ZIKA: DELAWARE PUBLIC HEALTH URGES CAUTION FOR TRAVELERS

Dover (January 29, 2016) - The Delaware Division of Public Health (DPH) endorsed Centers for Disease Control and Prevention (CDC) travel guidelines today, including urging pregnant women to postpone travel to areas where Zika transmission is ongoing. The countries listed include but are not limited to: Brazil, Colombia, Venezuela, Barbados, Dominican Republic, Haiti, Puerto Rico, U.S. Virgin Islands, Mexico, Guatemala, El Salvador, Honduras, and Panama. For the complete list of Caribbean, Central and South American, and African countries impacted, visit http://wwwnc.cdc.gov/travel/notices.

Because there is neither a vaccine nor antiviral medications available to prevent Zika virus infection, the CDC recommends that women who are pregnant in any trimester:

• Consider postponing travel to any area where Zika virus transmission is ongoing.
• If you must travel to one of these areas, talk to your doctor first and strictly follow steps to prevent mosquito bites during your trip.
• And women who are trying to become pregnant, before you travel, talk to your doctor about your plans to become pregnant and the risk of Zika virus infection.

There have been reports of a serious birth defect of the brain called microcephaly (http://www.cdc.gov/ncbddd/birthdefects/microcephaly.html ), a condition in which a baby's head is smaller than expected when compared to babies of the same sex and age, and other poor pregnancy outcomes in babies of mothers who were infected with Zika virus while pregnant. Knowledge of the link between Zika and these outcomes is evolving, but until more is known, DPH joins the CDC in recommending special precautions.

"All cases of Zika transmission have occurred outside the continental United States," said DPH Director Dr. Karyl Rattay. "All cases in the continental U.S. are linked to travel and we have no lab-confirmed cases in Delaware. But, given the reports of serious birth defects in babies of mothers infected with Zika, DPH wanted to reinforce the CDC travel guidelines."

While preventing mosquito bites is especially important in reproductive-age women, people of all ages should take steps to prevent mosquito bites during travel given there are several illnesses spread by mosquito bites, including Zika, dengue fever, West Nile Virus, Eastern equine encephalitis (EEE),and chikungunya, among others.

Mosquito prevention strategies include:

• Wear long-sleeved shirts and long pants.
• Stay in places with air conditioning or that use window and door screens to keep mosquitoes outside.
• Use Environmental Protection Agency (EPA)-registered insect repellents. All EPA-registered insect repellents are evaluated for effectiveness.
  • Always follow the product label instructions.
  • Reapply insect repellent as directed.
  • Do not spray repellent on the skin under clothing.
  • If you are also using sunscreen, apply sunscreen before applying insect repellent.
• If you have a baby or child:
• Do not use insect repellent on babies younger than 2 months of age.
• Dress your child in clothing that covers arms and legs, or
• Cover crib, stroller, and baby carrier with mosquito netting.
• Do not apply insect repellent onto a child's hands, eyes, mouth, and cut or irritated skin.
• Adults: Spray insect repellent onto your hands and then apply to a child's face.

• Treat clothing and gear with permethrin or purchase permethrin-treated items.
  • Treated clothing remains protective after multiple washings. See product information to learn how long the protection will last.
  • If treating items yourself, follow the product instructions carefully.
  • Do NOT use permethrin products directly on skin. They are intended to treat clothing.
• Sleep under a mosquito bed net if you are overseas or outside and not able to protect yourself from mosquitos.

Health care providers should ask all their patients about recent travel. Because of the similar geographic distribution and clinical presentation of Zika, dengue, and chikungunya virus infection, patients with symptoms consistent with Zika virus disease should also be evaluated for dengue and chikungunya virus infection, in accordance with existing guidelines.

All women who traveled to an area with ongoing Zika virus transmission during pregnancy should be evaluated for Zika virus infection and tested in accordance with CDC latest guidance. To report a potential illness or receive further guidance on testing, call the DPH Office of Infectious Disease Epidemiology at 302-744-4990.

Anyone who lives or travels in the impacted areas can be infected. Most people who are infected with Zika do not develop symptoms. About one in five people infected with the virus develop the disease and symptoms are generally mild. The most common symptoms of Zika virus disease are fever, rash, joint pain, or conjunctivitis (red eyes). Symptoms typically begin two to seven days after being bitten by an infected mosquito. Zika is primarily transmitted through the bite of infected Aedes mosquitoes. It can also be transmitted from a pregnant mother to her baby during pregnancy or around the time of birth. We do not know how often Zika is transmitted from mother to baby during pregnancy or around the time of birth.

For further information on Zika, visit CDC Frequently Asked Questions at http://www.cdc.gov/zika/disease-qa.html.

Zika and other many mosquito-borne illnesses are considered "mandatory reports" and must be reported to the DPH Office of Infectious Disease Epidemiology at 302-744-4990.

For clinical guidance on screening http://dhss.delaware.gov/dph/php/alerts/dhan356.html.

Individuals seeking TTY services should call 7-1-1 or 800-232-5460. A person who is deaf, hard-of-hearing, deaf-blind, or speech-disabled can use a TTY to type his/her conversation to a relay operator, who then reads the typed conversation to a hearing person at the DPH call center.

Delaware Health and Social Services is committed to improving the quality of the lives of Delaware's citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. DPH, a division of DHSS, urges Delawareans to make healthier choices with the 5-2-1 Almost None campaign: eat 5 or more fruits and vegetables each day, have no more than 2 hours of recreational screen time each day (includes TV, computer, gaming), get 1 or more hours of physical activity each day, drink almost no sugary beverages.

Delaware Health and Social Services is committed to improving the quality of the lives of Delaware's citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations.