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What can we do about the Zika virus in the United States?
Since Florida has seen several new cases of local mosquito-borne infection, controlling and preventing Zika infection has great urgency. Zika virus involves an arthropod-borne infection transmitted by Aedes aegypti and Aedes albopictus mosquitoes. Other modes of transmission include the maternal-fetal route, any sexual contact, blood transfusions, organ or tissue transplantation, and laboratory exposure.1
The first case of Zika infection in the United States and its territories occurred through international travel. According to the Centers for Disease Control and Prevention, as of October 12, 2016, there were 3807 travel-associated cases of Zika infection in the United States and 84 instances in its territories.2 As for local transmission, there were 128 people evidencing a Zika infection in the United States and 25,871 in US territories.2 Regions between Texas and Florida are at high risk because Aedes mosquitoes primarily inhabit the gulf coast.3 Many cases have occurred despite repellent use and eradication efforts, possibly due to resistance acquired by these mosquitoes.1
Control measures include using insect repellents, aerial spraying of insecticides, eliminating mosquito breeding sites, covering water tanks, and using mosquito nets or door and window screens. Infection during pregnancy is the greatest concern because of congenital anomalies (including microcephaly) that negatively affect brain development.4
Before a possible conception or any sexual contact, women exposed to Zika—with or without symptoms—must wait at least 8 weeks; men with or without symptoms should abstain for 6 months.4 Individuals should avoid traveling to areas with Zika infestation, wear long-sleeved clothing treated with permethrin, and minimize outside exposure, especially in evening hours.4
The World Health Organization is utilizing genetically modified mosquitoes to diminish Aedes populations; trials conducted in affected areas of Brazil revealed that the number of Aedes mosquitoes was reduced by 90%.5 This method of mosquito control is currently being studied in the United States.6 Vaccinations to prevent Zika infection are also under investigation.
Physicians should educate patients regarding the clinical manifestations and complications of Zika virus infection; people need to know that the Zika virus can be sexually transmitted. Doctors should also counsel patients to curtail travel to areas that have Zika infestations, or to at least wear protective clothing while in such areas to minimize mosquito bite risk. Educating travelers about appropriate postponement of sexual contact after any exposure to the Zika virus is also essential.4
Hema Madhuri Mekala, MD
Priyanga Jayakumar, MD
Rajashekar Reddy Yeruva, MD
Steven Lippmann, MD
Louisville, KY
1. Centers for Disease Control and Prevention. Zika virus: Transmission & risks. Available at: http://www.cdc.gov/zika/transmission/index.html. Accessed October 14, 2016.
2. Centers for Disease Control and Prevention. Zika virus: Case counts in the US. Available at: http://www.cdc.gov/zika/geo/united-states.html. Accessed October 14, 2016.
3. Castro L, Chen X, Dimitrov NB, et al. The University of Texas at Austin. Texas Arbovirus Risk. 2015. Available at: http://hdl.handle.net/2152/31934. Accessed October 14, 2016.
4. Centers for Disease Control and Prevention. Zika virus: Zika is in your area: What to do. Available at: http://www.cdc.gov/zika/intheus/what-to-do.html. Accessed October 14, 2016.
5. FL KEYS NEWS. Available at: http://www.flkeysnews.com/opinion/opn-columns-blogs/article83328707.html. Accessed October 14, 2016.
6. Ernst KC, Haenchen S, Dickinson K, et al. Awareness and support of release of genetically modified “sterile” mosquitoes, Key West, Florida, USA. Emerg Infect Dis. 2015;21:320-324.
Since Florida has seen several new cases of local mosquito-borne infection, controlling and preventing Zika infection has great urgency. Zika virus involves an arthropod-borne infection transmitted by Aedes aegypti and Aedes albopictus mosquitoes. Other modes of transmission include the maternal-fetal route, any sexual contact, blood transfusions, organ or tissue transplantation, and laboratory exposure.1
The first case of Zika infection in the United States and its territories occurred through international travel. According to the Centers for Disease Control and Prevention, as of October 12, 2016, there were 3807 travel-associated cases of Zika infection in the United States and 84 instances in its territories.2 As for local transmission, there were 128 people evidencing a Zika infection in the United States and 25,871 in US territories.2 Regions between Texas and Florida are at high risk because Aedes mosquitoes primarily inhabit the gulf coast.3 Many cases have occurred despite repellent use and eradication efforts, possibly due to resistance acquired by these mosquitoes.1
Control measures include using insect repellents, aerial spraying of insecticides, eliminating mosquito breeding sites, covering water tanks, and using mosquito nets or door and window screens. Infection during pregnancy is the greatest concern because of congenital anomalies (including microcephaly) that negatively affect brain development.4
Before a possible conception or any sexual contact, women exposed to Zika—with or without symptoms—must wait at least 8 weeks; men with or without symptoms should abstain for 6 months.4 Individuals should avoid traveling to areas with Zika infestation, wear long-sleeved clothing treated with permethrin, and minimize outside exposure, especially in evening hours.4
The World Health Organization is utilizing genetically modified mosquitoes to diminish Aedes populations; trials conducted in affected areas of Brazil revealed that the number of Aedes mosquitoes was reduced by 90%.5 This method of mosquito control is currently being studied in the United States.6 Vaccinations to prevent Zika infection are also under investigation.
