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Zika Virus Update: CDC Activates Emergency Operations Center, Expands Travel Alert


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by Melissa Jenco, January 22, 2016 · www.aapnews.org

The Centers for Disease Control and Prevention (CDC) activated its emergency operations center (EOC) on Friday to better coordinate response to the Zika virus.

It also expanded its related travel warning to eight more regions as officials continue to explore possible links between Zika in pregnant women and microcephaly in their babies.

“Pediatricians and parents have many questions and concerns about the Zika virus,” said AAP Executive Director/CEO Karen Remley, M.D., M.B.A., M.P.H., FAAP. “The CDC’s expanded support and coordination of response activities with its partners, including the Academy, will be beneficial in communicating the facts quickly and alleviating anxiety. The AAP will continue to work with the CDC to develop clinical guidance, including an algorithm to help pediatricians in clinical evaluation of Zika cases.”

The CDC now is advising pregnant women to consider delaying travel to Barbados, Bolivia, Ecuador, Guadeloupe, Saint Martin, Guyana, Cape Verde and Samoa.

Those regions have been added to the Level 2 travel alert that already includes Brazil, Colombia, El Salvador, French Guiana, Guatemala, Haiti, Honduras, Martinique, Mexico, Panama, Paraguay, Suriname, Venezuela and the Commonwealth of Puerto Rico.

Zika virus primarily is spread by Aedes mosquitoes and typically produces mild illness. However, health authorities including the CDC and Pan American Health Organization are investigating a possible association between Zika virus in pregnant women in Brazil and the birth defect microcephaly in their babies. Since October 2015, Brazil has recorded more than 3,500 cases of microcephaly.

Officials also are exploring possible ties between Zika virus and Guillain-Barré syndrome. In addition, travelers may be at risk of contracting dengue or chikungunya viruses from mosquitoes in these regions.

According to the CDC, women who are pregnant or trying to become pregnant should consult with their doctor if they do choose to travel to these regions and take precautions to avoid mosquito bites by using repellant with DEET, picaridin or IR3535. In addition, travelers should wear long sleeves and pants, preferably treated with permethrin, and stay in places with air conditioning or window screens.

There are no vaccines to protect against Zika virus, but the CDC said health officials are working to develop them.

Zika is a Flavivirus like West Nile and yellow fever and can be tough to diagnose. Roughly one in five people will develop symptoms that may include fever, rash, joint pain and conjunctivitis. Some people also may experience headache, muscle pain or vomiting.

The CDC recommends that pediatricians consider the possibility of Zika virus in patients who present with those symptoms and recently have traveled to an endemic area. They should report suspected cases to state health departments so diagnostic testing can be performed.

A testing algorithm for pregnant women who have traveled to affected regions and their babies is available at http://www.cdc.gov/mmwr/volumes/65/wr/mm6502e1.htm?s_cid=mm6502e1_w.  The CDC in collaboration with the AAP is developing an evaluation algorithm for infants who may have been exposed to Zika in utero. It is anticipated that this algorithm will be released shortly.