15 Clusters Involving Zika Sexual Transmission In The US

[niman]

The CDC press release describes 14 additional clusters involving local transmission of Zika via sexual encounters.These are in addition to the initial confirmation in Dallas Texas.  If all encounters are confirmed for both partners,the number local transmission in the US will increase from 1 to 15 and the number of people involved in these clusters will increase from 2 to 30,which is a significant percentage of the US  Zika cases.

Edited February 23, 2016 by niman

[niman]

Media Statement

 

 

 

 

 

For Immediate Release

 

 

Tuesday, February 23, 2016

 

 

                                                                         

 

 

Contact: CDC Media Relations

 

 

404-639-3286                                                 

 

 

 

 

CDC encourages following guidance to prevent sexual transmission of Zika virus

 

 

 

 

 

CDC has committed to sharing the latest information on Zika virus as it becomes available. On February 5, 2016, CDC published interim recommendations for protecting people against sexual transmission of Zika virus.  This guidance was issued after lab confirmation of the first case of Zika virus infection in a non-traveler in the continental United States, which was linked to sexual contact with an infected partner.

 

 

CDC and state public health departments are now investigating 14 new reports of possible sexual transmission of Zika virus, including several involving pregnant women. In two of the new suspected sexual transmission events, Zika virus infection has been confirmed in women whose only known risk factor was sexual contact with an ill male partner who had recently traveled to an area with local Zika virus transmission; testing for the male partners is still pending. For four additional suspected sexual transmission events, preliminary laboratory evidence (IgM antibody test) is available for the women, but confirmatory tests are pending. For eight other suspected events, the investigation is ongoing. In all events for which information is available, travelers were men and reported symptom onset was within 2 weeks before the non-traveling female partner’s symptoms began.  Like previously reported cases of sexual transmission, these cases involve possible transmission of the virus from men to their sex partners.  At this time, there is no evidence that women can transmit Zika virus to their sex partners; however, more research is needed to understand this issue.

 

 

Although sexual transmission of Zika virus infection is possible, mosquito bites remain the primary way that Zika virus is transmitted. Because there currently is no vaccine or treatment for Zika virus, the best way to avoid Zika virus infection is to prevent mosquito bites.

 

 

Because these new reports suggest sexual transmission may be a more likely means of transmission for Zika virus than previously considered, CDC issued a Health Advisory Notice (HAN) today to underscore the importance of adhering to the interim guidance published on February 5.

 

 

The CDC’s February 5 interim guidance includes:

 

 

Recommendations for pregnant women and men with pregnant sex partners who live in or have traveled to Zika-affected areas:

 

 

·         Pregnant women and their male sex partners should discuss the male partner’s potential exposures and history of Zika-like illness with the pregnant woman’s health care provider (http://www.cdc.gov/zika/symptoms/). Providers should consult CDC’s guidelines for evaluation and testing of pregnant women.

 

 

·         Men with a pregnant sex partner who reside in or have traveled to an area of active Zika virus transmission and their pregnant sex partners should use condoms the right way every time during sex (vaginal, anal, or oral) or abstain from sexual activity for the duration of the pregnancy. Using latex condoms the right way every time reduces the risk of sexual transmission of many infections, including those caused by other viruses.

 

 

Recommendations for non-pregnant women, and men with non-pregnant sex partners who live in or have traveled to Zika-affected areas:

 

 

·         Couples in which a man resides in or has traveled to an area of active Zika virus transmission who are concerned about sexual transmission of Zika virus may consider using condoms the right way every time during sex or abstaining from sexual activity.  

 

 

·         Couples may consider several factors when making this complex and personal decision to use condoms or not have sex:

 

 

o    Zika virus illness is usually mild. An estimated 4 out of 5 people infected never have symptoms; when symptoms occur they may last from several days to one week.

 

 

o    The risk of Zika infection depends on how long and how much a person has been exposed to infected mosquitoes, and the steps taken to prevent mosquito bites while in an affected area.

 

 

·         The science is not clear on how long the risk should be avoided. Research is now underway to answer this question as soon as possible. If you are trying to get pregnant, you may consider testing in discussion with your health care provider.

 

 

These investigations are preliminary, and CDC will continue to update its guidance as more information becomes available.  

