CDC’S Response to Zika

ZIKA 101

Updated September 21, 2017

INTRODUCTION
What is Zika?

• Zika virus is spread to people primarily

through the bite of an infected Aedes
species mosquito (Ae. aegypti and Ae.
albopictus).
• Many people infected with Zika virus won’t
have symptoms or will only have mild
symptoms.
• Zika virus infection during pregnancy can
cause microcephaly and other severe brain
defects.
Where has Zika been found?

• Before 2015, Zika outbreaks occurred in

Africa, Southeast Asia, and the Pacific
Islands.
• Currently outbreaks are occurring in
many countries and territories.

Areas with Risk of Zika

SPREAD AND SYMPTOMS
How is Zika spread?
• Zika can be spread through
» Mosquito bites
» From a pregnant woman to her fetus
» Sex with an infected person
» Laboratory exposure
• Zika may be spread through blood
transfusion.
• No reports of infants getting Zika through
breastfeeding.
How does Zika affect people?

• Many people with Zika will not have

symptoms or will only have mild
symptoms.
• Symptoms last several days to a week.
• People usually don’t get sick enough to
go to the hospital.
• People very rarely die of Zika.
What are the symptoms?
• For people with symptoms, the most
common symptoms
of Zika are
» Fever
» Rash
» Headache
» Joint pain
» Conjunctivitis (red eyes)
» Muscle pain
ZIKA AND PREGNANCY
How can Zika affect pregnancies?

• Zika virus can pass from a

pregnant woman to her fetus
during pregnancy or around the
time of birth.
• It is not known how often this
happens.
How can Zika affect pregnancies?

• Infection during pregnancy can cause

damage to the brain, microcephaly,
and congenital Zika syndrome
• Linked to other problems, such as
miscarriage, stillbirth, and birth defects
• No evidence that past infection will
affect future pregnancies once the
virus has cleared the body
How can Zika affect pregnancies?
• Congenital Zika syndrome
» Distinct pattern of birth defects in fetuses and infants
of women infected during pregnancy
» Associated with 5 types of birth defects not seen or
rarely seen with other infections during pregnancy
• Severe microcephaly (small head size) resulting in a partially
collapsed skull
• Decreased brain tissue with brain damage
• Damage to the back of the eye with a specific pattern of scarring
and increased pigment
• Limited range of joint motion, such as clubfoot
• Too much muscle tone restricting body movement soon after
birth
Assessing pregnant women for
possible Zika exposure
• At each prenatal care visit, all
pregnant women should be
asked if they
» Traveled to or live in an area with
risk of Zika
» Had sex without a condom with a
partner who lives in or traveled to
an area with risk of Zika
GUILLAIN- BARRÉ
SYNDROME
Does Zika cause Guillain-Barré
syndrome (GBS)?
• GBS is an uncommon sickness of the
nervous system in which a person’s
own immune system damages the
nerve cells, causing muscle weakness,
and sometimes, paralysis.
• GBS is strongly associated with Zika
but only a small proportion of people
with recent Zika infection get GBS.
• CDC is continuing to investigate the link
between GBS and Zika to learn more.
TESTING
How is Zika diagnosed?

• A doctor or other healthcare

provider will ask about any
recent travel and any signs and
symptoms.
• A blood or urine test can confirm
a Zika infection.
Who should be tested for Zika?
• Anyone who has or recently had Zika
symptoms
» And lives in or traveled to any area with risk
of Zika, or
» Had unprotected sex with a partner who
lives in or traveled to any area with risk of
Zika
Who should be tested for Zika?
• Pregnant women who live in or frequently
travel to areas with risk of Zika
• Pregnant women who have a fetus with
prenatal ultrasound findings consistent with
congenital Zika virus infection and
» Live in or traveled to any area with risk of Zika,
or
» Had unprotected sex with a partner who lives
in or traveled to any area with risk of Zika
Testing babies for Zika
CDC recommends laboratory testing for
• All infants born to mothers with laboratory
evidence of Zika virus infection during
pregnancy
• Infants who have abnormal clinical or
neuroimaging findings suggestive of
congenital Zika syndrome and a mother
with a possible exposure to Zika virus,
regardless of maternal Zika virus testing
results
WHAT TO DO IF YOU GET
INFECTED
How is Zika treated?
• There is no specific medicine or vaccine
for Zika virus infection.
• Treat the symptoms
» Rest
» Drink fluids to prevent dehydration
» Do not take aspirin or other non-steroidal
anti-inflammatory drugs (NSAIDS)
» Take acetaminophen (Tylenol®) to reduce
fever and pain
What to do if you have Zika

