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New Zika transmission guidelines and Delaware cases announced

July 30, 2016

The Delaware Division of Public Health updated its guidelines for sexual transmission of the Zika virus following the Centers for Disease Control and Prevention announcement of the first reported case of female to male sexual transmission in New York. DPH is also announcing two new travel-related cases in Delaware. A Sussex County woman and a New Castle County man tested positive for the Zika virus, bringing the total number of cases in Delaware to 10. All of the Zika positive test results are due to a mosquito bite while traveling abroad and none involve a pregnancy. Both individuals were tested within the last few weeks.

Zika is spread primarily through mosquito bite, but also can be sexually transmitted or passed from mother to fetus during pregnancy. CDC recommends that all pregnant women who have a sex partner who has traveled to, or resides in, an area with Zika use barrier methods every time they have sex or, they should not have sex during the pregnancy.

Although no cases of woman-to-woman Zika transmission have been reported, these recommendations now also apply to female sex partners of pregnant women. Condoms or dental dams should be used during oral sex, and condoms should be used for sex involving penetration. Sex includes vaginal, anal and oral sex, and may also include the sharing of sex toys.

A total of 145 individuals have been, or are in the process of being, tested in Delaware. At this time, there are 121 negative results, 10 positive results, 11 test results pending and two indeterminate results in pregnant females. Indeterminate means that it is not possible to definitively confirm the existence of the Zika virus in the human body. Both individuals with indeterminate results were traveling or living abroad this past winter. To protect patient privacy, DPH will not announce any other information on the status of the pregnancies. Consistent with other states, DPH will announce any Zika-related microcephaly cases after a birth should they occur.

According to the CDC, there are 1,404 confirmed cases of Zika virus in the United States and District of Columbia as of July 20. While no Zika cases have been confirmed to be from a mosquito bite that occurred in the continental U.S., Florida public health officials and the CDC are investigating two Zika cases that may have occurred due to a mosquito bite in that state.

DPH previously announced new Zika public education materials targeting pregnant women and their male partners, including offering Zika Prevention Kits to pregnant women. The kits are being distributed at Delaware Women, Infants and Children clinics and other locations. Recommended by the CDC, the kit contains mosquito repellent, condoms, thermometers and informational brochures. For updated information and links to educational materials, go to www.dhss.delaware.gov/dhss/dph/zika.html.

Zika, a generally mild illness, has been linked to serious birth defects in Brazil and other countries and is most often spread by mosquitoes.

Travel and transmission advisories

For those who are pregnant, postpone travel to the countries where Zika virus transmission is ongoing. If a sexual partner has traveled to or lives in an area with active Zika virus transmission, barrier methods (condoms, dental dams) should be used for the duration of the pregnancy. Although no cases of woman-to-woman Zika transmission have been reported to date, these recommendations regarding the use of protection now extend to the female partners of pregnant women. Discuss a partner's potential exposures and history of Zika-like illness with a doctor.

For those who are trying to become pregnant and have been diagnosed with Zika virus or have symptoms of Zika, wait at least eight weeks after symptoms first appeared before trying to conceive.

Men who have been diagnosed with Zika virus or have symptoms are advised to wait at least six months after symptoms first appeared before having vaginal, oral or anal unprotected sex.

Men and women who do not have symptoms of Zika but had possible exposure through recent travel or sexual contact should wait at least eight weeks after possible exposure before trying to conceive in order to minimize risk.

If a partner lives in an area with active Zika transmission but has not developed symptoms, use barrier methods for sex while there is active Zika virus transmission in the area. Sex includes vaginal, anal and oral sex, and may also include the sharing of sex toys.

For those who are pregnant or may become pregnant and must travel to an area with Zika, talk to a doctor first and strictly follow steps to prevent mosquito bites during the trip. If they traveled to an area with active Zika virus transmission up to eight weeks before their pregnancy was confirmed, they should discuss their travel history with a doctor.

About one in five people infected with the virus will develop the disease, and most people who are infected do not develop symptoms. The most common symptoms of Zika virus are fever, rash, joint pain and conjunctivitis (red eyes). Symptoms typically begin two to seven days after being bitten by an infected mosquito.

To report a potential Zika illness or receive further guidance on patient testing, call the DPH Office of Infectious Disease Epidemiology at 302-744-4990.

To reduce the risk of mosquito bites, use Environmental Protection Agency-registered insect repellents; stay in places with air conditioning or with window or door screens to keep mosquitoes outside; sleep under a mosquito bed net if outside; treat clothing and gear with permethrin available in pharmacies or purchase permethrin-treated items; and wear long-sleeved shirts and long pants.

To report intolerable numbers of biting mosquitoes and request local relief for the southern half of Kent County south of Dover and all of Sussex County, residents are encouraged to call Mosquito Control's Milford Office, 302-422-1512 or go to www.de.gov/mosquito.

 

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