 

 

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U.S. Department of Health and Human Services

[niman]

Update: Interim Guidelines for Prevention of Sexual Transmission of Zika Virus — United States, 2016

 

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This is an official

CDC HEALTH ADVISORY

Distributed via the CDC Health Alert Network
February 23, 2016, 14:15 EST (2:15 PM EST)
CDCHAN-00388

Summary: The Centers for Disease Control and Prevention (CDC) recently published recommendations for protecting people against sexual transmission of Zika virus (1). As stated in that report, information about possible sexual transmission of Zika virus was based on one published report of transmission from a man to a woman, one published report in which Zika virus was detected in semen of a man with hematospermia, and one case of possible sexual  transmission then under investigation in Texas. An additional case of Zika virus detected in semen in a man was reported after the CDC recommendations were published (2).  As of February 23, 2016, CDC and state public health departments are investigating 14 additional reports of possible sexual transmission of the virus, including several involving pregnant women. While additional investigations are being completed, CDC is issuing this HAN Advisory as a strong reminder to state, local, and US territorial public health departments, clinicians, and the public to be aware of and adhere to current recommendations for preventing sexual transmission of Zika virus, particularly for men with pregnant partners. These recommendations may change as more information becomes available.

 

Background

CDC is working with state, local, and US territorial public health departments, US Government agencies, and international partners in response to outbreaks of Zika virus disease (Zika) in multiple territories and countries in the Americas. Accumulating evidence links maternal Zika virus infection with congenital microcephaly, miscarriages, and other adverse fetal outcomes (3). In addition, there are reports of a possible association with Guillain-Barré syndrome (4). No vaccine or specific antiviral drug is currently available to prevent or treat Zika.

Zika virus is spread primarily by the bite of infected Aedes species mosquitoes (most commonly, Aedes aegypti). In areas where Zika virus transmission is ongoing, people should follow precautions to prevent mosquito bites (http://www.cdc.gov/zika/prevention/). Sexual transmission of Zika virus also can occur and is of particular concern during pregnancy. In early February 2016, the Dallas County Department of Health and Human Services announced an occurrence of sexually transmitted Zika infection (5). On February 5, 2016, following the confirmation of this Texas sexual transmission event, CDC published interim guidelines for preventing sexual transmission of Zika virus (1).

As of February 23, 2016, CDC and state public health departments are investigating 14 additional reports of possible sexual transmission of the virus, including several events involving possible transmission to pregnant women. In two of these new suspected sexual transmission events that have been investigated to date, Zika virus infection has been confirmed in women whose only known risk factor was sexual contact with an ill male partner who had recently travelled to an area with local Zika virus transmission; testing for the male partners is pending. For four additional suspected sexual transmission events, preliminary laboratory evidence (IgM antibody test) is available for the women, but confirmatory testing is still pending. For eight suspected events, the investigation is ongoing. In all events for which information is available, travelers reported symptom onset within 2 weeks prior to their non-traveling female partner’s symptom onset.

Because these reports suggest sexual transmission may be a more likely means of transmission for Zika virus than previously considered, CDC is issuing this HAN Advisory to underscore the importance of adhering to the interim guidance published on February 5 and outlined below. The recommendations, which apply to men who reside in or have traveled to areas with active Zika virus transmission (http://wwwnc.cdc.gov/travel/notices/) and their sex partners, will be revised as more information becomes available.

Recommendations for men and their pregnant partners

Men who reside in or have traveled to an area of active Zika virus transmission who have a pregnant partner should abstain from sexual activity or consistently and correctly use condoms during sex (i.e., vaginal intercourse, anal intercourse, or fellatio) for the duration of the pregnancy. Pregnant women should discuss their male partner’s potential exposures to mosquitoes and history of Zika-like illness (http://www.cdc.gov/zika/symptoms) with their health care provider; providers can consult CDC’s guidelines for evaluation and testing of pregnant women (6).

Recommendations for men and their nonpregnant sex partners

Men who reside in or have traveled to an area of active Zika virus transmission who are concerned about sexual transmission of Zika virus might consider abstaining from sexual activity or using condoms consistently and correctly during sex. Couples considering this personal decision should take several factors into account. Most infections are asymptomatic, and when illness does occur, it is usually mild with symptoms lasting from several days to a week; severe disease requiring hospitalization is uncommon. The risk for acquiring vector-borne Zika virus in areas of active transmission depends on the duration and extent of exposure to infected mosquitoes and the steps taken to prevent mosquito bites (http://www.cdc.gov/zika/prevention). After infection, Zika virus might persist in semen when it is no longer detectable in blood; studies to determine the duration of persistence in semen are not yet completed.