• Protect yourself from mosquito

bites. During the first week of
illness, Zika virus can be found in
blood.
• The virus can be passed from an
infected person to a mosquito
through bites.
• An infected mosquito can spread
the virus to other people.
SURVEILLANCE
Reporting of Zika in the United
States
• Healthcare providers should report
cases to their local, state, or territorial
health department.
• State and territorial health departments
are encouraged to report confirmed
cases to CDC through ArboNET, the
national surveillance system for arboviral
diseases.
• Pregnant women with any lab evidence
of possible Zika virus infection should be
reported to the US Zika Pregnancy
Registry. 2017 Case Counts in the US
Zika Pregnancy Registries
US Zika Pregnancy Registry
• CDC established the US Zika Pregnancy Registry
to collect information and learn more about
pregnant women in the US with Zika and their
infants.
• Data will be used to
» Update recommendations for clinical care
» Plan for services for pregnant women and families
affected by Zika
» Improve prevention of Zika infection during
pregnancy
• Zika Active Pregnancy Surveillance System is
used in Puerto Rico.
https://www.cdc.gov/zika/hc-providers/registry.html
https://www.cdc.gov/zika/public-health-partners/zapss.html
PREVENTION

Protect from mosquito bites

Zika is primarily spread through the
bite of an infected Aedes aegypti or
Ae. albopictus mosquito. Take steps
to protect yourself and others.
Control mosquitoes outside
• Here’s what you can do to help control
mosquitoes outside your home
» Once a week, empty and scrub, turn over,
cover, or throw out items that hold water.
» Tightly cover water storage containers.
» Use larvicides to kill larvae in containers of
water that cannot be emptied and will not be
used for drinking.
» Use an outdoor insect spray made to kill
mosquitoes in areas where they rest.
» If you have a septic tank, repair cracks or
gaps.
Control mosquitoes inside
• Here’s what you can do to help control
mosquitoes inside your home:
» Use window and door screens.
» Use air conditioning when possible.
» Once a week, empty, scrub, turn over,
or throw out items that hold water.
» If you have mosquitoes inside your
home, use an indoor insect fogger or
indoor insect spray.
• When using insecticides, always follow
label directions.
Wear insect repellent

• Use Environmental Protection Agency

(EPA)-registered insect repellents.
» Use a repellent with one of the following
active ingredients: DEET, picaridin, IR3535,
or oil of lemon eucalyptus, para-menthane-
diol, or 2-undecanone.
• Always follow the product label instructions.
• Do not spray repellent on the skin under
clothing.
• If also using sunscreen, apply sunscreen
before applying insect repellent.
Create a barrier between you and
mosquitoes
• Cover up exposed skin
» Wear long-sleeved shirts and long pants.

• Treat clothing and gear

» Use permethrin* to treat clothing and gear or buy
pre-treated items.
» See product information to learn how long the
protection will last.
» Do not use permethrin products directly on skin.

* Permethrin is not effective in Puerto Rico.

Protect your family

• For babies and children

» Dress your child in clothing that covers arms
and legs.
» For children older than 2 months, use insect
repellent on exposed skin.
» Cover crib, stroller, and baby carrier with
mosquito netting.
Protect your family

• Applying insect repellent on children

» Do not apply repellent onto hands, eyes,
mouth, and cut or irritated skin.
» Adults: Spray onto your hands and then
apply to a child’s face.
» Do not use insect repellent on babies
younger than 2 months old.
» Do not use products containing oil of lemon
eucalyptus or para-menthane-diol on
children younger than 3 years old.
PREVENTION
Preventing sexual transmission
About sexual transmission
• Zika can be passed through sex from a
person who has Zika to his or her sex
partners.
» Sex includes vaginal, anal, and oral
sex and the sharing of sex toys.
» Zika can be passed through sex before
symptoms start, during, and after
symptoms end.
» It can be passed even if the infected
person does not have symptoms at the
time or never develops symptoms.
• Zika virus can stay in semen longer
than in vaginal fluids, urine, and blood.
Protect your partner

• Not having sex eliminates the risk of getting

Zika from sex.
• Condoms can reduce the chance of getting
Zika from sex.
» Includes male and female condoms.
» Condoms should be used from start to finish,
every time during vaginal, anal, and oral sex
and the sharing of sex toys.

