Archive for the ‘Zika virus’ Category
CDC has been informed by the State of Florida that Zika virus infections in 4 people were likely caused by bites of local Aedes aegypti mosquitoes. The cases are likely the first known occurrence of local mosquito-borne Zika virus transmission in the continental United States.
Saturday, July 30th, 2016“….We continue to learn about Zika virus, and we are working hard to find out more about these cases. Here is what we do know:
- Zika is spread to people primarily through the bite of an infected Aedes species mosquito (Ae. aegypti and Ae. albopictus).
- A pregnant woman can pass Zika virus to her fetus during pregnancy or during birth.
- Zika virus infection can cause microcephaly and other severe fetal brain defects, and is associated with other adverse pregnancy outcomes.
- A person who is infected with Zika virus can pass it to sex partners.
- Many people infected with Zika virus won’t have symptoms or will only have mild symptoms.
- No vaccines or treatments are currently available to treat or prevent Zika infections……”
Outcomes of Pregnancies with Laboratory Evidence of Possible Zika Virus Infection in the United States, 2016
Friday, July 29th, 2016Pregnancy Outcomes in the United States and the District of Columbia
Liveborn infants with birth defects*: 13
Includes aggregated data reported to the US Zika Pregnancy Registry as of July 21, 2016
Pregnancy losses with birth defects**: 6
Includes aggregated data reported to the US Zika Pregnancy Registry as of July 21, 2016
Pregnancy Outcomes in the United States Territories
Liveborn infants with birth defects*: 0
Includes aggregated data from the US territories reported to the US Zika Pregnancy Registry and data from Puerto Rico reported to the Zika Active Pregnancy Surveillance System as of July 21, 2016
Pregnancy losses with birth defects**: 1
Includes aggregated data from the US territories reported to the US Zika Pregnancy Registry and data from Puerto Rico reported to the Zika Active Pregnancy Surveillance System as of July 21, 2016
Zika Update in the US
Friday, July 29th, 2016
As of July 27, 2016 (5 am EST)
- Zika virus disease and Zika virus congenital infection are nationally notifiable conditions.
- This update from the CDC Arboviral Disease Branch includes provisional data reported to ArboNET for January 01, 2015 – July 27, 2016.
US States
- Locally acquired mosquito-borne cases reported: 0
- Travel-associated cases reported: 1,657
- Laboratory acquired cases reported: 1
- Total: 1,658
- Sexually transmitted: 15
- Guillain-Barré syndrome: 5
US Territories
- Locally acquired cases reported: 4,729
- Travel-associated cases reported: 21
- Total: 4,750*
- Guillain-Barré syndrome: 17
Pregnant Women with Any Laboratory Evidence of Possible Zika Virus Infection
US States and the District of Columbia*: 433
*Includes aggregated data reported to the US Zika Pregnancy Registry as of July 21, 2016
US Territories**: 422
**Includes aggregated data from the US territories reported to the US Zika Pregnancy Registry and data from Puerto Rico reported to the Zika Active Pregnancy Surveillance System(http://www.cdc.gov/zika/public-health-partners/zapss.html) as of July 21, 2016
July 28, 2016 DEPARTMENT OF HEALTH DAILY ZIKA UPDATE: TWO NEW TRAVEL-RELATED CASES TODAY
Friday, July 29th, 2016“…..The department continues its investigations into four possible non-travel related Zika virus cases, with two in Miami-Dade and two Broward counties. Door-to-door outreach and sample collection are ongoing in all cases. The department will share more details as they become available. Residents and visitors are urged to participate in requests for urine samples by the department in the areas of investigation. These results will help the department determine the number of people affected.
Zika prevention kits and repellent are being distributed in the areas of investigation, through local OBGYN offices and at both DOH-Broward and DOH-Miami-Dade…..”