Accumulating evidence of sexual transmission suggests that exposure to Zika virus includes unprotected sexual contact with a symptomatic male partner who resides in or has traveled to an area of active Zika virus transmission. Zika virus testing is currently recommended to establish a diagnosis of infection in exposed persons with signs or symptoms consistent with Zika virus disease, and may be offered to asymptomatic pregnant women with possible exposure to Zika virus (6). However, interpretation of results is complex, and health care providers should contact their state, local, or territorial health department for assistance with arranging testing and interpreting results. At this time, testing of exposed, asymptomatic men for the purpose of assessing risk for sexual transmission is not recommended. Sexual transmission of Zika virus from infected women to their sex partners has not been documented, nor has transmission from persons who are asymptomatically infected.  Sexual transmission of many infections, including those caused by other viruses, is reduced by consistent and correct use of latex condoms.

As we learn more about the incidence and duration of seminal shedding from infected men and the utility and availability of testing in this context, recommendations to prevent sexual transmission of Zika virus will be updated.

References

1. Oster AM, Brooks JT, Stryker JE, et al. Interim Guidelines for prevention of sexual transmission of Zika virus — United States, 2016. MMWR Morb Mortal Wkly Rep 2016;65:120–121. http://www.cdc.gov/mmwr/volumes/65/wr/mm6505e1.htm
2. Atkinson B, Hearn P, Afrough B, et al. Detection of Zika virus in semen [letter]. Emerg Infect Dis. 2016 May [cited February 22, 2016].http://dx.doi.org/10.3201/eid2205.160107
3. Martines RB, Bhatnagar J, Keating MK, et al. Evidence of Zika virus infection in brain and placental tissues from two congenitally infected newborns and two fetal losses — Brazil, 2015. MMWR Morb Mortal Wkly Rep. 2016;65 (Early Release)(06):1-2. http://www.cdc.gov/mmwr/volumes/65/wr/mm6506e1.htm?s_cid=mm6506e1_e.  Published February 19, 2016.
4. European Centre for Disease Prevention and Control. Rapid risk assessment: Zika virus epidemic in the Americas: potential association with microcephaly and Guillain-Barré syndrome – 10 December 2015. http://ecdc.europa.eu/en/publications/Publications/zika-virus-americas-association-with-microcephaly-rapid-risk-assessment.pdf. Published 2015. Accessed Feb 1, 2016.
5. Dallas County Health and Human Services.  DCHHS reports first Zika virus case in Dallas County acquired through sexual transmission. February 2, 2016. http://www.dallascounty.org/department/hhs/press/documents/PR2-2-16DCHHSReportsFirstCaseofZikaVirusThroughSexualTransmission.pdf
6. Oduyebo T, Petersen EE, Rasmussen SA, et al. Update: interim guidelines for health care providers caring for pregnant women and women of reproductive age with possible Zika virus exposure—United States, 2016. MMWR Morb Mortal Wkly Rep 2016;65.http://www.cdc.gov/mmwr/volumes/65/wr/mm6505e2.htm?s_cid=mm6505e2_e

For More Information

• General information about Zika virus and disease: http://www.cdc.gov/zika/
• Zika virus information for clinicians: http://www.cdc.gov/zika/hc-providers/index.html
• Protection against mosquitoes: http://wwwnc.cdc.gov/travel/yellowbook/2016/the-pre-travel-consultation/protection-against-mosquitoes-ticks-other-arthropods
• Travel notices related to Zika virus: http://wwwnc.cdc.gov/travel/notices
• Information about Zika virus for travelers and travel health providers: http://wwwnc.cdc.gov/travel/yellowbook/2016/infectious-diseases-related-to-travel/zika
• HAN Advisory:  Recognizing, managing, and reporting Zika virus infections in travelers returning from Central America, South America, the Caribbean, and Mexico.  January 15, 2016.  http://emergency.cdc.gov/han/han00385.asp
• Pan American Health Organization PAHO): http://www.paho.org/hq/index.php?option=com_content&view=article&id=11585&Itemid=41688〈=en
• Approximate distribution of Aedes aegypti and Ae. albopictus mosquitoes in the United States:
  http://www.cdc.gov/chikungunya/resources/vector-control.html

The Centers for Disease Control and Prevention (CDC) protects people's health and safety by preventing and controlling diseases and injuries; enhances health decisions by providing credible information on critical health issues; and promotes healthy living through strong partnerships with local, national and international organizations.

