Health Alert: January 20, 2016

January 20, 2016

From: Donald Allegra MD, ID Consultant

Re: Zika Virus

CDC on Friday 1/15 took the unusual step of issuing a new travel alert at 7PM at night because of concern that the situation was so serious, it could not wait until Monday 1/18.

Zika is a mosquito-borne viral infection related to Dengue. It is spread by Aedes mosquitoes which also can spread Dengue and Chikungunya viruses. It was first described in humans in 1968 and typically occurs in Africa and Southeast Asia. The current outbreak in the Americas was first identified in May 2015 (only 8 months ago). It now involves 14 countries or territories including Brazil, Columbia, El Salvador, French Guiana, Guatemala, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Suriname, Venezuela, and Puerto Rico.

Infection with Zika virus is usually mild and only 1 in 5 even develop symptoms and hospitalization and fatalities are rare. The most common symptoms are nonspecific and include fever, rash, joint pain, pinkeye, headache, muscle pain, and vomiting and last several days to a week. Incubation period is 3-12 days.

CDC is now advising pregnant women in any trimester to consider postponing travel to the 14 endemic areas because of a growing link between microcephaly (a congenital condition associated with incomplete brain development) and Zika virus infection. Microcephaly can be associated with seizures, developmental delays, intellectual and motor disabilities, and hearing loss. It is a rare congenital disease but in Brazil alone, 3500 cases of microcephaly have occurred from October 2015 to January 2016. This is far above the expected number and Zika virus has been identified in some of the fetal tissues of affected babies. There is no specific treatment for Zika infection and no commercially available test. Testing is only available through the NJ State Lab and CDC.

In summary, the following recommendations have been made:

  1. All pregnant women should be advised to postpone travel to the 14 areas where Zika virus has been identified.
  2. If a pregnant woman travels to an area with Zika virus, she should be advised to strictly follow steps to avoid mosquito bites.
  3. If a pregnant woman returns from a Zika-infected area and develops 2 or more symptoms (fever, rash, joint pain, or pinkeye) within 2 weeks of travel or has ultrasound evidence of microcephaly or intracranial calcification, she should be tested for Zika virus.