Advice to Blood Collection Establishments on Non-Travel Related Cases of Zika Virus in Florida
Friday, July 29th, 2016July 27, 2016
The Office of the Florida Department of Health State Surgeon General has announced that it is conducting an epidemiological investigation into a number of non-travel related cases of Zika virus in Miami-Dade and Broward Counties. These may be the first cases of local Zika virus transmission by mosquitoes in the continental United States. Miami-Dade County and Broward County are adjacent counties in South Florida.
In consideration of the possibility of an emerging local outbreak of Zika virus, and as a prudent measure to help assure the safety of blood and blood products, FDA is requesting that all blood establishments in Miami-Dade County and Broward County cease collecting blood immediately until the blood establishments implement testing of each individual unit of blood collected in the two counties with an available investigational donor screening test for Zika virus RNA or until the blood establishments implement the use of an approved or investigational pathogen inactivation technology.
Additionally, FDA recommends that adjacent and nearby counties implement the precautions above to help maintain the safety of the blood supply as soon as possible.
For blood collection establishments outside of this region, FDA suggests that donors who have traveled to Miami-Dade and Broward Counties during the previous 4 weeks be deferred.
FDA will continue to monitor this potential outbreak in cooperation with the Centers for Disease Control and Prevention (CDC) and Florida State public health authorities and provide updates as additional information becomes available.
Florida: There are 17 new travel-related cases today with three in Palm Beach, two in Brevard, two in Broward, two in Orange, one in Escambia, one in Osceola, one in Polk, one in Seminole and four involving a pregnant women.
Thursday, July 28th, 2016
Zika cases creeping upwards in Florida
Wednesday, July 27th, 2016July 26, 2016
DEPARTMENT OF HEALTH DAILY ZIKA UPDATE: SIX NEW TRAVEL-RELATED CASES
Contact:
Communications Office
NewsMedia@flhealth.gov
(850) 245-4111
Tallahassee, Fla.—In an effort to keep Florida residents and visitors safe and aware about the status of the Zika virus, the Florida Department of Health will issue a Zika virus update each week day at 2 p.m. Updates will include a CDC-confirmed Zika case count by county and information to better keep Floridians prepared.
There are six new travel-related cases with two in Broward, one in Miami-Dade, one in Hillsborough, one in Orange and one involving a pregnant women. According to CDC, symptoms associated with the Zika virus last between seven to 10 days.
The department’s investigations into the possible non-travel related Zika virus cases in Miami-Dade and Broward counties are ongoing and the department will share more details as they become available.
Governor Rick Scott and State Surgeon General Dr. Celeste Philip are hosting a Zika roundtable this afternoon in Broward County to discuss with local leaders ongoing Zika preparedness and response needs.
Residents and visitors are urged to participate in requests for urine samples by the department in the areas of investigation. These results will help the department determine the number of people affected.
Zika prevention kits and repellent are being distributed in the areas of investigation, through local OBGYN offices and at both DOH-Broward and DOH-Miami-Dade.
CDC recommends that women who are pregnant or thinking of becoming pregnant postpone travel to Zika affected areas. According to CDC guidance, providers should consider testing all pregnant women with a history of travel to a Zika affected area for the virus. CDC recommends that a pregnant woman with a history of Zika virus and her provider should consider additional ultrasounds.
Florida has been monitoring pregnant women with evidence of Zika regardless of symptoms since January. The total number of pregnant women who have been monitored is 49, with 15 having met the previous CDC case definition.
The Council of State and Territorial Epidemiologists and CDC released a new case definition for Zika that now includes reporting both asymptomatic and symptomatic cases of Zika. Prior to this change, states reported only symptomatic non-pregnant cases and pregnant cases regardless of symptoms. This change comes as a result of increased availability for testing in commercial laboratories.
All cases are travel-associated. There have been no locally-acquired cases of Zika in Florida. For more information on the Zika virus, click here.On Feb. 12, Governor Scott directed the State Surgeon General to activate a Zika Virus Information Hotline for current Florida residents and visitors, as well as anyone planning on traveling to Florida in the near future. The hotline, managed by the Department of Health, has assisted 2,396 callers since it launched. The number for the Zika Virus Information Hotline is 1-855-622-6735.
