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August 03, 2016

Zika virus: What YOU should be doing to avoid an outbreak here this summer

The Aedes mosquito will return to the Philadelphia region again this summer, bringing with it fears of a Zika virus outbreak here.

Zika virus, which has caused a public health emergency in South America, has now been transmitted locally in the United States. Fifteen cases have been reported in Miami-Dade and Broward counties in south Florida. Concerned the infection could spread in the United States as mosquitoes proliferate this summer, U.S. health officials are advising local health departments to prepare for the possibility of an outbreak.

As of May 11, the Centers for Disease Control and Prevention had confirmed 61 travel-related Zika cases in Pennsylvania, with 250 pending test results. Fifty travel-related cases were reported in New Jersey.

Federal and local health officials, including those in Montgomery County, have issued advice for residents to help combat the spread of Zika in this region, including steps to avoid mosquitoes.

And the CDC has emphasized the avoidance of mosquito bites in its public education campaign.

But apparently that important message isn't getting through.

According to a recent survey by the Annenberg Public Policy Center of the University of Pennsylvania, only 1 in 3 Americans say that protecting against mosquito bites is a step recommended by scientists to avoid the negative health effects of the Zika virus. In fact, just 35 percent of respondents correctly said that protecting against mosquito bites is one way to avoid Zika.

Here's a primer on the Zika virus and what local residents should be doing to help prevent a local outbreak:

WHAT IS THE ZIKA VIRUS?

The Zika virus is spread to people primarily through the bite of an infected Aedes species mosquito (A. aegypti and A. albopictus). Though most people don't get sick enough to go to the hospital, Zika virus infection during pregnancy can cause a serious birth defect called microcephaly, as well as other severe fetal brain defects. It has been reported that an increased number of people who have been infected with the Zika virus also have Guillain-Barré syndrome (GBS), an uncommon sickness of the nervous system in which a person’s own immune system damages the nerve cells, causing muscle weakness and, sometimes, paralysis. GBS is very likely triggered by Zika in a small proportion of infections. The CDC is investigating the link between Zika and GBS.

RISKS AND TRANSMISSION

Anyone who lives in or travels to an area where the Zika virus is found and has not already been infected with the Zika virus can get it from mosquito bites. Once a person has been infected, he or she is likely to be protected from future infections.

IF YOU ARE PREGNANT

Pregnant women should talk to a doctor or another health care provider if they or their male sex partners recently traveled to an area with Zika, even if they don’t feel sick.

DIAGNOSIS AND TREATMENT

The most common symptoms of Zika are fever, rash, joint pain and conjunctivitis (red eyes). The illness is usually mild, with symptoms lasting for several days to a week after being bitten by an infected mosquito. People usually don’t get sick enough to go to the hospital, and they very rarely die of Zika. For this reason, many people might not realize they have been infected. There is no vaccine to prevent or medicine to treat the Zika virus.

• See your doctor or another health care provider if you develop the symptoms described above and have visited an area where Zika is found. Tell your doctor or another health care provider when and where you traveled. They may order blood tests to look for Zika or other similar viruses like dengue or chikungunya.

If you are diagnosed, treat the symptoms at home:

• Get plenty of rest.

• Drink fluids to prevent dehydration.

• Take medicine like acetaminophen or paracetamol to reduce fever and pain.

• Do not take aspirin and other non-steroidal anti-inflammatory drugs (NSAIDS) until dengue can be ruled out to reduce the risk of bleeding.

• If you are taking medicine for another medical condition, talk to your doctor or another health care provider before taking additional medication.

• If you have Zika, prevent mosquito bites for the first week of your illness. During the first week of infection, the Zika virus can be found in the blood and passed from an infected person to a mosquito through mosquito bites. An infected mosquito can then spread the virus to other people.

NoneSource/Centers for Disease Control and Prevention

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HOW WOULD A U.S. OUTBREAK OCCUR?

For Zika to cause an outbreak in the continental United States, all of the following must happen:

• People infected with the virus enter the United States.

• An Aedes mosquito in the United States bites the infected person while the virus can be found in the person’s blood, typically only for the first week of infection.

• The infected mosquito lives long enough for the virus to multiply and then bites another person.

• The cycle continues multiple times to start an outbreak. Recent outbreaks in the continental United States of chikungunya and dengue, which are spread by the same type of mosquito that can transmit Zika, have been relatively small and limited to a small area. Even with the locally transmitted cases in South Florida, it is unclear how much activity to anticipate in other areas of the country.

• Despite other modes of disease transmission (i.e. via sex with an infected male, mother to baby during pregnancy or through a blood transfusion), mosquitoes continue to be the primary source of disease spread with Zika.

NoneSource/Centers for Disease Control and Prevention

PREVENTION

If you live in a state or area with the mosquito that spreads the Zika virus and you are concerned about Zika, learn how to build your own Zika Prevention Kit. Your kit should include items that will reduce your risk of getting Zika. Reducing the risk for Zika is particularly important for pregnant women. Your kit should include a bed net, insect repellent, permethrin spray, standing water treatment tabs and condoms.

