The Centers for the Disease Control has issued an official health advisory on recognizing, managing and reporting Zika virus infections, the V.I. Department of Health reported Tuesday.
Acting Health Commissioner Juan Figueroa-Serville released a summary of the advisory.
The World Health Organization in May reported the first local transmission of Zika virus in the Western Hemisphere, with locally acquired cases identified in Brazil. As of Jan. 15, local transmission had been identified in at least 14 countries or territories in the Americas, including Puerto Rico. Further spread to other countries in the region is likely, according to the summary.
Local transmission of Zika virus has not yet been documented in the continental United States or in the U.S. Virgin Islands. With the recent outbreaks in the Americas, the number of Zika virus disease cases among travelers visiting or returning to the United States likely will increase.
The CDC said Zika virus infection should be considered in patients with acute onset of fever, maculopapular rash, arthralgia or conjunctivitis who traveled to areas with ongoing transmission in the two weeks prior to illness onset. Clinical disease usually is mild.
However, during the current outbreak, Zika virus infections have been confirmed in several infants with microcephaly and in fetal losses in women infected during pregnancy.
"We do not yet understand the full spectrum of outcomes that might be associated with infection during pregnancy, nor the factors that might increase risk to the fetus. Additional studies are planned to learn more about the risks of Zika virus infection during pregnancy," the CDC summary said.
Health officials encouraged care providers to report suspected Zika virus disease cases to the Department of Health to facilitate diagnosis and to mitigate the risk of local transmission. State health departments are requested to report laboratory-confirmed cases to CDC. CDC is working with states to expand Zika virus laboratory testing capacity, using existing RT-PCR protocols.
The CDC health advisory includes information and recommendations about Zika virus clinical disease, diagnosis, and prevention, and provides travel guidance for pregnant women and women who are trying to become pregnant. Until more is known, pregnant women should consider postponing travel to any area where Zika virus transmission is ongoing, the CDC said.
Pregnant women who do travel to these areas should talk to their doctors or other health care providers first and strictly follow steps to avoid mosquito bites during the trip.
Women trying to become pregnant should consult with their health care providers before traveling to these areas and strictly follow steps to avoid mosquito bites during the trip, the medical center added.
The CDC advisory included the following advice.
TREATMENT
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 non-steroidal anti-inflammatory drugs should be avoided until dengue can be ruled out to reduce the risk of hemorrhage. In particular, pregnant women who have a fever should be treated with acetaminophen.
People infected with Zika, chikungunya or dengue virus should be protected from further mosquito exposure during the first few days of illness to reduce the risk of local transmission.
PREVENTION
No vaccine or preventive drug is available. The best way to prevent Zika virus infection is to:
– Avoid mosquito bites.
– Use air conditioning or window and door screens when indoors.
– Wear long sleeves and pants, and use insect repellents when outdoors. Most repellents, including DEET, can be used on children older than two months. Pregnant and lactating women can use all Environmental Protection Agency (EPA)-registered insect repellents, including DEET, according to the product label.
RECOMMENDATIONS FOR HEALTH CARE PROVIDERS AND PUBLIC HEALTH PRACTITIONERS
– Zika virus infection should be considered in patients with acute fever, rash, arthralgia or conjunctivitis who traveled to areas with ongoing transmission in the two weeks prior to onset of illness.
– All travelers should take steps to avoid mosquito bites to prevent Zika virus infection and other mosquito-borne diseases.
– Until more is known and out of an abundance of caution, pregnant women should consider postponing travel to any area where Zika virus transmission is ongoing. Pregnant women who do travel to one of these areas should talk to their doctors or other health care providers first and strictly follow steps to avoid mosquito bites during the trip. Women trying to become pregnant should consult with their health care providers before traveling to these areas and strictly follow steps to avoid mosquito bites during the trip.
– Fetuses and infants of women infected with Zika virus during pregnancy should be evaluated for possible congenital infection and neurologic abnormalities.
– Health care providers are encouraged to report suspected Zika virus disease cases to their state or local health department to facilitate diagnosis and to mitigate the risk of local transmission.
– Health departments should perform surveillance for Zika virus disease in returning travelers and be aware of the risk of possible local transmission in areas where Aedes species mosquitoes are active.
– State and territory health departments are requested to report laboratory-confirmed Zika virus infections to CDC.
FOR MORE INFORMATION
– General information about Zika virus and disease: http://www.cdc.gov/zika/
– Zika virus information for clinicians: http://www.cdc.gov/zika/hc-providers/index.html
– Protection against mosquitoes: http://wwwnc.cdc.gov/travel/yellowbook/2016/the-pre-travel-consultation/protection-against-mosquitoes-ticks-other-arthropods
– Travel notices related to Zika virus: http://wwwnc.cdc.gov/travel/notices
– Information about Zika virus for travelers and travel health providers: http://wwwnc.cdc.gov/travel/yellowbook/2016/infectious-diseases-related-to-travel/zika
– Pan American Health Organization (PAHO): http://www.paho.org/hq/index.php?option=com_topics&view=article&id=427&Itemid=41484&lang=en
