The Centers for Disease Control (CDC) recently issued a health and travel advisory regarding Zika virus in the Americas (http://emergency.cdc.gov/han/han00385.asp). Zika virus is a mosquito-borne flavivirus, and to date has been identified in 20 countries or territories in South and Central America, Mexico, and the Caribbean, including Puerto Rico. Local transmission of Zika virus has not been documented in the continental United States. However, Zika virus infections have been reported in travelers returning to the U.S.
Clinical disease is usually mild and includes sudden onset of fever, maculopapular rash, arthralgia or conjunctivitis that lasts for a few days to a week. However, during the current outbreak, Zika virus infections have been confirmed in several infants with microcephaly and in fetal losses in women infected during pregnancy. Healthcare providers should ask all pregnant women about recent travel.
The CDC has developed guidance for pregnant women who may be traveling to areas in the Americas where Zika virus is circulating, "Interim Guidelines for Pregnant Women During a Zika Virus Outbreak-United States, 2016 (http://www.cdc.gov/mmwr/volumes/65/wr/pdfs/mm6502e1er.pdf). Please share this guidance with healthcare providers in your area.
Zika virus infection should be considered in Michigan patients, particularly pregnant women, with acute onset of symptoms and who traveled to areas with ongoing transmission in the two weeks prior to illness onset (http://www.cdc.gov/zika/geo/index.html). Patients with suspected Zika virus infection should also be evaluated and managed for possible dengue or chikungunya infection. Healthcare providers are encouraged to report suspected Zika virus disease cases to their local health department or to the Michigan Department of Health and Human Services to facilitate diagnosis and testing.
Healthcare providers should consider Zika virus testing in pregnant patients with clinical illness and recent travel. Currently, there are no commercial tests available for Zika virus. Contact the MDHHS at 517-335-8165 for assistance with submitting specimens for diagnostic testing.
Until more is known and out of an abundance of caution, pregnant women should consider postponing travel to any area where Zika virus transmission is ongoing. Pregnant women and women trying to become pregnant who do travel to these areas should talk to their doctors or other healthcare providers first and strictly follow steps to avoid mosquito bites during the trip.
For current information, visit CDC's Zika virus website at http://www.cdc.gov/zika/index.html/.