The department urges Floridians to drain standing water weekly, no matter how seemingly small. A couple drops of water in a bottle cap can be a breeding location for mosquitoes. Residents and visitors also need to use repellents when enjoying the Florida outdoors.
More Information on DOH action on Zika:
- On Feb. 3, Governor Scott directed the State Surgeon General to issue a Declaration of Public Health Emergency for the counties of residents with travel-associated cases of Zika.
- There have been 29 counties included in the declaration– Alachua, Brevard, Broward, Charlotte, Citrus, Clay, Collier, Duval, Escambia, Highlands, Hillsborough, Lake, Lee, Manatee, Martin, Miami-Dade, Okaloosa, Okeechobee, Orange, Osceola, Palm Beach, Pasco, Pinellas, Polk, Santa Rosa, Seminole, St. Johns, St. Lucie and Volusia – and will be updated as needed.
- DOH encourages Florida residents and visitors to protect themselves from all mosquito-borne illnesses by draining standing water; covering their skin with repellent and clothing; and covering windows with screens.
- DOH has a robust mosquito-borne illness surveillance system and is working with CDC, the Florida Department of Agriculture and Consumer Services and local county mosquito control boards to ensure that the proper precautions are being taken to protect Florida residents and visitors.
- On April 6, Governor Scott and Interim State Surgeon General Dr. Celeste Philip hosted a conference call with Florida Mosquito Control Districts to discuss ongoing preparations to fight the possible spread of the Zika virus in Florida. There were 74 attendees on the call.
- On May 11, Governor Scott met with federal leaders on the importance of preparing for Zika as we would a hurricane. Governor Scott requested 5,000 Zika preparedness kits from HHS Secretary Sylvia Burwell as well as a plan from FEMA on how resources will be allocated to states in the event an emergency is declared.
- On June 1, Governor Scott requested for President Obama to provide preparedness items needed in order to increase Florida’s capacity to be ready when Zika becomes mosquito-borne in our state.
- On June 9, Governor Scott spoke with Health and Human Services Secretary Sylvia Burwell and CDC Director Dr. Tom Frieden on Zika preparedness and reiterated the requests that he has continued to make to the federal government to prepare for the Zika virus once it becomes mosquito-borne in Florida. Governor Scott also requested that the CDC provide an additional 1,300 Zika antibody tests to Florida to allow individuals, especially pregnant women and new mothers, to see if they ever had the Zika virus.
- On June 23, Governor Scott announced that he will use his emergency executive authority to allocate $26.2 million in state funds for Zika preparedness, prevention and response in Florida.
- On June 28, the department announced the first confirmed case of microcephaly in an infant born in Florida whose mother had a travel-related case of Zika. The mother of the infant contracted Zika while in Haiti. Following the confirmation of this case, Governor Scott called on CDC to host a call with Florida medical professionals, including OBGYNs and physicians specializing in family medicine, to discuss the neurological impacts of Zika and what precautions new and expecting mothers should take.
- On July 1, CDC hosted a call with Florida medical professionals, including OBGYNs, pediatricians and physicians specializing in family medicine, to discuss the neurological impacts of Zika and what precautions new and expecting mothers should take. More than 120 clinicians participated.
- Florida currently has the capacity to test 4,769 people for active Zika virus and 2,129 for Zika antibodies.
Federal Guidance on Zika:
- According to CDC, Zika illness is generally mild with a rash, fever and joint pain. CDC researchers have concluded that Zika virus is a cause of microcephaly and other birth defects.
- The FDA released guidance regarding donor screening, deferral and product management to reduce the risk of transfusion-transmission of Zika virus. Additional information is available on the FDA website here.
- CDC has put out guidance related to the sexual transmission of the Zika virus. This includes CDC recommendation that if you have traveled to a country with local transmission of Zika you should abstain from unprotected sex.
