1. ZIKA CASES (1/15 -9/7/16) USA- 2,964 total Travel associated 2,920
Locally acquired mosquito borne cases 43
Lab acquired 1
Sexually transmitted 24
US TERRITORIES-15,869 (most locally acquired-not travel mainly PR, USVI & Samoa)
NYS 734 (NYC 553)

2. Incubation period 3-14 days
80% asymptomatic
Incubation period 3-14 days
Viremia: after symptom onset-days to 1 wk (some cases longer)
Zika RNA+ in semen 6 mo after
Can be negative in blood but + in placenta & semen (very limited data)-
Main s & s-rash, fever, conjunctivitis, H/A, aches
Whole blood appears to have longer periods of detectable viremia than compared to serum. Zika RNA has been detected in whole blood as late as 58 days after symptom onset.
Zika virus infection in pregnancy is a cause of microcephaly & other fetal brain abnormalities. Miscarriage, stillbirth, hearing deficits, are what has been seen so far but the full clinical effects of Zika in pregnancy is not known yet.
Zika has been assoc with an increased incidence of GB syndrome (38 cases connected to Zika in US & US territories-most in PR)

3. FDA guidance on tissue (3/2016)
FDA identifies zika as a transfusion-transmitted infection-(8/26/16 guidance)
In a 2013 outbreak 2.8% samples from asymptomatic blood donors + zika RNA
In % of blood donors in PR +zika
Probable transfusion transmission in Brazil
Tissue Guidance recommends no deceased donation from people with a dx of zika in the past 6 mo-no recommendations on people who have travelled to zika area or had sex
FDA- no living donation from a person with it or at risk (travel, sex with someone infected) for 6 mo
Initial blood guidance focused on screening for history of travel & self deferral of donation. Now recommend testing of all donations.
PR & FL required to test immediately. NY is listed as one of 11 states that should do so within 4 wks of guidance ( )

4. ZIKA RISKS TO RECIPIENT
Flavivirus-same type of arbovirus as WNV
Antigenic cross talk with Dengue & WNV
Proliferates in immune system cells
WNV donor transmission-NYC 2005
GB connection to Zika
Organ Trx pts: neuroinvasive disease 40X pop WNV; Zika 100X
38 GB cases have been found to test positive for zika. (not sure which tests-PCR, serology, urine )

5. DTAC GUIDANCE Focus on recent travel hx
Signs & Symptoms (Rash, fever, H/A, conjunctivitis) in donor
Living donors-defer donation, if possible
Diagnostic and donor screening is limited/under development
There are diagnostic tests-molecular (RNA-PCR) & serological tests & urine. But all limited commercially. This is changing daily, especially with the FDA blood screening recommendations.
No FDA licensed donor screening tests are available-but an investigational IND has been developed and testing under IND implemented in PR, & FL. 2 new IND applications (investigational new drug application under and emergency use authorization (EUA) have been submitted recently to include organ donor testing.
AOPO and AATB are keeping on top of this & working with the FDA & CDC & HRSA.
DTAC has their meeting in October

6. RESOURCES NYSDOH Zika Info Line 888-364-4723 (M-F0 9AM-5PM)
Webinar for transplant professionals hosted by the NYSDOH-NYS Transplant Council September noon
Hear from NYS public health experts & DTAC

7. OTHER RESOURCES NYSDOH – http://www.health.ny.gov/diseases/zika_virus/
CDC Zika page
FDA Zika

8. ZIKA WEBINAR INFO Host: NYSDOH and the NYS Transplant Council
Date/time: Thursday, September 22nd 2016, p.m. EST
Speakers: Kirsten St. George, MAppSc, PhD, Chief Viral Diseases, Wadsworth Center, NYSDOH; Lewis Teperman MD, FACS, Vice Chair of Surgery and Director of Transplant, Northwell Heath and Marian Michaels, MD, MPH, Professor of Pediatrics and Surgery, University of Pittsburgh School of Medicine, Disease Transmission Advisory Committee (DTAC) Vice Chair, United Network for Organ Sharing (UNOS)
Click here to register:

9. NYSDOH CONTACTS Nancey Agard RN, MS nancey.agard@health.ny.gov
Lisa McMurdo RN, MPH

10. NYS HEALTH COMMERCE A health professional can request an HCS account