Updated CDC Guidance for Travel and Testing Ongoing Investigation of Zika Virus in Florida

​Message Details
Date Sent: 09/20/2016 02:09 PM EDT
Sender: Michigan Health Alert Network
Subject: Updated CDC Guidance for Travel and Testing Ongoing Investigation of Zika Virus in Florida

Message:
The Florida Department of Health (FL DOH) has determined that active Zika virus transmission is no longer ongoing in the one-square-mile area of Wynwood after three mosquito incubation periods have passed without any new cases of local transmission. As of September 19, 2016, CDC has modified recommendations for the Wynwood area. CDC no longer recommends pregnant women and their partners avoid travel to the Wynwood area. However, pregnant women and partners of pregnant women who are concerned about potential Zika virus exposure may consider postponing nonessential travel to all parts of Miami-Dade County, including areas without identified active transmission. For all of Miami-Dade County, CDC advises strict adherence to precautions to prevent mosquito bites.

FL DOH continues to investigate active Zika virus transmission in South Florida. Investigation has shown an expanded area of active transmission in Miami Beach, now measuring 4.5 square miles, which includes the original 1.5-square-mile area.
For detailed information and recommendations, please review the attached document.

​Below are the updated recommendations from the CDC.

Miami Beach

1.  Pregnant women should avoid travel to the identified 4.5-square-mile area of Miami Beach (http//www.cdc.gov/zika/intheus/florida-update.html) located in Miami-Dade County, because active Zika virus transmission has been confirmed in this area.

2.  Pregnant women and their partners living in or traveling to the designated Miami Beach area should be aware of active Zika virus transmission and should strictly follow steps to prevent mosquito bites (http://www.cdc.gov/zika/prevention/prevent-mosquito-bites.html). Healthcare providers caring for pregnant women and their partners should visit CDC’s Zika website (http://www.cdc.gov/zika/) frequently for the most up-to-date recommendations.

3.  Women and men who live in or traveled to the designated area of Miami Beach any time after July 14, 2016, should be aware of active Zika virus transmission, and those who have a pregnant sex partner should consistently and correctly use condoms to prevent infection during sex or should not have sex during the pregnancy.

4.  Pregnant women with ongoing risk of possible Zika virus exposure include those who live in or frequently travel to the designated area of Miami Beach. Pregnant women with limited risk of Zika virus exposure include those who traveled to the designated area of Miami Beach or had sex without using condoms to prevent infection with a partner who lives in or traveled to the designated area of Miami Beach without using condoms or other barriers to prevent infection.

5. Pregnant women with ongoing or limited risk of exposure to Zika virus and signs or symptoms consistent with Zika virus disease should be tested for Zika virus infection based on time of evaluation relative to symptom onset in accordance with CDC guidance (http://www.cdc.gov/mmwr/volumes/65/wr/mm6529e1.htm?s_cid=mm6529e1_e).

6.  Pregnant women with ongoing risk of possible Zika virus exposure who do not report symptoms of Zika virus disease should be tested in the first and second trimesters of pregnancy in accordance with CDC guidance (http://www.cdc.gov/mmwr/volumes/65/wr/mm6529e1.htm?s_cid=mm6529e1_e).

7.  Pregnant women with limited risk of possible Zika virus exposure who do not report symptoms should consult with their healthcare providers to obtain testing for Zika virus infection based on the elapsed interval since their last possible exposure in accordance with CDC guidance (http://www.cdc.gov/mmwr/volumes/65/wr/mm6529e1.htm?s_cid=mm6529e1_e).

Wynwood

8.  Women and men who live in or traveled to Wynwood should be aware that this location was considered an area of active Zika virus transmission from June 15 to September 18, 2016. Pregnant women who lived in or traveled to Wynwood during this time or had sex without using condoms to prevent infection with a partner who lived in or traveled to Wynwood during this time should talk to their healthcare provider about getting tested for Zika virus. People who lived in or traveled to this area during this time and have a pregnant sex partner should consistently and correctly use condoms to prevent infection during sex, or should not have sex during the pregnancy.

Additional Recommendations

9.  Pregnant women and partners of pregnant women who are concerned about potential Zika virus exposure may also consider postponing nonessential travel to all parts of Miami-Dade County.

10.  All pregnant women in the United States should be evaluated for possible Zika virus exposure and signs or symptoms consistent with Zika virus disease at each prenatal care visit. Each prenatal evaluation should include an assessment of signs and symptoms of Zika virus disease (acute onset of fever, rash, arthralgia, conjunctivitis), travel history, and exposure during sex to determine whether Zika virus testing is indicated. Healthcare providers should discuss the limitations of laboratory tests used to diagnose Zika virus infection with pregnant women and their partners.

11.  CDC currently recommends that women with Zika virus disease should wait at least eight weeks after symptom onset to attempt conception, and men with Zika virus disease should wait at least six months after symptom onset to attempt conception with their partner.

12.  Women and men with possible Zika virus exposure who do not report signs or symptoms consistent with Zika virus disease should wait at least eight weeks after last possible exposure to attempt conception.

13.  Women and men with ongoing risk of possible Zika virus exposure who do not have signs or symptoms consistent with Zika virus disease and are considering pregnancy should consult their healthcare provider. Because of the ongoing risk of possible Zika virus exposure in the identified area in Miami-Dade County, healthcare providers should discuss the risks of Zika, emphasize ways to prevent Zika virus infection, and provide information about safe and effective contraceptive methods. As part of their pregnancy planning and counseling with their healthcare providers, some women and their partners living in the designated Miami Beach area might consider postponing pregnancy because of the possibility of exposure to Zika virus during pregnancy or the periconceptional period.

​(This alert is being sent to Communicable Disease, Emergency Preparedness, Health Officer, Medical Director and PIO Roles)


Attachments:

• Final HAN 396_CDC Updates Guidance for Travel and Testing of Pregnant Wo....pdf