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Zika virus health risk grows

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The Zika virus is spread primarily through the bite of an infected mosquito, but can also be spread through sexual contact with an infected person, from mother to child, through blood transfusion or lab exposure.

This fall, the CDC expanded its travel guidance to include people traveling to Miami-Dade County in South Florida because of documented Zika virus spread in this geography. Specifically, the CDC confirmed mosquito-borne spread of Zika in a 1 square mile area in Miami-Dade County, Florida.

Because of the spread of Zika in this area, the CDC updated its guidance for pregnant women and women and men of reproductive age.

Pregnant women should consider postponing travel to all areas of Miami-Dade County, according to the CDC. The agency is also recommending pregnant women who have lived in, traveled to or had unprotected sex with someone who lived in or traveled to Miami-Dade County after Aug. 1, 2016, should be tested for the Zika virus.

Members and individuals should check with their doctor before travel to areas of known Zika transmission. They should also check with the CDC  for Zika updates, since the situation is fluid and continues to be monitored by local, state and federal agencies.

What is Zika?

In May 2015, the Pan American Health Organization issued alerts regarding the first confirmed Zika virus infection in Brazil. Since then more than 20 countries in Central and South America have confirmed cases of the virus, including cases in the United States and Europe in people who had traveled to the Americas.

There is currently no vaccine or specific treatment for the Zika virus infection.

People can contract the virus by being bitten by an infected Aedes mosquito (A. aegypti and A. albopictus) – the same type of mosquito that spreads dengue, chikungunya, and yellow fever, according to the CDC. This is important because these species exist in the U.S. mainland and tend to live near humans, where they breed in standing water. They may bite any time of day but, primarily, at dawn or dusk. The virus can also be spread from a pregnant mother to her baby during pregnancy. Babies infected in utero can develop certain birth defects, such as  microcephaly – abnormal smallness of the head – and other poor outcomes in babies, according to the CDC..

The World Health Organization’s International Health Regulations Committee declared on Feb. 1, 2016 that the Zika virus is a global public health emergency requiring an urgent, united response from world health organizations.

Zika spreads to the United States

In early 2016, the Dallas County Health and Human Services department reported it had received confirmation from the CDC of the first Zika virus case acquired through sexual transmission in Dallas County.

Miami-Dade County, Florida, became an active area of transmission in the continental United States in August 2016, according to the CDC.

The warning in Florida came after 14 people were found to have been infected with Zika virus after being bitten by local mosquitoes.

The CDC added that it is working with state health departments, along with blood and tissue collection organizations to help ensure the safety of blood and tissue supplies. The efforts are to help reduce the risk of transmitting the Zika virus through blood and tissue transplants. The CDC believes that there is a strong possibility that Zika virus can be spread through blood transfusions. In addition, since most people infected with Zika don’t show any symptoms, blood donors may not know they have been infected.

Zika virus currently poses a low risk to the blood supply in the continental U.S., but that fact could change depending on how many people become infected with the virus, according to the CDC.

CDC recommendations

The CDC recommends that women who are pregnant or trying to be should take the following precautions:

  • Pregnant women should not travel to any areas where Zika is spreading. Pregnant women who must travel to one of these areas should talk to their doctor or other health care professional first and strictly follow steps to avoid mosquito bites during the trip.  Until more is known, the CDC advises that any pregnant woman’s sexual partner who has traveled to or lives in an area with active Zika virus transmission, should abstain from sex or use condoms the right way for all vaginal, anal or oral sex for the duration of the pregnancy.
  • Women trying to become pregnant should consult with their health care professional before traveling to these areas and strictly follow steps to prevent mosquito bites during the trip.

Most people infected with Zika do not have symptoms. The most common symptoms for those that develop the infection are fever, rash, joint pain, and conjunctivitis. The illness is usually mild with symptoms lasting from several days to a week. The incubation time for Zika is currently being investigated, but is believed to be between days and weeks. Rest and fluids may help to decrease symptoms. The CDC has said that once a person has been infected with Zika, he or she is likely to be protected from a future Zika infection.

Treatment?

There is currently no vaccine or specific treatment for the infection. The best protection is to try to avoid mosquito bites. This can be done by using insect repellent containing DEET, picaridin, oil of lemon eucalyptus (OLE), or IR3535 (ethyl butylacetylaminopropionate); wearing clothes (preferably light-colored) that cover as much of the body as possible and are permethrin-treated; using physical barriers such as screens, closed doors and windows; and sleeping under mosquito nets. It is also important to empty, clean, or cover containers that can hold even small amounts of water, such as buckets, flower pots or tires, to deter mosquito breeding.

In addition to microcephaly, Guillain-Barré syndrome (GBS), which is when your immune system attacks your nervous system, has been reported as “likely triggered” by the Zika virus in a small proportion of infections. The CDC is currently working to study the possibility of a link between Zika and GBS.

If you’re being treated for Zika and are considering taking aspirin or ibuprofen, be sure that Dengue Fever has been ruled out to avoid complications (such as excessive bleeding) that can occur when the disease and medications interact.

What is Aetna doing? 

While local authorities and physicians are on the front line of treatment during epidemics, Aetna constantly monitors reports of all infectious diseases, including the Zika virus. We are in contact with the CDC, U.S. federal agencies, state and local health departments, health care providers, medical evacuation providers, and others so that we can appropriately promote awareness and prevention. We also review our clinical policies for the most current evidence-based coverage criteria and we work with health care providers to reduce barriers to the timely delivery of health care services. The costs related to Zika virus in the U.S. are very difficult to predict. We will track them as they accrue. We do not have forward looking projections at this time.

Want to learn more?

If you are traveling, nearly 40 countries have already been issued level 2 travel alerts by the CDC because of the spread of Zika. The alert means travelers should practice enhanced precautions.

The best way to protect yourself is to learn about prevention, symptoms and treatment guidelines. For more information about the Zika virus, visit the following CDC resources:

Visit these pages regularly for updates and alerts:

Due to the fluid nature of the Zika situation, this post has been updated frequently to reflect current information. As the situation develops, additional updates will be forthcoming.

  • Oct. 24, 2016 – Post updated to reflect stats of Zika cases in the U.S. and new travel guidance recommendations by the CDC.
  • Sept. 22, 2016 – Post updated to reflect stats of Zika cases in the U.S.
  • Aug. 3, 2016 – Post was updated to reflect CDC warnings on blood and tissue transplants and the active transmission of Zika in Miami-Dade County, Florida.
  • July 26, 2016 – Post was updated to reflect CDC confirmation that transmission of the disease can occur between any sexual partner (male or female) and to take the necessary precautions if a sexual partner has recently traveled to an area with active Zika transmission.
  • April 14, 2016 – Post was updated to reflect CDC confirmation that Zika virus is linked to microcephaly.
  • April 11, 2016 – Post was updated to reflect new travel alerts from the CDC and to inform that most people infected with Zika don’t show symptoms.