For more information on Zika virus, click here.
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Zika virus disease in the United States, 2015–2016
Wednesday, July 27th, 2016Zika virus disease in the United States, 2015–2016
As of July 20, 2016 (5 am EST)
- Zika virus disease and Zika virus congenital infection are nationally notifiable conditions.
- This update from the CDC Arboviral Disease Branch includes provisional data reported to ArboNET for January 01, 2015 – July 20, 2016.
US States
- Locally acquired mosquito-borne cases reported: 0
- Travel-associated cases reported: 1,403
- Laboratory acquired cases reported: 1
- Total: 1,404
- Sexually transmitted: 15
- Guillain-Barré syndrome: 5
US Territories
- Locally acquired cases reported: 3,815
- Travel-associated cases reported: 12
- Total: 3,827*
- Guillain-Barré syndrome: 14
*Sexually transmitted cases are not reported for areas with local mosquito-borne transmission of Zika virus because it is not possible to determine whether infection occurred due to mosquito-borne or sexual transmission.
Laboratory-confirmed Zika virus disease cases reported to ArboNET by state or territory — United States, 2015–2016 (as of July 20, 2016)
CDC Issues Updated Zika Recommendations: To all men and women who have traveled to or reside in areas with active Zika virus transmission* and their sex partners.
Tuesday, July 26th, 2016Zika virus has been identified as a cause of congenital microcephaly and other serious brain defects (1). CDC issued interim guidance for the prevention of sexual transmission of Zika virus on February 5, 2016, with an initial update on April 1, 2016 (2). The following recommendations apply to all men and women who have traveled to or reside in areas with active Zika virus transmission* and their sex partners. The recommendations in this report replace those previously issued and are now updated to reduce the risk for sexual transmission of Zika virus from both men and women to their sex partners. This guidance defines potential sexual exposure to Zika virus as having had sex with a person who has traveled to or lives in an area with active Zika virus transmission when the sexual contact did not include a barrier to protect against infection. Such barriers include male or female condoms for vaginal or anal sex and other barriers for oral sex.† Sexual exposure includes vaginal sex, anal sex, oral sex, or other activities that might expose a sex partner to genital secretions.§ This guidance will be updated as more information becomes available.
As of July 20, 2016, 15 cases of Zika virus infection transmitted by sexual contact had been reported in the United States.¶ Sexually transmitted Zika virus infection has also been reported in other countries (3). In published reports, the longest interval after symptom onset that sexual transmission from a man might have occurred was 32–41 days (4). Using real-time reverse transcription–polymerase chain reaction (rRT-PCR), which detects viral RNA but is not necessarily a measure of infectivity, Zika virus RNA has been detected in semen up to 93 days after symptom onset (5). In addition, one report describes an asymptomatically infected man with Zika virus RNA detected by rRT-PCR in his semen 39 days following departure from a Zika virus-affected area and who might have sexually transmitted Zika virus to his partner (6). In most cases, serial semen specimens were not collected until Zika virus RNA was no longer detectable so that the precise duration and pattern of infectious Zika virus in semen remain unknown. Zika virus also has been transmitted from a symptomatically infected woman to a male sex partner (7), and Zika virus RNA has been detected in vaginal fluids 3 days after symptom onset and in cervical mucus up to 11 days after symptom onset (8). For sex partners of infected women, Zika virus might be transmitted through exposure to vaginal secretions or menstrual blood. Sexual transmission of infections, including those caused by other viruses, is reduced by consistent and correct use of barriers to protect against infection.
With this update, CDC is expanding its existing recommendations to cover all pregnant couples, which includes pregnant women with female sex partners. This guidance also describes what other couples (those who are not pregnant or planning to become pregnant) can do to reduce the risk for Zika virus transmission. CDC’s recommendations for couples planning to become pregnant have been published separately (9).
