Zika Virus
Lisa Engle, MPH Epidemiologist
Chesapeake Health Department
February 28, 2017
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Zika Virus Disease (Zika)
• Spread to people primarily through bite of infected mosquitoes (Aedes
species)
– In our area is the Aedes albopictus (Asian tiger mosquito)
• Mosquitoes become infected by feeding on infected persons
• Only 1 of 5 infected persons get sick
– Incubation period for Zika is likely 3–14 days
– Zika virus remains in an infected person’s blood for about 1 week
– Fever, rash, joint pain and conjunctivitis are most common symptoms – usually
a mild illness
– Illness lasts several days to 1 week
– No vaccine or medications to prevent or treat
• No animal reservoir is known to be involved in Zika transmission in the
Americas
Nancy M. Welch, MD, MHA, MBA
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Estimated range of Aedes aegypti and Aedes
albopictus in the United States, 2016
Source: CDC: http://www.cdc.gov/zika/vector/range.html
Nancy M. Welch, MD, MHA, MBA
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Transmission of Zika
• Transmitted from mother to child
– During pregnancy or at time of delivery
• Transmitted by blood or sexual contact
– Spread through blood transfusion and sexual contact has
been reported
– Blood collection centers in the United States to screen all
donated blood for Zika
– Virus has been found to persist for several weeks in saliva
and urine but it is not known if Zika can be spread from
those body fluids
Nancy M. Welch, MD, MHA, MBA
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Zika and Microcephaly
• CDC studies continue an
association with microcephaly
• Defined as having smaller than
normal head or brain
circumference, as compared to
babies of same sex and age
AP Photo/Felipe Dana
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Zika Prevention Strategies:
Avoid Mosquito Bites
• Personal Protection
— Choose an EPA-registered insect repellent and follow label
directions
— Products containing DEET, picaridin, IR3535, and some oil
of lemon eucalyptus and para-menthane-diol products
provide longer-lasting protection
— Cover exposed skin by wearing long sleeves, pants, and
hats
Nancy M. Welch, MD, MHA, MBA
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About the Virginia Vector
• Asian tiger mosquitoes are found throughout Virginia and are
the most common nuisance mosquito in urban and suburban
areas
• Asian tiger mosquitoes fly and bite during daylight hours
when people are likely to be outdoors
• Enter homes through unscreened windows or open doors and
bite inside day and night
• Lay eggs exclusively in containers of water and like shady
areas; do not originate from puddles, ditches or natural
bodies of water on the ground
Nancy M. Welch, MD, MHA, MBA
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Common Backyard Mosquito Sources
Adult female Aedes
mosquitoes lay eggs in natural
and artificial water-holding
containers (tree holes, used
tires, plastic containers,
clogged gutters, etc.)
Once a week, empty standing
water sources around home to
reduce mosquito breeding
sites
Image: http://www.countyofglenn.net/govt/departments/gchhsa/public_health/images/MosquitoSources.jpg
Nancy M. Welch, MD, MHA, MBA
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Should Businesses Worry?
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Florida Travelers Cautioned
Count of locally acquired Zika infections:
215 (Feb 22, 2017 CDC)
Nancy M. Welch, MD, MHA, MBA
Florida Depends on Tourism
• Roger Dow, president and CEO of the U.S. Travel
Association, explained that tourists spent a record $89
billion in Florida in 2015 and the tourism industry employs
1.2 million jobs in the state
Nancy M. Welch, MD, MHA, MBA
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Economic Impact
• After health officials found Zika in Wynwood, sales in the
area slumped 50%
• In August, airfare prices to Miami International and Fort
Lauderdale-Hollywood International Airports fell 17%
• Revenue and tips at R House Restaurant have dropped by
75% which led to cutting hours and laying off a quarter of
the staff
• At a September 14 City Commission meeting, Miami Beach
Mayor Philip Levine, said the Loews Miami Beach Hotel had
had more than 700 room cancellations
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• A credit analyst at Standard & Poor warned that MiamiDade’s AA bond rating could eventually be threatened
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Florida’s Zika Image Problem
• A poll conducted August 18-24, 2016 by the Kaiser Family
Foundation found 48% of Americans would be uncomfortable
traveling to Zika infection areas within the U.S., including
Miami
• Florida officials have tried to balance informing the public,
fighting Zika and luring tourists
– Keep the public informed
• Travel related and local acquired cases
• Mosquito pools testing positive
– Fight Zika with an aggressive aerial pesticide spraying
– Luring tourists back to their area
• Miami arts district offered free two-hour parking Memorial Day
Nancy M. Welch, MD, MHA, MBA
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Business Prevention Strategy
• Avoid mosquitoes
– Personal interventions
– If job requires a great deal of outdoor exposure,
should business provide repellant?
