The Acute Disease Service (ADS) of the Oklahoma State Department of Health (OSDH) has received confirmation that Oklahoma residents have acquired Zika during international travel to countries experiencing local transmission of the virus. The OSDH ADS will post weekly Zika case statistics each Thursday by 10:00 a.m.
 

      *One travel-associated case in a pregnant woman

Zika is a reportable disease in Oklahoma as an “unusual disease or syndrome”.  Zika is a mosquitoborne viral disease.  Outbreaks of Zika virus have been reported in multiple countries including tropical Africa, Southeast Asia, Pacific Islands, and Brazil. On February 1, 2016, the World Health Organization (WHO) declared Zika Virus a Public Health Emergency of International Concern (PHEIC).   Since that time, local transmission has been identified in numerous countries and territories in the Americas.  Specific areas where Zika virus is spreading are often difficult to determine and are likely to change over time.  Visit the CDC Zika Travel Information to find where Zika is occurring.

Zika virus is primarily transmitted to people through the bite of an infected mosquito.  Mosquitoes become infected when they feed on a person already infected with the virus.  Infected mosquitoes can then spread the virus to other people through bites.  Zika virus is most often spread to people by Aedes aegypti, and might be spread by Aedes albopictus mosquitoes as well.  These are the same mosquitoes that transmit dengue and chikungunya.  They most frequently bite during the daytime, both indoors and outdoors.  They are most active during the early morning and late afternoon.  Transmission has also been found through blood transfusion, sexual transmission, and perinatal (mother-to-fetus) transmission.

    Aedes aegypti

   Aedes albopictus

Most people infected with Zika virus won’t even know they have the disease because they won’t have symptoms.  Symptoms occur only in 20 to 25 percent of individuals that are infected. If symptoms develop, the most common are fever, rash, conjunctivitis (red eyes) or joint pain. Other symptoms may include headache and muscle pain.  Symptoms usually begin 2 - 14 days after being bitten by an infected mosquito, and last several days to a week.  The Brazil Ministry of Health has reported an increased number of people who have been infected with Zika virus that also have Guillian-Barre syndrome (GBS), an uncommon sickness of the nervous system causing muscle weakness, and sometime paralysis.  GBS is very likely triggered by Zika in a small proportion of infections; however, scientists are still investigating the link between Zika and GBS. Because of the similar geographic distribution and symptoms, a healthcare provider may consider dengue fever and chikungunya virus as the cause of a person’s illness.

Recently, scientists announced that Zika virus infection during pregnancy can cause microcephaly and other severe fetal brain defects in infants.  Microcephaly means an abnormally small head, which is usually associated with developmental delays and intellectual disabilities.  Zika virus during pregnancy has been linked to other serious problems in infants such as eye defects, hearing loss, and impaired growth.  Scientists are still studying the full range or other potential health problems that Zika virus infection during pregnancy may cause.  If you are pregnant or are planning on becoming pregnant, talk to your healthcare provider prior to traveling to a Zika affected country. 

Information for Health Care Providers and Laboratorians:
Zika Clinician Screening Forms and Lab Guidance
The New England Journal of Medicine Special Report:  Zika Virus and Birth Defects - Reviewing the Evidence for Causality
OK-HAN 234 January 20, 2016:  Recognizing Managing and Reporting Zika Virus Infections in Travelers
OK-HAN 236 February 12, 2016:  Guidelines for Preventing Sexual Transmission of Zika Virus - Updated Pregnant Women Testing 
OK-HAN 239 June 23, 2016:  Recommendations for Subsequent Zika IgM Antibody Testing
OK-HAN 241 August 1, 2016 - CDC Guidance for Travel and Testing of Pregnant Women Related to Local Zika Virus Transmission in Florida
OK-HAN 242 August 11, 2016 - Revised Clinician Screening Form and Laboratory Guidance
OK-HAN 243 August 22, 2016 - Expanded Guidance for Travel and Testing of Pregnant Women, Women of Reproductive Age, and Their Partners in Miami Dade, Florida
OK-HAN 258 October 10, 2017 - Updated Zika and other Travel-associated Arboviral Diseases Screening Guidance
 
Travel Recommendations
The CDC has issued a Level 2 (Practice Enhanced Precautions) travel alert for people traveling to regions and countries where Zika virus transmission is ongoing, including many areas in Central and South America.  Because this is an ongoing situation, and more countries are likely to be added to the list, it is important to check the CDC’s website for all travel notices and the most up to date information. 

It is recommended that pregnant women in any trimester should consider postponing travel to any area where transmission of the Zika virus is ongoing.  If a person is pregnant or trying to become pregnant, and going to travel to one of these areas, it is important to consult with your healthcare provider and to follow the necessary steps to prevent mosquito bites.

Links:
CDC Traveler’s Health Zika Virus
Pan American Health Organization (PAHO) Zika Virus Map of Affected Countries

Prevention:
There is no vaccine, preventative drug, or specific treatment drug available for Zika.  The best way to prevent infection is to avoid mosquito bites while traveling to areas with Zika virus.  Mosquito exposure prevention tips while traveling to affected areas include:

• Use air conditioning or window/door screens to keep mosquitoes outside.  If you are not able to protect yourself from mosquitoes inside your home or hotel, sleep under a mosquito bed net.
• Use mosquito repellents according to instructions.
• If weather permits, wear long-sleeved shirts and long pants.
• Help reduce the number of mosquitoes outside your home or hotel room by emptying standing water from containers such as flowerpots or buckets.

Fact Sheets and Resources:
Zika Virus Fact Sheet  
   Virus Zika Hoja Informativa (Spanish Translation)
   Zika Virus (Portuguese Translation)
Zika and Pregnancy Fact Sheet
Mosquitoborne Disease Prevention
Mosquito Protection Fact Sheet
Mosquito Repellent Fact Sheet

Infographics:
Mosquito Bite Prevention (OSDH)
Mosquito Repellent (OSDH)
Zika Virus Prevention (PAHO)  
   Portuguese:  Como se previne o zika? (PAHO)
Zika Virus Treatment (PAHO)  
   Portuguese:  Qual é o tratamento? (PAHO)
What is Zika? (PAHO)   
   Portuguese:  O que é o zika? (PAHO)
International Travel Safety (OSDH)

External Zika Virus Resources:
Zika Virus (CDC)   
   Spanish: El virus del Zika (CDC)
Zika Virus Travel Notice Information (CDC) 
Zika Virus (PAHO)
Q&A Zika and Pregnancy (PAHO)
Information for countries in the Americas with local transmission (PAHO)
Map of countries in the Americas with autochthonous transmission (PAHO)
World Health Organization Zika Virus (WHO)  
   Portuguese:  Doenca do virus Zika (WHO)
Zika-affected areas – Global Countries and territories with active Zika virus transmission (CDC)

                This page last updated October 11, 2017.