Physicians should educate patients regarding the clinical manifestations and complications of Zika virus infection; people need to know that the Zika virus can be sexually transmitted. Doctors should also counsel patients to curtail travel to areas that have Zika infestations, or to at least wear protective clothing while in such areas to minimize mosquito bite risk. Educating travelers about appropriate postponement of sexual contact after any exposure to the Zika virus is also essential.4
Hema Madhuri Mekala, MD
Priyanga Jayakumar, MD
Rajashekar Reddy Yeruva, MD
Steven Lippmann, MD
Louisville, KY
Since Florida has seen several new cases of local mosquito-borne infection, controlling and preventing Zika infection has great urgency. Zika virus involves an arthropod-borne infection transmitted by Aedes aegypti and Aedes albopictus mosquitoes. Other modes of transmission include the maternal-fetal route, any sexual contact, blood transfusions, organ or tissue transplantation, and laboratory exposure.1
The first case of Zika infection in the United States and its territories occurred through international travel. According to the Centers for Disease Control and Prevention, as of October 12, 2016, there were 3807 travel-associated cases of Zika infection in the United States and 84 instances in its territories.2 As for local transmission, there were 128 people evidencing a Zika infection in the United States and 25,871 in US territories.2 Regions between Texas and Florida are at high risk because Aedes mosquitoes primarily inhabit the gulf coast.3 Many cases have occurred despite repellent use and eradication efforts, possibly due to resistance acquired by these mosquitoes.1
Control measures include using insect repellents, aerial spraying of insecticides, eliminating mosquito breeding sites, covering water tanks, and using mosquito nets or door and window screens. Infection during pregnancy is the greatest concern because of congenital anomalies (including microcephaly) that negatively affect brain development.4
Before a possible conception or any sexual contact, women exposed to Zika—with or without symptoms—must wait at least 8 weeks; men with or without symptoms should abstain for 6 months.4 Individuals should avoid traveling to areas with Zika infestation, wear long-sleeved clothing treated with permethrin, and minimize outside exposure, especially in evening hours.4
The World Health Organization is utilizing genetically modified mosquitoes to diminish Aedes populations; trials conducted in affected areas of Brazil revealed that the number of Aedes mosquitoes was reduced by 90%.5 This method of mosquito control is currently being studied in the United States.6 Vaccinations to prevent Zika infection are also under investigation.
Physicians should educate patients regarding the clinical manifestations and complications of Zika virus infection; people need to know that the Zika virus can be sexually transmitted. Doctors should also counsel patients to curtail travel to areas that have Zika infestations, or to at least wear protective clothing while in such areas to minimize mosquito bite risk. Educating travelers about appropriate postponement of sexual contact after any exposure to the Zika virus is also essential.4
Hema Madhuri Mekala, MD
Priyanga Jayakumar, MD
Rajashekar Reddy Yeruva, MD
Steven Lippmann, MD
Louisville, KY
1. Centers for Disease Control and Prevention. Zika virus: Transmission & risks. Available at: http://www.cdc.gov/zika/transmission/index.html. Accessed October 14, 2016.
2. Centers for Disease Control and Prevention. Zika virus: Case counts in the US. Available at: http://www.cdc.gov/zika/geo/united-states.html. Accessed October 14, 2016.
3. Castro L, Chen X, Dimitrov NB, et al. The University of Texas at Austin. Texas Arbovirus Risk. 2015. Available at: http://hdl.handle.net/2152/31934. Accessed October 14, 2016.
4. Centers for Disease Control and Prevention. Zika virus: Zika is in your area: What to do. Available at: http://www.cdc.gov/zika/intheus/what-to-do.html. Accessed October 14, 2016.
5. FL KEYS NEWS. Available at: http://www.flkeysnews.com/opinion/opn-columns-blogs/article83328707.html. Accessed October 14, 2016.
6. Ernst KC, Haenchen S, Dickinson K, et al. Awareness and support of release of genetically modified “sterile” mosquitoes, Key West, Florida, USA. Emerg Infect Dis. 2015;21:320-324.
1. Centers for Disease Control and Prevention. Zika virus: Transmission & risks. Available at: http://www.cdc.gov/zika/transmission/index.html. Accessed October 14, 2016.
2. Centers for Disease Control and Prevention. Zika virus: Case counts in the US. Available at: http://www.cdc.gov/zika/geo/united-states.html. Accessed October 14, 2016.
3. Castro L, Chen X, Dimitrov NB, et al. The University of Texas at Austin. Texas Arbovirus Risk. 2015. Available at: http://hdl.handle.net/2152/31934. Accessed October 14, 2016.
4. Centers for Disease Control and Prevention. Zika virus: Zika is in your area: What to do. Available at: http://www.cdc.gov/zika/intheus/what-to-do.html. Accessed October 14, 2016.
5. FL KEYS NEWS. Available at: http://www.flkeysnews.com/opinion/opn-columns-blogs/article83328707.html. Accessed October 14, 2016.
6. Ernst KC, Haenchen S, Dickinson K, et al. Awareness and support of release of genetically modified “sterile” mosquitoes, Key West, Florida, USA. Emerg Infect Dis. 2015;21:320-324.