Mosquito avoidance

• The best way to prevent diseases spread by mosquitoes is to protect yourself and your family from mosquito bites.

• Use Environmental Protection Agency (EPA)-registered insect repellents. Always follow the product label instructions. When used as directed, these insect repellents are proven safe and effective, even for pregnant and breastfeeding women.

• Do not use insect repellents on babies younger than 2 months old. Do not use products containing oil of lemon eucalyptus or para-menthane-diol on children younger than 3 years old.

Indoors

• Stay in places with air conditioning and window and door screens to keep mosquitoes outside.

• Check and repair windows and screens to prevent mosquitoes from entering your home.

Outdoors

• Wear long-sleeved shirts and long pants.

• Treat your clothing and gear with permethrin or buy pretreated items.

• Mosquito netting can be used to cover babies younger than 2 months old in carriers, strollers or cribs to protect them from mosquito bites.

• Sleep under a mosquito bed net if air-conditioned or screened rooms are not available or if sleeping outdoors.

• To discourage mosquito breeding, eliminate any standing water that collects on your property.

• Survey your property and dispose of containers that can collect standing water like old tires, cans, bottles, buckets and toys.

• After it rains, empty any plant containers, birdbaths, flowerpots, kiddie pools and pool covers to keep water from collecting in these items.

• Make sure roof gutters drain properly and rooftops are free of standing water.

• Clean and chlorinate swimming pools, outdoor saunas and hot tubs. Keep them empty and covered if not in use. Drain water that collects in pool covers.

• Drill several holes in the bottom of recycling buckets so water can drain from them. Trash containers should be covered so no rain can accumulate in them.

• Learn about four natural methods to deter mosquitoes

If you have Zika, protect others from getting sick

During the first week of infection, the Zika virus can be found in the blood and passed from an infected person to another mosquito through mosquito bites. An infected mosquito can then spread the virus to other people.

To help prevent others from getting sick, strictly follow steps to prevent mosquito bites during the first week of illness.

The Zika virus can be spread during sex by a man or woman infected with Zika to sex partners.

To help prevent spreading Zika from sex, you can use condoms correctly, from start to finish, every time you have sex. This includes vaginal, anal and oral (mouth-to-penis) sex. Not having sex is the only way to be sure that someone does not get sexually-transmitted Zika virus.

If you have traveled to an area with Zika

• If your partner is pregnant, either use condoms correctly, from start to finish, every time you have vaginal, anal and oral sex, or do not have sex during the pregnancy.

• Even if they do not feel sick, travelers returning to the United States from an area with Zika should take steps to prevent mosquito bites for three weeks so they do not spread Zika to mosquitoes that could spread the virus to other people.

WHERE'S ZIKA?

• The following countries and territories have active Zika transmission:

Americas

Anguilla, Argentina, Aruba, Barbados, Belize, Bolivia, Bonaire, Brazil, Colombia, Commonwealth of Puerto Rico (U.S. territory), Costa Rica, Cuba, Curacao, Dominica, Dominican Republic, Ecuador, El Salvador, French Guiana, Guadeloupe, Guatemala, Guyana, Haiti, Honduras, Jamaica, Martinique, Mexico, Nicaragua, Panama, Paraguay, Peru, Saba, Saint Barthélemy, Saint Lucia, Saint Martin, Saint Vincent and the Grenadines, Sint Maarten, Suriname, Trinidad and Tobago, U.S. Virgin Islands, Venezuela

Oceania/Pacific Islands

American Samoa, Fiji, Kosrae (Federated States of Micronesia), Marshall Islands, New Caledonia, Papua New Guinea, Samoa, Tonga, Cape Verde

WHAT IF I HAVE A BABY OR CHILD?

• Do not use insect repellent on babies younger than 2 months old.

• Do not use products containing oil of lemon eucalyptus or para-menthane-diol on children younger than 3 years old.

• Dress your child in clothing that covers arms and legs.

• Cover crib, stroller and baby carrier with mosquito netting.

• Adults can spray insect repellent onto hands and then apply to a child’s face.

CONTACT YOUR LOCAL HEALTH DEPARTMENT

All suspected and confirmed cases of arboviral infections (including Zika, West Nile, chikungunya and dengue) should be reported immediately to your local health department.

  • Have Zika, or think you do? Contact your local health department
  • Bucks County - 215-345-3318
  • Montgomery County - 610-278-5117
  • Chester County - 610-344-6452
  • Delaware County - Call the state health department at 1-877-PA-HEALTH
  • Philadelphia - 215-686-5200 
  • Camden County - (856) 374-6000
  • Burlington County - 609-265-5548
  • Gloucester County - (856) 218-4101

Your assistance regarding enhanced surveillance, appropriate testing and reporting of suspected arborviral infections and associated complications enables your local health department to determine potential exposure locations, direct additional mosquito-control efforts and accurately monitor severe illness if it occurs.

In addition to these infections, suspected or confirmed Zika cases that are associated with reports of Guillain-Barré syndrome or reports of adverse pregnancy or birth outcomes are of utmost importance and should be reported immediately.

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Sources: U.S. Centers for Disease Control and Prevention; the Montgomery County Health Department; and the National Institutes of Health.