DEPARTMENT OF HEALTH AND HUMAN SERVICES

http://emergency.cdc.gov/han/han00388.asp

 

[niman]

World | Wed Feb 24, 2016 3:20am IST

Related: WORLD

Zika may have been sexually transmitted in 14 cases - U.S. CDC

 

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Aedes aegypti mosquitoes are seen inside Oxitec laboratory in Campinas, Brazil, February 2, 2016.

REUTERS/PAULO WHITAKER

 

The Zika virus may have been sexually transmitted in 14 new U.S. cases, including several involving pregnant women, the Centers for Disease Control and Prevention said on Tuesday about the disease linked to thousands of birth defects in Brazil.

In two of the suspected cases, the infection has been confirmed in women whose only known risk factor was sexual contact with an ill male partner who had recently travelled to an area where the virus is present, the agency said.

The reports suggest sexual transmission may be a more likely means of spreading Zika than previously considered, the CDC said.

Testing of the male partners is still pending, the CDC said.

Mosquito bites remain the primary way the virus is spread, although sexual transmission from men to women is possible, the agency added. Condoms can help prevent transmission.

There is no evidence that women can transmit Zika virus to their sex partners, CDC said.

There is no cure or treatment for Zika and much remains unknown, including whether the virus actually causes the birth defect microcephaly, a condition marked by unusually small heads that can result in developmental problems.

Brazil on Tuesday raised the number of microcephaly cases linked to Zika. It has confirmed 583 cases of microcephaly, up from 508 a week earlier. Suspected cases rose to 4,107 from 3,935.

The first known case of Zika virus transmission in the United States was reported in Texas in early February by local health officials, who said it likely was contracted through sex and not a mosquito bite.

Zika has caused outbreaks in at least 29 countries in the Americas. The CDC added Trinidad and Tobago and Marshall Islands to its travel advisory on Tuesday.

The agency in early February revised its guidelines for pregnant women to include a recommendation that even those without symptoms of the Zika virus should be tested after returning from affected areas.

 

(Reporting by Natalie Grover and Ankur Banerjee in Bengaluru; Editing by Sriraj Kalluvila, Bernard Orr)

http://in.reuters.com/article/health-zika-cdc-idINKCN0VW2D4

 

[niman]

The CDC is warning about sexually transmitted Zika as more possible US cases pop up

Updated by Julia Belluz on February 23, 2016, 4:30 p.m. ET @juliaoftoronto [email protected]

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As researchers learn more about Zika, they're answering some very basic questions about the virus — such as how exactly it spreads.

Evidence is mounting that it's not just mosquitoes that can pass the disease from person to person: Zika can be spread through sex, too.

 

The Centers for Disease Control and Prevention just announced it's investigating 14 cases of sexual transmission of Zika in the United States. The cases all involved male travelers who recently visited a region with a Zika outbreak and then returned to the United States, where they reportedly passed on the virus to their female partners.

Several of the cases include pregnant women, which is worrisome considering Zika hasbeen linked with a birth defect called microcephaly. All together, the CDC suggested sexually transmitted Zika may be more common than researchers previously believed.

Researchers have a lot of questions about sexually transmitted Zika

There have already been several cases in the medical literature that suggest Zika can be spread through sex.

In one case, a man who traveled to Senegal in 2008 and contracted Zika gave it to his wife through intercourse after he returned home to Colorado. In another, Zika was found in semen.

The first case of sexual transmission in the United States during this current outbreak was documented in Dallas in February. A traveler returned from Venezuela, where the virus was circulating, and infected his or her partner.

 

But there's still a lot of uncertainty here. Researchers aren't sure how long Zika can remain in semen, when people are most at risk of passing on the virus, or what types of sex acts are more likely to spread the virus. They also don't know how commonly Zika is spread sexually as compared with mosquito bites, though they think it's relatively rare.

Sexual transmission is also thought to spread only from men to women (not vice versa). Again, that information might change as we learn more.

Men coming from Zika-affected regions should avoid unprotected sex with pregnant partners

For now, the CDC has issued interim guidance on safe sex during a Zika outbreak: Men who have traveled or lived in countries where Zika is circulating and have female partners who are pregnant should either avoid sex or use condoms for vaginal, anal, and oral sex for the duration of the pregnancy.

For couples who aren't pregnant, the CDC still recommends considering condoms or abstaining if the male has traveled or lived in a place with Zika. 

"The science is not clear on how long the risk should be avoided," the CDC said in its announcement. That's because researchers don't know how long the virus can live in the semen — and how long it remains infectious. In the UK, researchers found virus in a man's semen 62 days after he got sick.

