Dear VEP Providers,

Below are the key facts about Zika from the CDC.  As of today, over 1000 travel-associated cases have been reported in the U.S. but no cases of locally acquired mosquito-borne infection.

Here’s the case count for states with VEP EDs:  California 69, Virginia 33, North Carolina 17, Texas 53, Kansas 5, West Virginia 6,  Ohio 21.

TRANSMISSION:
• Transmitted through bite of infected Aedes species mosquito.
• Maternal-fetal transmission.
• Sexual transmission from infected male or female.
• Incubation period is 3-14 days, viremia up to one week, virus in semen longer than blood.

CLINICAL COURSE:
• Usually mild with only rare hospitalization or death.
• Many infections asymptomatic.
• Symptoms last up to a week: fever, maculopapular rash, arthralgias and myalgias, conjunctivitis,
headache, retrobulbar pain.

DIFFERENTIAL DIAGNOSIS:
• Dengue, chikungunya, leptospirosis, malaria, rickettsia, rubella, measles, parvovirus, enterovirus,
adenovirus, group A strep, and more.

TESTING:
• Test symptomatic patients and asymptomatic pregnant women if they live in, or recently visited, an
area with Zika, or if they had unprotected sex with a confirmed Zika partner.
• Tests not reliable; contact state health department for guidance.
• Testing available at CDC, select commercial labs, some state health departments.
• Methods include reverse transcriptase-polymerase chain reaction for viral RNA in serum or urine, or
serology for IgM and neutralizing antibodies in serum.

ZIKA AND PREGNANCY:
• Zika can cause microcephaly, other severe brain defects, eye defects, hearing loss, impaired growth,
fetal loss.

TREATMENT:
• No vaccines or effective drugs.
• Patients should rest, stay hydrated, use Tylenol for fever and pain.
• Avoid ASA or NSAIDS until dengue ruled out to reduce bleeding risk.

Robert Wyman, MD | Vice President of Quality
Tel: 925-482-2802 | Fax: 925-482-2838
rwyman@vephealthcare.com

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