika-virus-have-lasting-impact-on-male-fertility/

October 31, 2016
‘It’s a full-frontal attack’: Utah companies, universities continue Zika research
http://www.deseretnews.com/article/865666101/Its-a-full-frontal-attack-Utah-companies-universities-continue-Zika-research.html

October 26, 2016
Experts hope bacteria can beat Zika
http://www.heraldextra.com/news/world/experts-hope-bacteria-can-beat-zika/article_7710cbb0-19f6-5da2-af59-a25b5f73793e.html

October 13, 2016
CDC Working with Florida to respond to new active Zika transmission area in Miami-Dade County
https://www.cdc.gov/media/releases/2016/p1014-zika-transmission.html

October 11, 2016
Zika ‘syndrome’: Health problems mount as babies turn 1
http://www.heraldextra.com/news/world/zika-syndrome-health-problems-mount-as-babies-turn/article_2959454d-b19b-5883-bbfe-a3ac167bd757.html

October 5, 2016
The New England Journal of Medicine: 
Guillain-Barre’ Syndrome Associated with Zika Virus Infection in Columbia
http://www.nejm.org/doi/full/10.1056/NEJMoa1605564

October 2016
Culex Pipiens and Aedes Triseriatus Mosquito Susceptibility to Zika
http://wwwnc.cdc.gov/eid/article/22/10/16-1082_article

October 2016
Distinct Zika Virus Lineage in Salvador, Bahai, Brazil
http://wwwnc.cdc.gov/eid/article/22/10/16-0663_article

September 26, 2016
Zika Virus Damage Can Mislead Parents, Experts Say
http://www.nbcnews.com/storyline/zika-virus-outbreak/zika-virus-damage-can-mislead-parents-experts-say-n654181

September 26, 2016
Inside the Public Health Lab Zika Response: ‘It’s the Great Unknown as to How Much Longer This Will Go On’
http://www.aphlblog.org/2016/09/inside-the-public-health-lab-zika-response-its-the-great-unknown-as-to-how-much-longer-this-will-go-on

September 19, 2016
Officials Relax Zika Warning for Pregnant Women in Miami Neighborhood
http://www.nytimes.com/2016/09/20/us/officials-relax-zika-warning-for-pregnant-women-in-miami-neighborhood.html?_r=1

September 19, 2016
Is Another Zika Brewing in the Caribbean?
http://www.usnews.com/news/articles/2016-09-19/is-another-zika-brewing-in-the-caribbean

September 13, 2016
Finding compounds that inhibit Zika
https://www.nih.gov/news-events/nih-research-matters/finding-compounds-inhibit-zika

September 12, 2016
New CDC app for iOS and Android Devices: Family Planning Guidance for Healthcare Providers
https://content.govdelivery.com/accounts/USCDC/bulletins/162731d

September 6, 2016
Treating Zika Infection: Repurposed Drugs Show Promise
https://directorsblog.nih.gov/2016/09/06/treating-zika-infection-repurposed-drugs-show-promise/

August 29, 2016
NIH collaboration helps advance potential Zika treatments
https://www.nih.gov/news-events/news-releases/nih-collaboration-helps-advance-potential-zika-treatments

August 27, 2016
Weekly Address: Taking Action Against the Zika Virus
https://www.whitehouse.gov/the-press-office/2016/08/27/weekly-address-taking-action-against-zika-virus

August 24, 2016
Prolonged Shedding of Zika Virus Associated with Congenital Infection
http://www.nejm.org/doi/full/10.1056/NEJMc1607583?query=featured_home

August 24, 2016
Zika: Worse Than Thalidomide?
http://jama.jamanetwork.com/article.aspx?articleid=2546671

August 23, 2016
Vaccines protect monkeys against Zika infection
https://www.nih.gov/news-events/nih-research-matters/vaccines-protect-monkeys-against-zika-infection

August 17, 2016
Zika can be transmitted by blood transfusion, report confirms
http://www.ctvnews.ca/health/zika-can-be-transmitted-by-blood-transfusion-report-confirms-1.3032741

August 10, 2016
Study details possible link between Zika and severe joint condition
http://in.reuters.com/article/health-zika-joints-idINKCN10L09U?il=0

August 5, 2016
FDA approves Zika-fighting genetically modified mosquito
http://www.cnn.com/2016/08/05/health/fda-approve-gmo-mosquito-zika-florida/index.html

August 3, 2016
NIH begins testing investigational Zika vaccine in humans
https://www.nih.gov/news-events/news-releases/nih-begins-testing-investigational-zika-vaccine-humans

July 5, 2016
Zika Vaccine: Two Candidates Show Promise in Mice
https://directorsblog.nih.gov/2016/07/05/zika-vaccine-two-candidates-show-promise-in-mice/

July 5, 2016
NIH funds Zika virus study involving U.S. Olympic team
https://www.nih.gov/news-events/news-releases/nih-funds-zika-virus-study-involving-us-olympic-team

June 8, 2016
Wolbachia Blocks Currently Circulating Zika Virus Isolates in Brazilian Aedes aegypti Mosquitoes
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4906366/

May 19, 2016
Snapshots of Life: Portrait of Zika Virus
https://directorsblog.nih.gov/2016/05/19/snapshots-of-life-portrait-of-zika-virus/

April 11, 2016
‘Scarier than we initially thought’: CDC Sounds Warning on Zika Virus
http://www.usatoday.com/story/news/politics/2016/04/11/scarier-than-we-initially-thought-cdc-sounds-warning-zika-virus/82894878/

Utah Zika Summit Materials – September 1, 2016

The Utah Zika Summit was held at the Salt Lake City Sheraton on September 1, 2016. There were 120 participants from across the state, including Local Health Departments, Tribes, Hospital Liaisons, and Executive Leadership. Documentation from the Summit is attached.

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