Zika Virus - Serious & Growing Concern

April 28, 2016

The Zika virus is a growing threat in Alabama as our weather warms and Alabamians continue to travel to Zika affected areas for business, tourism and mission work. We learn more about Zika almost daily. There is no vaccine or specific treatment, and only about one in five people infected experience symptoms. Most concerning is the potential effect that the Zika virus has on the unborn baby because it has been found to be the cause of severe birth defects and other poor birth outcomes linked with infection during pregnancy. Congenital microcephaly, a condition characterized by an abnormally small head and hampered brain development, has been recognized in large numbers of newborns in Brazil since the onset of the current Zika outbreak. Babies with microcephaly can have other health problems ranging from mild to severe which can be life-threatening or lifelong. All Zika infection in the United States, including three cases so far in Alabama, have been related to either travel to a Zika affected area or through sexual contact with such a traveler.

Controlling mosquitoes helps protect yourself and your community from the Zika virus. Zika is transmitted by Aedes species mosquitoes which are present throughout Alabama and bite both day and night. To prevent mosquito bites, make it a habit to wear repellants routinely and take steps to reduce the sources of standing water which can become a breeding ground for mosquitoes.

The Centers for Disease Control and Prevention (CDC) provides the following guidance to protect yourself and your family from mosquito bites and the Zika virus:

  • Wear long-sleeved shirts and long pants.
  • Stay in places with air conditioning and window and door screens to keep mosquitoes outside.
  • Treat your clothing and gear with permethrin or buy pre-treated items.
  • Use Environmental Protection Agency (EPA)-registered insect repellents containing DEET, picaridin, oil of eucalyptus, or IR3535 as directed.
  • 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. 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.

Outside your home:

  • Install or repair and use window and door screens. Do not leave doors propped open.
  • Once a week, empty and scrub, turn over, cover, or throw out any items that hold water like tires, buckets, planters, toys, pools, birdbaths, flowerpot saucers, or trash containers. Mosquitoes lay eggs near water.
  • Tightly cover water storage containers (buckets, cisterns, rain barrels) so that mosquitoes cannot get inside to lay eggs.
  • For containers without lids, use wire mesh with holes smaller than an adult mosquito.
  • Use larvicides to treat large containers of water that will not be used for drinking and cannot be covered or dumped out.
  • Use an outdoor flying insect spray where mosquitoes rest. Mosquitoes rest in dark, humid areas like under patio furniture, or under the carport or garage.

When using insecticides, always follow label instructions.

  • If you have a septic tank, repair cracks or gaps. Cover open vent or plumbing pipes. Use wire mesh with holes smaller than an adult mosquito.
  • Consider hiring a pest control expert to treat your yard and outdoor areas with long-lasting insecticide or larvicide to control mosquitoes up to several weeks.

Inside your home:

  • Use air conditioning when possible.
  • Keep mosquitoes from laying eggs inside your home. Once a week, empty and scrub, turn over, cover, or throw out any items that hold water like vases and flowerpot saucers.
  • Kill mosquitoes inside your home. Use an indoor flying insect fogger or indoor insect spray to kill mosquitoes and treat areas where they rest. These products work immediately, but may need to be reapplied. Always follow label directions.
  • Mosquitoes rest in dark, humid places like under the sink, in closets, under furniture, or in the laundry room.

For the one in five persons infected with Zika virus who will have symptoms, these are generally mild and include fever, rash, joint pain, conjunctivitis (red eyes), muscle pain, and headache. During the first week of infection, Zika virus can be found in a person’s blood and can pass from an infected person to a mosquito through mosquito bites. An infected mosquito can then spread the virus when it bites other people. To help prevent others from getting sick, strictly follow steps to prevent mosquito bites during the first week of illness. Further, even if they do not feel ill, travelers returning to the United States from an area with Zika should take care to prevent mosquito bites for three weeks after return so they do not pass Zika to mosquitoes that could then spread the virus to other people.

The CDC has also issued guidance regarding travel and sexual contact. Pregnant women should avoid travel to Zika-affected areas. A regularly updated list of countries experiencing Zika outbreaks can be found at http://www.cdc.gov/zika/geo/. Any pregnant woman who has traveled to a Zika-affected area during pregnancy should be evaluated and tested, regardless of whether or not she has had symptoms. Pregnant women whose male sex partners have traveled to an area with Zika need to be concerned about sexual transmission of the Zika virus and the male should use condoms every time or not have sex during the entire pregnancy.

Couples considering becoming pregnant should seek counseling and consider postponing travel to a Zika-affected area. For individuals who traveled to a Zika-affected area and have been diagnosed with Zika or who have had symptoms consistent with Zika (fever, rash, joint pain or red eyes), ADPH advises women to wait at least eight weeks after symptoms first appear before trying to get pregnant and men to wait at least six months after symptoms first occur before trying to get their partner pregnant. For individuals who traveled to a Zika-affected area but did not develop symptoms consistent with Zika, both women and men should consider using condoms or not having sex for at least eight weeks after returning from travel before attempting a pregnancy. Condom use in all recommendations applies to all forms of sexual contact.

The current understanding is that the virus can persist for an extended period of time in semen. That is why there is a longer time frame for the male recommendation. Couples should discuss these recommendations with their physician or other healthcare provider.
While much about Zika remains unknown, strides are being made in understanding how to recognize, diagnose, and manage the complications of this virus. The Alabama Department of Public Health continues to work with a variety of partners to prepare, protect, and educate Alabamians to meet the challenges of the virus and its risks to the health of our babies. For further information, visit www.adph.org/mosquito.

This information prepared by
Thomas M. Miller, M.D.
State Health Officer
Alabama Department of Public Health