http://www.cdc.gov/mmwr/volumes/65/wr/pdfs/mm6529e2.pdf
Protect your partner

• People with a partner who traveled to an

area with risk of Zika can use condoms or
not have sex
» If the traveler is female: For at least 8 weeks
after return, or after start of symptoms or
diagnosis
» If the traveler is male: For at least 6 months
after return, or after start of symptoms or
diagnosis
• People living in an area with risk of Zika
can use condoms or not have sex.
During pregnancy

• Pregnant couples in which one or both

partners live in or traveled to an area with
risk of Zika should:
» Use condoms from start to finish every time
they have sex (oral, vaginal, or anal) or not
have sex during the pregnancy.
» Not share sex toys during the pregnancy.
If you’re thinking about having a
baby
Exposure from travel to or sex without a condom with
someone who lives in or traveled to an area with a
CDC Zika travel notice
Women Men

Wait at least 2 Wait at least 6 months

months after after symptoms start
symptoms start or or last possible
last possible exposure exposure before trying
before trying to get to conceive with your
pregnant. partner.
If you’re thinking about having a baby
Exposure from travel to or sex without a condom with
someone who lives in or traveled to an area with risk
of Zika but without a CDC Zika travel notice
Women Men

If no symptoms, talk
If no symptoms, talk
with a healthcare
with a healthcare
provider about plans
provider about plans
for pregnancy.
for pregnancy.

Wait at least 6 months

Wait at least 2 months
after symptoms start
after symptoms start
before trying to get
before trying to get
pregnant.
pregnant.
If you’re thinking about having a baby

People living in or frequently traveling to any

area with risk of Zika
Women Men

If no symptoms, talk If no symptoms, talk

with a healthcare with a healthcare
provider about plans provider about plans
for pregnancy. for pregnancy.

Wait at least 2 months Wait at least 6 months

after symptoms start after symptoms start
before trying to get before trying to get
pregnant. pregnant.
PREVENTION

Traveling
Travel guidance for pregnant
women
• If you are pregnant, do not travel to areas
with risk of Zika.
• If you must travel, talk to your doctor or
other healthcare provider and strictly
follow steps to prevent mosquito bites
during the trip.
Protect yourself while traveling

• If you travel to an area with risk of Zika

» Strictly follow steps to prevent mosquito
bites.
» Use condoms or do not have sex
during the trip.
Protect yourself while traveling

• Stay in places with air conditioning and

with window and door screens.
• Use a bed net if air conditioned or
screened rooms are not available or if
sleeping outdoors.
Protect yourself and others after travel

• Even if they do not feel sick, travelers

returning from an area with risk of Zika
should take steps to prevent mosquito
bites for 3 weeks so they do not spread
Zika to uninfected mosquitoes.
Do your homework before
traveling
See the latest travel notices at:

wwwnc.cdc.gov/travel/page/zika-travel-information
WHAT CDC IS DOING
What is CDC doing?

• Activated Emergency Operations Center (EOC) to level 1

• Alerting healthcare providers and the public about Zika
• Posting travel guidance
• Monitoring infections among pregnant women to identify the
long-term consequences of congenital Zika infection.
• Working with clinical experts and organizations to update
guidance
• Researching factors that might affect birth defects in fetuses and
babies, including the timing of Zika infection during pregnancy.
• Improving laboratory testing for Zika and providing state, tribal,
local, and territorial health laboratories with diagnostic tests.
CDC is working with partners to

• Monitor and report cases of Zika.

• Conduct studies to learn more about the potential link
between Zika and Guillain-Barré syndrome.
• Create action plans for state and local health officials to
improve Zika preparedness.
• Publish and disseminate guidelines to inform testing
and treatment of people with suspected or confirmed
Zika.
• Working with partners to better understand the risk and
spectrum of birth defects from Zika infection during
pregnancy and risks for sexual transmission.
Zika in the United States

• Local mosquito-borne spread of

Zika virus was identified in
Miami-Dade County, Florida,
and Brownsville, Texas. Brownsville, Texas

» Pregnant women should consider

postponing travel to Brownsville,
Texas (currently a yellow area).
» CDC lifted the yellow area
designation for Miami-Dade County
on June 2, 2017.

Miami-Dade County, Florida

CDC’S Response to Zika

For more information, contact CDC

1-800-CDC-INFO (232-4636)
TTY: 1-888-232-6348 www.cdc.gov

The findings and conclusions in this report are those of the authors and do not necessarily
represent the official position of the Centers for Disease Control and Prevention.