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Zika Virus

Zika virus is transmitted to people primarily through the bite of an infected Aedes aegypti and Aedes albopictus mosquito. These are the same mosquitoes that spread viruses such as dengue, chikungunya, and yellow fever. These mosquitoes bite during the day and night. Mosquitoes become infected with Zika virus when it bites an infected person during the period of time when the virus can be found in the person's blood, typically only through the first week of infection. Infected mosquitoes can then spread the virus to other people through bites.

Zika virus can also be passed through sex from a person who has Zika to his or her partner, even if the infected person does not have symptoms. The virus can also be passed from a pregnant woman to her fetus during pregnancy or around the time of birth. It is likely that the virus can also be passed through blood transfusions, but there have not been any confirmed blood transfusion-transmission cases in the United States.

Outbreaks of Zika have been reported in tropical Africa, Southeast Asia, the Pacific Islands, and in the Americas. There were cases of local transmission of Zika in the continental US by mosquitoes in 2016-2017 in Florida and Texas, but there have been no confirmed Zika cases of local transmission in the continental US since 2017.

For the latest information on Zika in the U.S.: CDC: Zika Virus in the United States.

Pregnancy and Zika Infection

The Alabama Department of Public Health advises pregnant women to consider postponing travel to areas where the Zika virus is being transmitted. Infection with the Zika virus causes mild or no symptoms in the majority of cases, but an apparent link to serious birth defects and other pregnancy-related poor outcomes has been associated with infection during pregnancy. Out of an abundance of precaution, the ADPH is recommending that health care providers advise their patients who are pregnant about the risk of travel to these areas. More information from the CDC can be found here: Zika and Birth Defects.

Zika can be passed through sex, even if the infected person does not have symptoms. Both males and females can pass it to sex partners. Sex includes vaginal, anal, and oral sex, and the sharing of sex toys. Couples with a partner who lives in or has traveled to an area with a Zika outbreak or an area with current or past Zika transmission should use condoms (or other barrier methods to protect against infection).

These are the current recommendations for couples who have returned from an area with active Zika transmission, whether or not symptoms of Zika infection were present:

If the partner traveling was female, use barrier methods or abstain from sex for at least 2 months after returning or date of diagnosis.
If the partner traveling was male, use barrier methods or abstain from sex for at least 3 months after returning or date of diagnosis.
If the partner who traveled has a pregnant partner, barrier protection should be used or abstain from sex for the duration of the pregnancy.

Symptoms of Zika

About 1 in 5 people infected with Zika virus become ill (i.e., develop Zika).
The illness is usually mild with symptoms lasting for several days to a week. Severe disease requiring hospitalization and deaths are uncommon.
The most common symptoms of Zika are fever, rash, joint pain, or conjunctivitis (red eyes). Other common symptoms include muscle pain and headache.
Zika virus passed to a fetus can cause birth defects, including microcephaly and other severe fetal brain defects.
The incubation period (the time from exposure to symptoms) for Zika virus disease is around 3-14 days.
Zika virus usually remains in the blood of an infected person for a few days but it can be found longer in some people.

Treatment

There is no vaccine for Zika.
There are no specific antiviral medications.

Suggested Treatment for symptoms of Zika include:

Get plenty of rest and stay well hydrated.
Take acetaminophen (for example, Tylenol®) for fever and pain.
Do not take aspirin or other non-steroidal anti-inflammatory drugs (NSAIDS) until a dengue infection can be ruled out to reduce the risk of bleeding.
If you or your family member develop the symptoms of Zika contact your healthcare provider.

For more information on caring for a person with Zika: CDC Zika Treatment.

Prevent Zika Infection

The best preventive measure for residents living in areas infested with Aedes aegypti or Aedes albopictus is to eliminate the places where the mosquito lays her eggs, primarily artificial containers that hold water. These mosquitoes typically lay eggs in and near standing water in things like buckets, bowls, animal dishes, flower pots and vases. Items that collect rainwater or store water (for example, plastic containers, 55-gallon drums, buckets, or used automobile tires) should be covered or properly discarded. Pet and animal water containers and vases with fresh flowers should be emptied and cleaned (to remove eggs) at least once a week. This will eliminate the mosquito eggs and larvae and reduce the number of mosquitoes present in these areas. For more ways to eliminate breeding sites around your home, visit the Vector Control page.

Using air conditioning or window and door screens reduces the risk of mosquitoes coming indoors. These Aedes mosquitoes are aggressive daytime biters, prefer to bite people, and live indoors and outdoors near people. Proper application of mosquito repellents on exposed skin and proper clothing decreases the risk of being bitten by mosquitoes. Learn more by visiting Avoid the Bite Page. To learn more about insect repellents, visit this Environmental Protection Agency website: Insect Repellent Information from the EPA.

Zika Communication Toolkits

These toolkits contain communication materials that can be tailored for various groups to use when preparing for local Zika virus transmission in the United States.

Detect, Test, and Report

Testing should be performed on pregnant women who have symptoms who live in or had recent travel to areas with active dengue transmission and risk of Zika. Women who are pregnant with recent travel to areas with Zika but do not have symptoms should speak with their doctor about testing since it is no longer routinely recommended for this group. Non-pregnant individuals who have symptoms should refer to testing guidance for dengue. Because of the similar geographic distribution and clinical presentation of Zika, patients with symptoms consistent with Zika virus disease should also be evaluated for dengue and chikungunya virus infection.

Alabama physicians are asked to complete an online consultation form for ALL suspect Zika patients to request approval for Zika virus testing. Go to our Healthcare Providers page for more information and guidance. The submitted consultation form will be reviewed and answered within 24 hours or the next business day. All specimens submitted for testing must be approved by ADPH prior to submission. Any provider with a suspect Zika patient suffering a fetal loss or with a suspect Zika patient giving birth are asked to call the Infectious Diseases & Outbreaks Division at 1-800-338-8374 prior to submitting the online consultation form.