• Environment
– Landscape that repels mosquitoes
– During mosquito season, routinely spray
Nancy M. Welch, MD, MHA, MBA
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Costs of prevention for Zika ? Who pays?
Symptomatic
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The All Natural Mosquito Repellant
• Can be planted
or used fresh
to repel pests
• May be used in
companion
planting for
pest control in
agricultural
and garden
situations
Nancy M. Welch, MD, MHA, MBA
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Basil
Catnip
Thyme
Marigold
Rosemary
Lemon Grass
Lemon Balm
Garlic
Lantana
Tea Tree
Lavender
Geranium
Eucalyptus
Peppermint
http://wiki.nurserylive.com/t/no-more-malaria-lets-bring-14-easy-to-grow-plants-to-repel-mosquito-fly-away/233
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Questions?
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References and Resources
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Besnard M, et al. Evidence of perinatal transmission of Zika virus, French Polynesia, December 2013 and February 2014 . Euro
Surveill 2014;19(13):20751. http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20751
•
Duffy MR, et al. Zika virus outbreak on Yap Island, Federated States of Micronesia. N Engl J Med 2009;360:2536–2543.
http://www.nejm.org/doi/pdf/10.1056/NEJMoa0805715
•
Foy BD, et al. Probable non-vector-borne transmission of Zika virus, Colorado, USA. Emerg Infect Dis 2011;17(5):880–882.
http://wwwnc.cdc.gov/eid/article/17/5/pdfs/10-1939.pdf
•
Hayes EB. Zika virus outside Africa. Emerg Infect Dis 2009;15(9)1347–1350. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2819875/
•
Kusana S, et al. Two cases of Zika fever imported from French Polynesia to Japan, December to January 2013. Euro Surveill 2014;19(4):20683.
http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20683
•
Kwong JC, et al. Case report: Zika virus infection acquired during brief travel to Indonesia. Am J Trop Med Hyg 2013;89(3):516‒517.
http://www.ajtmh.org/content/89/3/516.long
•
Lanciotti RS, et al. Genetic and serologic properties of Zika virus associated with an epidemic, Yap State, Micronesia, 2007. Emerg Infect
Dis 2008;14(8):1232‒1239. http://wwwnc.cdc.gov/eid/article/14/8/08-0287_article
•
Musso D, et al. Potential for Zika virus transmission through blood transfusion demonstrated during an outbreak in French Polynesia, November 2013
to February 2014. Euro Surveill 2014;19(14):20761. http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20761
•
Oehler E, et al. Zika virus infection complicated by Guillain-Barre syndrome – case report, French Polynesia, December 2013. Euro
Surveill 2014;19(9):20720. http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20720
•
Petersen LR, et al. Zika Virus. NEJM 2016; 374:1552-1563. http://www.nejm.org/doi/full/10.1056/NEJMra1602113
•
Rabe IB, et al. Interim Guidance for Interpretation of Zika Virus Antibody Test Results. MMWR 2016; 65.
http://www.cdc.gov/mmwr/volumes/65/wr/mm6521e1.htm
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Tappe D, et al. First case of laboratory-confirmed Zika virus infection imported into Europe, November 2013. Euro Surveill 2014;19(4):20685.
http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20685
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CDC: http://www.cdc.gov/zika/index.html
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PAHO: http://www.paho.org/hq/index.php?option=com_content&view=article&id=11585&Itemid=41688&lang=en
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WHO: http://www.wpro.who.int/mediacentre/factsheets/fs_05182015_zika/en/
•
VDH: http://www.vdh.virginia.gov/epidemiology/Zika/index.htm
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Media Sources: www.theatlantic.com, www.miamiherald.com, http://observer.com
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