Zika FAQ (adapted from CDC)

Zika is a mosquito-borne virus that, although discovered in 1947, has recently reemerged, leading to widespread epidemics in many countries, including most of South and Central America.
Zika virus infection is of public health significance due to its negative impact on specific populations – pregnant women and both men and women of reproductive age who may be planning on having children.
- An infected pregnant woman can pass the virus to her fetus leading to congenital birth defects, including microcephaly (small heads with incomplete brain development) and potentially lifelong disabilities.
Rare cases of complications such as the neurological illness called Guillain-Barre Syndrome have occurred. However though GBS can be a serious illness marked by weakness of limbs (sometimes paralysis), treatments are available.

Known routes of transmission include mosquitoes, perinatal (breastfeeding not yet confirmed), and sexual. While the Food and Drug Administration (FDA) has recommended universal screening of blood in the US, transmission through blood transfusion has not been confirmed.
- Some new evidence does exist for Zika transmission through platelet transfusion.
Specific travel to high-risk areas has been the primary way by which vulnerable populations of men, women, and children have been exposed to Zika-carrying mosquitoes and subsequent infection.
- Zika virus circulated in Africa and Asia, but since May 2015, it has caused an estimated 1 million infections in Brazil, with spread to many surrounding countries.

Employers and workers in healthcare settings and laboratories should follow standard infection control and biosafety practices (including universal precautions) as appropriate, to prevent or minimize the risk of Zika virus transmission.
- Standard precautions include, but are not limited to, hand hygiene and the use of PPE to avoid direct contact with blood and other potentially infectious materials, including laboratory specimens/samples. PPE may include gloves, gowns, masks, and eye protection.
Hand hygiene consists of washing with soap and water or using alcohol-based hand rubs containing at least 60 percent alcohol. Soap and water are best for hands that are visibly soiled. Perform hand hygiene in the following situations: before and after any contact with a patient; after any contact with potentially infectious material; and before putting on and upon removing PPE, including gloves.
Zika virus has spread into > 50 countries and most recently resulted in local transmission in limited areas of Florida. Most cases in the US have occurred because of individuals traveling to and from locations that have ongoing Zika transmission.

The most important thing is to prevent Zika infection – e.g., protecting yourself from mosquito bites and/or barrier protection/abstinence for potential exposure through sexual routes. However, if you suspect exposure and infection, keep in mind Zika virus can be found in the blood during the first week of illness.
- Since the virus can be passed from an infected patient (especially during the first 1-2 weeks when the virus is circulating in the blood) to a mosquito through bites, and an infected mosquito can spread the virus to other people, it is critical that the Zika-infected individual avoids mosquitos bites especially during that timeframe.
Symptomatic individuals or those who have risk factors for Zika infection should seek medical advice from their care providers. Providers can help further decision-making for the appropriateness and timing of testing as well as the type of specimen.
In the event a team member does get exposed/ infected with Zika and shows symptoms, relief can be obtained for this self-limited illness through bed rest, fluids, and acetaminophen. No aspirin or aspirin-like products like non-steroidal anti-inflammatory drugs – e.g., ibuprofen, because of the risk of getting “Reye’s syndrome.”

Zika infection is often associated with no clinical symptoms, but about 20% of infected patients will have a mild flu-like illness, with fever, joint pains, eye inflammation, and skin rash.
Other mosquito-borne illnesses should remain on the differential diagnostic list.
Due to poor reliance on clinical presentation, the diagnosis of Zika requires serologic testing to confirm an infection.

Zika-infected patients may be evaluated in the ambulatory, inpatient, or emergency room settings either because they have clinical illness due to Zika itself or related complications. They may also be seen for independent reasons, and only incidentally found to be infected, if they have specific exposure/infection risk factors, such as travel, or unprotected sex with someone who is Zika-infected or at high risk for ongoing exposure/infection.
Fortunately, Zika is not considered an infection that puts health care workers at risk for exposure/infection because it is not confirmed to be passed on via, e.g. needle sticks or other routes such as respiratory or casual contact.
Guidelines exist for the appropriate clinical management and referral for individuals at-risk for Zika or those infected with the virus, including algorithms focused on pregnant women in terms of testing, referral and management of mother and fetus/baby.

Although Zika infection is not immediately life-threatening, an infected pregnant woman can pass the virus to her fetus leading to congenital birth defects, including microcephaly (small heads with incomplete brain development) and potentially lifelong disabilities.

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