Update: Guidance and Resources For Zika Virus Infection

Indiana Health Alert Network Notification—April 19, 2016 


As of April 13, 2016, the Centers for Disease Control and Prevention (CDC) has reported 358 travel-associated Zika virus cases and no locally acquired vector-borne cases in the US. Of these cases, 31 were identified in pregnant women, 7 were sexually transmitted, and 1 case was associated with Guillain-Barre syndrome. Six travel-associated Zika virus cases have been reported in Indiana, with no locally acquired vector-borne cases. The ISDH is collaborating with partners to finalize a Zika action plan regarding vector control, surveillance, and communications. Starting today, the ISDH will issue weekly updates regarding the Zika virus outbreak and updated CDC guidance. In addition, more information on Zika virus can be found at http://in.gov/isdh/26910.htm and www.cdc.gov/zika

- Zika virus testing may be considered for the following patients: 

o Travelers to an area with Zika transmission who have one or more of the FRAC (fever, rash, arthralgia, conjunctivitis) symptoms 

o Pregnant women who have traveled to an area with Zika transmission, regardless of symptoms 

o Pregnant women who have had unprotected sex with a man who has traveled to an area with Zika transmission and is symptomatic 

- Updated guidance for health care providers caring for women of reproductive age may be found at http://www.cdc.gov/mmwr/volumes/65/wr/mm6512e2.htm?s_cid=mm6512e2_w

- Updated recommendations for prevention of sexual transmission of Zika virus may be found at http://www.cdc.gov/mmwr/volumes/65/wr/mm6512e3.htm?s_cid=mm6512e3_w

o Women with Zika virus disease should wait at least 8 weeks after symptom onset before attempting conception. 

o Men with Zika virus disease should wait at least 6 months after symptom onset before attempting conception. 

o Asymptomatic women and men with possible Zika virus exposure should wait at least 8 weeks after the last date of exposure before attempting conception. 

- Guidance for preventing transmission of Zika virus in labor and delivery settings may be found at http://www.cdc.gov/mmwr/volumes/65/wr/mm6511e3.htm?s_cid=mm6511e3_w

- US Zika Pregnancy Registry 

o To understand more about Zika virus infection, the CDC established the US Zika Pregnancy Registry to collect information about Zika virus infection during pregnancy and congenital Zika virus infection. 

o People who are eligible for inclusion in the Registry include pregnant women in the U.S. with laboratory evidence of Zika virus infection (positive or inconclusive test results), infants born to these women and infants with laboratory evidence of congenital Zika virus infection and their mothers. 

o The ISDH will be collaborating with local health departments to collect Registry information and will be responsible for submitting data to the CDC. 

- CDC Zika Male Study 

o The CDC is conducting a study to understand how often, and for how long, Zika virus is found in the semen and urine of infected men. 

o Men who are 18 years and older and have been diagnosed with Zika virus disease may be eligible for this study. 

o Local health departments with residents who are eligible for this study will be contacted with further information on study enrollment. 

- According to the CDC, there is now sufficient evidence to conclude that there is a causal relationship between Zika virus infection in pregnant women and microcephaly in infants. 

o The full article describing the available evidence may be found at http://www.nejm.org/doi/full/10.1056/NEJMsr1604338?query=featured_home

For more information, or for Zika virus testing authorization, please contact Taryn Stevens, Infectious Disease Epidemiologist, at tastevens@isdh.in.gov or 317-234-9727.