Pregnant women have been advised to avoid Zika hot spots

Meanwhile, American women who are pregnant have been advised to stay out of countries where the Zika virus is circulating. The CDC also issued guidance on how to care for pregnant women during a Zika outbreak, safe sex, and when to get tested for Zika. (See our graphic above.)

If you're trying to get pregnant, proceed with caution if visiting these areas. The CDC recommends consulting your doctor before your trip and following steps to prevent mosquito bites during the trip.

If you'd like to get pregnant in the more distant future, however, there appears to be no need to worry. Zika does not seem to pose a risk of birth defects for future pregnancies. As best researchers can tell, the virus clears itself from the body pretty quickly, remaining in the blood for only about a week after infection. (If you want more information, see ourZika pregnancy explainer.)

Mosquitoes are still thought to be the main disease vector

Right now, researchers believe you're most likely to get Zika through a mosquito bite. The virus is mainly carried by a specific type of mosquito called Aedes aegypti, which spreads the disease through bites.

Aedes mosquitoes bite during the day and are incredibly well-adapted to thrive alongside humans. They can breed and rest in small pools of water and moist environments around people's homes and apartments. (You can see examples of the mosquito's main aquatic habitats here, ranging from rain-filled cavities in trees to outdoor pots and animal drinking pans.)

There's also some evidence that suggests the Asian tiger mosquito (Aedes albopictus) can transmit the virus, too. This is a worry because the Aedes albopictus has a much larger range in the United States, reaching at least 32 states, though researchers think this mosquito doesn't spread the virus as efficiently.

http://www.vox.com/2016/2/23/11101500/zika-sexual-transmission

 

[niman]

US investigates 14 possible cases of sexually transmitted Zika virus

Officials look into cases of men who visited areas affected by virus and who may have infected their female partners

 

 A model of a mosquito is pictured in a laboratory in Hamburg, Germany. Zika is typically transmitted by mosquito bites, but researchers are investigating possible sexually transmitted cases. Photograph: Christian Charisius/EPA

Associated Press in New York

Tuesday 23 February 2016 17.56 ESTLast modified on Tuesday 23 February 201618.00 EST

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US health officials are investigating more than a dozen possible Zika infections that may have been spread through sex.

The 14 cases all involve men who visited areas with Zika outbreaks, and who may have infected their female sex partners, who had not travelled to those areas.

Zika virus is mainly spread by mosquito bites, and sexual transmission has been considered rare. There have been two reported cases, including a recent one in Texas, and at least two other reports of the Zika virus found in semen.

Mosquito-borne Zika outbreaks have erupted across most of Latin America and the Caribbean in the last year. So far, all the 82 Zika infections diagnosed in the US have involved people who travelled to outbreak regions.

On Tuesday, the Centers for Disease Control and Prevention said the 14 possible cases of sexual transmission in the US include two pregnant women whose infections have been confirmed. Tests have not been completed for their male partners.

In four other cases, preliminary tests indicate women were infected but confirmatory tests are pending. Eight other cases are still being investigated, according to a CDC statement.

The agency said there is no evidence that women can spread the virus to their sex partners, but more research is needed.

In most people, Zika causes mild or no symptoms – fever, joint pain, rash and red eyes – that last about a week. But in Brazil, health officials are investigating a possible connection between the virus and babies born with brain defects and abnormally small heads.

The link has not been confirmed but the possibility has prompted health officials to take cautionary steps to protect fetuses from the virus.

Research is also under way into a possible link between Zika infection and a paralyzing condition in adults called Guillain-Barré syndrome.

The CDC is advising men who have recently been to a Zika outbreak area to use a condom when they have sex with a pregnant women, or to abstain from sex during the pregnancy. It has also recommended that pregnant women postpone trips to more than 30 destinations with outbreaks. The CDC on Tuesday expanded its Zika travel advisory to two more places – the Marshall Islands, and Trinidad & Tobago.

There is no vaccine for Zika. Researchers are scrambling to develop one, as well as better diagnostic tests.

Two Texas hospitals say they have developed first rapid tests for Zika virus

 

Read more

The Zika virus is mostly spread by the same kind of mosquito that transmits other tropical diseases, including dengue and chikungunya. That same mosquito is found in the southern US and officials expect they will eventually spread the virus, too. But they don’t expect to see major outbreaks.

