Zika info for international travelers May, 2017

transmission bite of infected Aedes aegypti maternal-fetal sex transfusion lab transmission

check wwwnc.cdc.gov before you travel find out if level 1, level 2, level 3 level one: practice usual mosquito bite prevention precautions level 2: zika virus is present in mosquitos and causing disease from local transmission; local transmission means infected mosquitos are spreading it to people pregnant or going to get pregnant don’t go level 3: ebola, malaria, too dangerous for non essential travel level 1; practice usual precautions level 2: practice enhanced precautions level 3; avoid travel

global distribution of Zika illness solid purple areas locally acquired cases of Zika that means bitten by infected mosquito and became ill locally acquired infection means bitten by infected mosquito and became ill with Zika

Case counts U.S. states Jan. 1, 2015-April 19, 2017 5,238 Zika virus disease cases reported 4939 cases were returning travelers 222 cases acquired through local mosquito-borne transmission Florida 76 cases acquired through sexual transmission, congenital infection no new locally acquired cases in Florida 2017

case counts U.S. territories 36,575 Zika virus cases reported 143 cases in returning travelers from affected areas 36,432 cases acquired through presumed local mosquito- borne transmission US territories Puerto Rico, US Virgin Islands, Guam, American Samoa, others

all islands Indian Ocean level 2 alerts for divers all islands Caribbean all islands Indian Ocean South Pacific level 1 alert Australia I looked for dive locations that are Zika-free; not many. Australia has no Zika as of March 10,2017 ongoing local transmission of Zika in Mexico, Bonaire, Curacao, Aruba, St. Vincents, Dominica, etc. on and on Indian ocean Maldives, sulawesi, etc

Aedes aegypti mosquito same mosquito that causes chikungunya, dengue, zika, yellow fever female bites more aggressive white markings on legs prefers humans lives near humans lives 45 days doesn’t fly far gets infected by biting an infected person during the one week viremia

Aedes aegypti mosquito different from other mosquitos; prefers humans over animals; likes to breed in flower pots, showers, tires, very shallow water in man made containers, all year long in tropical climates more aggressive white markings legs bites any time of day prefers humans breeds in standing water

for 2 hours after sunrise for 2 hours before sunset

transmission of Zika virus same mosquito that transmits dengue fever, chikungunya, yellow fever, more aggressive, prefers, biting humans during day, but also bite at night, prefer to live close to people. mosquito become infected on a sick person , then spreads to virus to other people through bites. person infected is viremic for one week after infection; life span one month; doesn’t fly far Aedes mosquito transmission of Zika virus

any kind of sex virus present in all body secretions Zika remains in semen for six months

transmission through sex CDC level 2 precautions for Bahamas use condoms or do not have sex during trip after travel to The Bahamas, take steps to prevent mosquito bites for 3 weeks after your trip even if you are not sick if traveler to Bahamas has pregnant partner, no sex during the pregnancy pregnant women should not go zika can be passed through sex from a person with ZIka through vaginal, anal, oral sex timeframes that men and women can pass Zika through sex are different bc Zika virus stays in semen longer than in other body fluids bc most people infected with Zika won’t have symptoms they may not know they have been infected

, arthralgias hands and feet conjunctivitis , arthralgias hands and feet 20 percent infected get symptoms (mild) fever pruitic rash 80% don’t know about infection no symtoms illness first week after bite of infected Aedes mosquito

zika neurotropism microcephaly Guillain-Barre syndrome seizures meningoencephalitis first known mosquito borne cause of birth defects zika likes neurons infects nerve cells very bad congenital defects of nervous system GB syndrome is uncommon, but with Zika infection incidence is 2 to 9.8 times higher than baseline

microcephaly Brazil Zika has been confirmed as cause of microcephaly by CDC first known mosquito borne cause of birth defects normal US risk of microcephaly extremely rare-0.02-0.1% Zika 14% controversial some people claim other cause insect repellents cause microcephaly, etc

congenital Zika syndrome microcephaly decreased brain tissue/subcortical calcifications orbital abnormalities congenital contractures/clubfoot, etc hypertonia, hyperreflexia, seizures, etc as defined by CDC there are many other brain and spin

Congenital Zika Syndrome WHO report Congenital Zika Syndrome Brazil has 10,867 suspected cases 2,336 confirmed cases by medical personnel

outcomes for pregnancies with positive Zika tests in USA CDC April 11, 2017 outcomes for pregnancies with positive Zika tests in USA completed pregnancies 1,367 liveborn pregnancies with birth defects 58 pregnancy losses with birth defects 7

no excess microcephaly noticed cases in French Polynesia 2013 in one year had over 20,000cases Zika and GB was noticed 2 cases of GB is considered normal but with outbreak at 42 cases in Tahiti outbreak disappeared very quickly-good news.

cause of dengue, chikungunya, yellow fever

US distribution of Aedes mosquito 2016 estimate

does zika recovery confer immunity? probably yes

info for infected travelers don’t get pregnant don’t have unprotected sex check for standing water around house get tested avoid mosquito bites blood test urine test

South Florida Miami - Dade County no US residents have contracted March 10, 2017 preparation for spring mosquito season pesticide larvicide on the ground inspections 130 bug traps across county South Florida hit very hard last summer with no US residents have contracted Zika from a local mosquito 2017

size of circle estimated monthly average arrivals to US from countries on /CDC Zika advisory; color is Aedes aegypti potential abundance in July 2017 U.S. forecast for summer 2017

prevention for travelers check CDC website bring good repellent long pants and sleeves mosquito nets AC, screens check room showers and toilets for larvae check for standing water –

DEET vaccine GMO prevention

vaccine phase 2 trials already going on by NIH maybe 2020? vaccine available multiple private companies and governments are researching