Updated Recommendations
Recommendations for pregnant couples. Zika virus infection is of particular concern during pregnancy. Pregnant women with sex partners (male or female) who live in or who have traveled to an area with active Zika virus transmission should consistently and correctly use barriers against infection during sex or abstain from sex for the duration of the pregnancy. These recommendations reduce the risk for sexual transmission of Zika virus during pregnancy, which could have adverse fetal effects. Pregnant women should discuss with their health care provider their own and their sex partner’s history of having been in areas with active Zika virus transmission and history of illness consistent with Zika virus disease**; providers can consult CDC’s guidance for evaluation and testing of pregnant women (10).
Recommendations for couples who are not pregnant and are not planning to become pregnant. Several factors could influence a couple’s level of concern about sexual transmission of Zika virus. The risk for acquiring mosquito-borne Zika virus infection in areas with active transmission depends on the duration and extent of exposure to infected mosquitoes and the steps taken to prevent mosquito bites.†† According to currently available information, most Zika virus infections appear to be asymptomatic, and when illness does occur, it is usually mild, with symptoms lasting from several days to a week; severe disease requiring hospitalization is uncommon (11).
Men and women who want to reduce the risk for sexual transmission of Zika virus should use barrier methods against infection consistently and correctly during sex or abstain from sex when one sex partner has traveled to or lives in an area with active Zika virus transmission. Based on expert opinion and on limited but evolving information about the sexual transmission of Zika virus, the recommended duration of consistent use of a barrier method against infection or abstinence from sex depends on whether the sex partner has confirmed infection or clinical illness consistent with Zika virus disease and whether the sex partner is male or female (Box). The rationale for these time frames has been published previously (9).
Couples who do not desire pregnancy should use available strategies to prevent unintended pregnancy and might consider multiple options, including (in addition to condoms, the only method that protects against both pregnancy and sexual transmission of Zika virus) use of the most effective contraceptive methods that can be used correctly and consistently (9,12). In addition, couples should be advised that correct and consistent use of barrier methods against infection, such as condoms, reduces the risk for other sexually transmitted infections.
Zika Virus Testing and Sexual Transmission
At present, Zika virus testing for the assessment of risk for sexual transmission is of uncertain value, because current understanding of the duration and pattern of shedding of Zika virus in the male and female genitourinary tract is limited. Therefore, testing of specimens to assess risk for sexual transmission is currently not recommended.
Zika virus testing is recommended for persons who have had possible sexual exposure to Zika virus and who develop signs or symptoms consistent with Zika virus disease.§§ All pregnant women should be tested if they have had possible exposure to Zika virus, including sexual exposure (9,10). CDC urges health care providers to report to local and state health departments all cases of Zika virus disease, including those suspected to have occurred by sexual transmission.
Corresponding author: John T. Brooks, zud4@cdc.gov, 404-639-3894.