The CDC recommends that all travellers use insect repellent while in Zika outbreak areas, and continue to use it for three weeks after travel in case they might be infected but not sick. That is to prevent mosquitoes from biting them and possibly spreading Zika to others in the US.

http://www.theguardian.com/world/2016/feb/23/zika-virus-sexually-transmitted-disease-us-cases

 

[niman]

CDC Expert Commentary

Advising Pregnant Women About Zika: The Latest Guidance From CDC

Titilope Oduyebo, MD, MPH

Disclosures|February 17, 2016

 

 

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Hello. I am Dr Titilope Oduyebo, an obstetrician-gynecologist with the Pregnancy and Birth Defects Team for CDC's 2016 Zika Virus Response. Over the next few minutes, I will discuss what we know about Zika virus infection during pregnancy and review the current CDC recommendations for the screening, testing, and management of women with possible Zika virus exposure.

Currently, data on pregnant women infected with Zika virus are limited. Data suggest that pregnant women can be infected with Zika virus in any trimester; however, the incidence of Zika virus infection in pregnant women is not known.^[1-3] There is no evidence to suggest that pregnant women are more susceptible to Zika virus or experience more severe disease than nonpregnant individuals.

With respect to Zika virus transmission, there is evidence of transmission of Zika virus from mother to fetus during pregnancy and also around the time of delivery.^[1-3] Because neither a vaccine nor a prophylactic medication is available to prevent Zika virus infection, CDC recommends that pregnant women in any trimester should consider postponing travel to areas with ongoing Zika virus transmission. If a pregnant woman lives in or travels to an area with Zika virus transmission, she should strictly follow steps to avoid mosquito bites.

Strategies to avoid mosquito bites are multifaceted. CDC recommends the use of EPA-registered insect repellents, such as DEET, picaridin, and IRIR3535. These insect repellants are considered safe for use in pregnancy when used in accordance with the package label. Other strategies include wearing long-sleeved shirts and pants to cover exposed skin, wearing permethrin-treated clothing, and staying and sleeping in screened-in or air-conditioned rooms. Because the mosquitos that transmit Zika virus bite mostly during the daytime, it is recommended that pregnant women practice these strategies throughout the entire day.^[4,5]

I would like to briefly review CDC's updated interim guidelines for healthcare providers caring for pregnant women and women of reproductive age with possible Zika virus exposure, which were published on February 5, 2016, in CDC's Morbidity and Mortality Weekly Report.^[6] CDC updated its interim guidelines for US healthcare providers caring for pregnant women during a Zika virus outbreak. As in the original guidance, pregnant women with a history of travel to an area with Zika virus infection and who have symptoms consistent with Zika virus disease (which include fever, rash, joint pain, and red eyes) should be prioritized for testing for Zika virus infection. The updated guidelines include a new recommendation to offer serologic testing to pregnant women with a history of travel to an area with ongoing Zika virus transmission and who are asymptomatic (meaning they do not report clinical illness consistent with Zika virus disease). Testing should be performed 2-12 weeks after travel. Although we have limited information about antibody testing of asymptomatic persons, data from related viruses suggest that this testing may be useful when the timeframe of exposure is known.

The updated guidelines also provide guidance to healthcare providers caring for women living in areas with ongoing Zika virus transmission and include recommendations for screening, testing, and management of pregnant women and recommendations for counseling women of reproductive age (15-44 years). Pregnant women who reside in areas with ongoing Zika virus transmission have an ongoing risk for infection throughout pregnancy. Thus, in pregnant women with clinical illness consistent with Zika virus disease, testing is recommended during the first week of illness. In addition, testing is recommended at the initiation of prenatal care with follow-up testing at mid–second trimester for asymptomatic pregnant women living in areas with ongoing Zika virus transmission. Local health officials should determine when to implement testing of these pregnant women based on information about levels of Zika virus transmission and laboratory capacity. Healthcare providers should discuss reproductive life plans, including pregnancy intention and timing, with women of reproductive age in the context of the potential risks associated with Zika virus infection.

For more detailed information about CDC's recommendations, please read CDC's "Updated Interim Guidelines for Health Care Providers Caring for Pregnant Women and Women of Reproductive Age with Possible Zika Virus Exposure." CDC's guidance will be updated as we learn more. For more information about Zika virus, visit www.cdc.gov/zika.

Titilope Oduyebo, MD, MPH , is an obstetrician-gynecologist completing an Epidemic Intelligence Service (EIS) fellowship at the Centers for Disease Control and Prevention. Dr Oduyebo completed internship and residency training at the Brigham and Women's Hospital and Massachusetts General Hospital. She earned her MD from Yale University School of Medicine, MPH from Johns Hopkins School of Public Health, and BS from University of Maryland, College Park.

http://www.medscape.com/viewarticle/858892