Board of Health: Zika Virus Advisory

With many of the TV news outlets in a frenzy over reports of the Zika virus spreading throughout South America and the world, a few calm, thoughtful, and factual words about what is actually known about the virus is appropriate.

Zika virus disease is a relatively new emerging disease caused by the Zika virus. Most cases of Zika virus disease are transmitted to humans by bites from one of two species of Aedes mosquitos: Aedes aegypti and Aedes albopictus. The good news is that these two types of mosquitoes do not thrive well here in cooler New England, although a small number of uninfected Aedes albopictus mosquitos have in the past been found in western Massachusetts. More good news is that Zika virus disease is not currently circulating in the continental United States, though a number of cases have turned up here from folks who have traveled to Zika-infected areas of the world.

Further, there have also been some mostly uncorroborated cases thought to have been sexually transmitted between partners where one partner had traveled to a Zika-infected area. Research continues to determine if this particular route of transmission is firmly established or not. Accordingly, the Centers for Disease Control and Prevention (CDC) have recommended that prophylactic “safer sex” practices be used when one or more partner is involved who has traveled to one of these affected areas.

The Zika virus is a mosquito-borne flavivirus (in the same family as yellow fever, dengue, and West Nile viruses) previously found largely in Africa and Southeast Asia. In 2007, it was found for the first time on the Pacific island of Yap and subsequently in French Polynesia. In May 2015, the World Health Organization reported the first local transmission of Zika virus in the Western Hemisphere in Brazil. As of January 2016, local transmission had been identified in at least 14 countries or territories in the Americas, including Puerto Rico and the Caribbean, and in American Samoa, though not yet in the continental United States as of this writing. Further spread to other countries in this hemisphere is likely. With the recent outbreaks, the number of Zika virus disease cases among travelers visiting or returning to the United States likely may increase.

An estimated 80 percent of persons infected with Zika virus have no symptoms. In symptomatic infection, the incubation period is 3-12 days. When symptomatic, the disease is generally mild and characterized by at least two of the following: acute onset of fever; maculopapular rash (a flat bumpy red rash); arthralgia (joint pain); and/or nonpurulent conjunctivitis (reddish inflammation of the eye free of secretion).

Symptoms usually last from several days to one week. Severe disease requiring hospitalization is uncommon, and fatalities are rare.

Very recently, Brazil has reported an increase in infants with microcephaly (small or misshapen head) occurring over the same time period as the Zika virus outbreak in that country. While the association is compelling, it is not known if the increase in microcephaly cases is directly caused by Zika virus infections.

Pregnant women can be infected with Zika virus in any trimester. No evidence exists to suggest that pregnant women are more susceptible to Zika virus infection or experience more severe disease during pregnancy. It is also suspected, though not confirmed, that Zika virus may in a few cases cause fetal loss. Multiple studies are under way internationally to investigate if there is an association of Zika virus infection with microcephaly and fetal losses, but no direct cause and effect has been documented so far.

Because there is neither a vaccine nor prophylactic medications available to prevent Zika virus infection, as a precautionary measure the CDC and the Massachusetts Department of Public Health, as well as the Canton Board of Health are recommending that all pregnant women consider postponing travel to areas where Zika virus transmission is ongoing. If a pregnant woman travels to an area with Zika virus transmission, it is advised that she strictly follow steps to avoid mosquito bites. Mosquitoes that spread Zika virus bite both indoors and outdoors, day and night, so it is important to ensure protection from mosquitoes throughout the entire day in these infected areas. Mosquito prevention strategies recommended for all travelers to an area with Zika virus transmission include:

* Wearing long-sleeved shirts and long pants;

* Using U.S. Environmental Protection Agency (EPA)-registered insect repellents;

* Using permethrin-treated clothing and gear;

* Staying and sleeping in screened-in or air-conditioned rooms.

When used as directed on the product label, insect repellents containing DEET, picaridin, and IR3535 are deemed safe for pregnant women.

If you plan to travel and would like more information about areas where Zika infection has been identified, visit wwwnc.cdc.gov/travel/notices.

Submitted by John L. Ciccotelli, RS, CHO, Canton Public Health Director

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Posted by Canton Citizen on Mar 4 2016. Filed under Featured Content. Both comments and pings are currently closed.