References
- Rasmussen SA, Jamieson DJ, Honein MA, Petersen LR. Zika virus and birth defects—reviewing the evidence for causality. N Engl J Med 2016;374:1981–7. CrossRef PubMed
- Oster AM, Russell K, Stryker JE, et al. Update: interim guidance for prevention of sexual transmission of Zika virus—United States, 2016. MMWR Morb Mortal Wkly Rep 2016;65:323–5.CrossRef PubMed
- World Health Organization. Prevention of sexual transmission of Zika virus: interim guidance update. June 7, 2016. Geneva, Switzerland: World Health Organization; 2016.http://apps.who.int/iris/bitstream/10665/204421/1/WHO_ZIKV_MOC_16.1_eng.pdf?ua=1
- Turmel JM, Abgueguen P, Hubert B, et al. Late sexual transmission of Zika virus related to persistence in the semen. Lancet 2016;387:2501. CrossRef PubMed
- Mansuy J, Pasquier C, Daudin M, et al. Zika virus in semen of a patient returning from a non-epidemic area. Lancet Infect Dis 2016;16:894–5. CrossRef
- Fréour T, Mirallié S, Hubert B, et al. Sexual transmission of Zika virus in an entirely asymptomatic couple returning from a Zika epidemic area, France, April 2016. Euro Surveill 2016;21(23).PubMed
- Davidson A, Slavinski S, Komoto K, Rakeman J, Weiss D. Suspected female-to-male sexual transmission of Zika virus—New York City, 2016. MMWR Morb Mortal Wkly Rep 2016;65:716–7.CrossRef PubMed
- Prisant N, Bujan L, Benichou H, et al. Zika virus in the female genital tract. Lancet Infect Dis 2016. Epub July 11, 2016. CrossRef
- Petersen EE, Polen KN, Meaney-Delman D, et al. Update: interim guidance for health care providers caring for women of reproductive age with possible Zika virus exposure—United States, 2016. MMWR Morb Mortal Wkly Rep 2016;65:315–22. PubMed
- Oduyebo T, Igbinosa I, Petersen EE, et al. Update: interim guidance for health care providers caring for pregnant women with possible Zika virus exposure—United States, July 2016. MMWR Morb Mortal Wkly Rep 2016. Epub July 25, 2016.
- Duffy MR, Chen TH, Hancock WT, et al. Zika virus outbreak on Yap Island, Federated States of Micronesia. N Engl J Med 2009;360:2536–43. CrossRef PubMed
- CDC. Reproductive health: contraception. Atlanta GA: US Department of Health and Human Services, CDC; 2016.http://www.cdc.gov/reproductivehealth/unintendedpregnancy/contraception.htm
* http://www.cdc.gov/zika/geo/index.html.
† Barrier methods to protect against infection include male or female condoms for vaginal or anal sex, male condoms for oral sex (mouth-to-penis), and male condoms cut to create a flat barrier or dental dams for oral sex (mouth-to-vagina).
§ For the purpose of these guidelines, sex is specifically defined as vaginal sex (penis-to vagina sex), anal sex (penis-to-anus sex), oral sex (mouth-to-penis sex or mouth-to-vagina sex), and the sharing of sex toys.
¶ http://www.cdc.gov/zika/geo/united-states.html.
** Clinical illness consistent with Zika virus disease includes one or more of the following signs or symptoms: acute onset of fever, maculopapular rash, arthralgia, or conjunctivitis.
BOX. Recommendations for prevention of sexual transmission of Zika virus for couples in which one or both partners have traveled to or reside in an area with active Zika virus transmission
Couples in which a woman is pregnant
- Couples in which a woman is pregnant should use barrier methods against infection consistently and correctly or abstain from sex for the duration of the pregnancy.
Couples who are not pregnant and are not planning to become pregnant*
- Couples in which a partner had confirmed Zika virus infection or clinical illness consistent with Zika virus disease should consider using barrier methods against infection consistently and correctly or abstain from sex as follows:
― Men with Zika virus infection for at least 6 months after onset of illness;
― Women with Zika virus infection for at least 8 weeks after onset of illness. - Couples in areas without active Zika transmission in which one partner traveled to or resides in an area with active Zika virus transmission but did not develop symptoms of Zika virus disease should consider using barrier methods against infection or abstaining from sex for at least 8 weeks after that partner departed the Zika-affected area.
- Couples who reside in an area with active Zika virus transmission might consider using barrier methods against infection or abstaining from sex while active transmission persists.
* Couples who do not desire pregnancy should use the most effective contraceptive methods that can be used correctly and consistently in addition to barrier methods to protect against infections, such as condoms, which reduce the risk for both sexual transmission of Zika and other sexually transmitted infections. Couples planning conception might have multiple factors to consider, which are discussed in more detail in the following: Petersen EE, Polen KN, Meaney-Delman D, et al. Update: interim guidance for health care providers caring for women of reproductive age with possible Zika virus exposure—United States, 2016. MMWR Morb Mortal Wkly Rep 2016;65:315–22.