Details:

Journal Article:
MMWR. Morbidity and mortality weekly report
Personal Author:
Dirlikov, Emilio ; Ryff, Kyle R. ; Torres-Aponte, Jomil ; Thomas, Dana L. ; Perez-Padilla, Janice ; ... More +
Dirlikov, Emilio ; Ryff, Kyle R. ; Torres-Aponte, Jomil ; Thomas, Dana L. ; Perez-Padilla, Janice ; Muñoz-Jordan, Jorge L ; Caraballo, Elba V. ; Garcia, Myriam ; Segarra, Marangely Olivero ; Malavem Graciela ; Simeone, Regina M. ; Shapiro-Mendoza, Carrie K. ; Reyes, Lourdes Romero ; Alvarado-Ramy, Francisco ; Harris, Angela F. ; Rivera, Aidsa ; Major, Chelsea G. ; Mayshack, Marrielle ; Alvarado, Luisa I. ; Lenhart, Audrey ; Valencia-Prado, Miguel ; Waterman, Stephen H. ; Sharp, Tyler M. ; Rivera-García, Brenda Less -
Description:
On April 29, 2016, this report was posted online as an MMWR Early Release.

Zika virus is a flavivirus transmitted primarily by Aedes species mosquitoes, and symptoms of infection can include rash, fever, arthralgia, and conjunctivitis (1).* Zika virus infection during pregnancy is a cause of microcephaly and other severe brain defects (2). Infection has also been associated with Guillain-Barré syndrome (3). In December 2015, Puerto Rico became the first U.S. jurisdiction to report local transmission of Zika virus, with the index patient reporting symptom onset on November 23, 2015 (4). This report provides an update to the epidemiology of and public health response to ongoing Zika virus transmission in Puerto Rico. During November 1, 2015-April 14, 2016, a total of 6,157 specimens from suspected Zika virus-infected patients were evaluated by the Puerto Rico Department of Health (PRDH) and CDC Dengue Branch (which is located in San Juan, Puerto Rico), and 683 (11%) had laboratory evidence of current or recent Zika virus infection by one or more tests: reverse transcription-polymerase chain reaction (RT-PCR) or immunoglobulin M (IgM) enzyme-linked immunosorbent assay (ELISA). Zika virus-infected patients resided in 50 (64%) of 78 municipalities in Puerto Rico. Median age was 34 years (range = 35 days-89 years). The most frequently reported signs and symptoms were rash (74%), myalgia (68%), headache (63%), fever (63%), and arthralgia (63%). There were 65 (10%) symptomatic pregnant women who tested positive by RT-PCR or IgM ELISA. A total of 17 (2%) patients required hospitalization, including 5 (1%) patients with suspected Guillain-Barré syndrome. One (<1%) patient died after developing severe thrombocytopenia. The public health response to the outbreak has included increased laboratory capacity to test for Zika virus infection (including blood donor screening), implementation of enhanced surveillance systems, and prevention activities focused on pregnant women. Vector control activities include indoor and outdoor residual spraying and reduction of mosquito breeding environments focused around pregnant women's homes. Residents of and travelers to Puerto Rico should continue to employ mosquito bite avoidance behaviors, take precautions to reduce the risk for sexual transmission (5), and seek medical care for any acute illness with rash or fever.

What is already known about this topic? Zika virus transmission in Puerto Rico has been ongoing, with the first patient reporting symptom onset in November 2015. Zika virus infection is a cause of microcephaly and other severe birth defects. Zika virus infection has also been associated with Guillain-Barré syndrome.

What is added by this report? During November 1, 2015–April 14, 2016, a total of 6,157 specimens from suspected Zika virus–infected patients from Puerto Rico were evaluated and 683 (11%) had laboratory evidence of current or recent Zika virus infection. The public health response includes increased capacity to test for Zika virus, preventing infection in pregnant women, monitoring infected pregnant women and their fetus for adverse outcomes, controlling mosquitos, and assuring the safety of blood products.

What are the implications for public health practice? Residents of and travelers to Puerto Rico should continue to employ mosquito bite avoidance behaviors, take precautions to reduce the risk for sexual transmission, and seek medical care for any acute illness with rash or fever. Clinicians who suspect Zika virus disease in patients who reside in or have recently returned from areas with ongoing Zika virus transmission should report cases to public health officials.

Suggested citation for this article: Dirlikov E, Ryff KR, Torres-Aponte J, et al. Update: Ongoing Zika Virus Transmission — Puerto Rico, November 1, 2015–April 14, 2016. MMWR Morb Mortal Wkly Rep 2016;65:451–455. DOI: http://dx.doi.org/10.15585/mmwr.mm6517e2.

mm6517e2.pdf

PMID: 27149205


Subjects:
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Zika virus infection/transmission
Series:
MMWR. Morbidity and mortality weekly report ; v. 65, no. 17, p. 451–455
Pubmed ID:
27149205
Document Type:
Journal Article
Place as Subject:
Puerto Rico
Collection(s):
Morbidity and Mortality Weekly Report (MMWR)
Main Document Checksum:
[+]
urn:sha256:cd6be016b801e4dfca6cac521e96e8c0f38ae60d942b9fba957ecfb7da504e02
Download URL:
https://stacks.cdc.gov/view/cdc/39349/cdc_39349_DS1.pdf
File Type:

Supporting Files

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