MDHHS Zika Virus Updates

Date Sent: 02/11/2016 03:44 PM EST
Sender: Michigan Health Alert Network
Subject: MDHHS Zika Virus Updates, February 11, 2016

Message:

On February 5, 2016, the Centers for Disease Control and Prevention (CDC) issued "Updated Interim Guidelines for Health Care Providers Caring for Pregnant Women and Women of Reproductive Age with Possible Zika Virus Exposure" (http://www.cdc.gov/mmwr/volumes/65/wr/pdfs/mm6505e2er.pdf) and "Interim Guidelines for Preventing Sexual Transmission of Zika Virus" (http://www.cdc.gov/mmwr/volumes/65/wr/pdfs/mm6505e1er.pdf). Highlights include:

New recommendations for Zika testing in pregnant women who have traveled to areas with ongoing Zika virus transmission:
oFor pregnant women not experiencing symptoms consistent with Zika virus disease, testing is recommended within 2-12 weeks of after returning from areas with ongoing Zika virus transmission

This is in addition to the previous recommendation that pregnant women, who have traveled to areas with ongoing Zika virus transmission and develop symptoms consistent with Zika virus disease (two or more of the following: fever, rash, joint paint, red irritated eyes) within 2 weeks of their return from travel be tested for Zika virus. Also, Zika virus testing is recommended for infants with microcephaly or intracranial calcifications born to women who have traveled or resided in an area with Zika virus transmission while pregnant, or infants born to mothers with positive or inconclusive Zika virus testing.

In addition, after confirming, through laboratory testing, the first case of Zika virus infection in a non-traveler in the continental United States, CDC has issued new interim guidance on preventing sexual transmission of Zika virus. To date, there have been no reports of sexual transmission of Zika virus from infected women to their sex partners.

New recommendations for pregnant women, and men with pregnant sex partners who live in or have traveled to Zika-affected areas:

• Pregnant women and their male sex partners should discuss the male partner's potential exposures and history of Zika-like illness with the pregnant woman's health care provider (http://www.cdc.gov/zika/symptoms/). Providers should consult CDC's updated guidelines for the evaluation and testing of pregnant women. (http://www.cdc.gov/mmwr/volumes/65/wr/pdfs/mm6505e2er.pdf).
• Men with a pregnant sex partner who reside in or have traveled to an area of active Zika virus transmission and their pregnant sex partners should consistently and correctly use condoms during sex (vaginal, anal, or oral) or abstain from sexual activity for the duration of the pregnancy. 

Although sexual transmission of Zika virus infection is possible, mosquito bites remain the primary way that Zika virus is transmitted. Because there currently is no vaccine or treatment for Zika virus, the best way to avoid Zika virus infection is to prevent mosquito bites. All travelers to or residents of areas with ongoing Zika virus transmission should strictly follow measures to prevent mosquito bites.

Michigan health care providers are encouraged to:

• Evaluate patients, particularly pregnant women, for potential exposure to Zika virus by asking about recent travel for the patients or their sex partners. 
• They should report any suspect cases to the local health department in the county where the suspect patient resides. Testing for Zika virus is not currently commercially available and is being performed by public health (CDC). Zika virus testing can be requested through your local health department. 

Because of the risk of congenital defects in the developing fetus of pregnant women exposed to Zika virus during pregnancy, testing should be prioritized for these patients. Testing is available for other patients with travel to areas where Zika virus is currently circulating, and who have developed signs of Zika virus disease (two or more of the following symptoms: fever, rash, joint pain, conjunctivitis). The utility of testing in non-pregnant patients is low, as Zika virus is generally a mild illness with complete recovery within a few days to a week. These patients should also be evaluated for other mosquito-borne diseases such as dengue and chikungunya.

This situation is rapidly evolving and new information is becoming available daily. Please regularly check the CDC's Zika page at www.cdc.gov/zika/index.html for the most up to date information.