Zika virus surveillance and preparedness — New York City, 2015–2016
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Zika virus surveillance and preparedness — New York City, 2015–2016
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    On June 21, 2016, this report was posted online as an MMWR Early Release. Zika virus has rapidly spread through the World Health Organization’s Region of the Americas since being identified in Brazil in early 2015. Transmitted primarily through the bite of infected Aedes species mosquitoes, Zika virus infection during pregnancy can cause spontaneous abortion and birth defects, including microcephaly (1,2). New York City (NYC) is home to a large number of persons who travel frequently to areas with active Zika virus transmission, including immigrants from these areas. In November 2015, the NYC Department of Health and Mental Hygiene (DOHMH) began developing and implementing plans for managing Zika virus and on February 1, 2016, activated its Incident Command System. During January 1–June 17, 2016, DOHMH coordinated diagnostic laboratory testing for 3,605 persons with travel-associated exposure, 182 (5.0%) of whom had confirmed Zika virus infection. Twenty (11.0%) confirmed patients were pregnant at the time of diagnosis. In addition, two cases of Zika virus-associated Guillain-Barré syndrome were diagnosed. DOHMH’s response has focused on 1) identifying and diagnosing suspected cases; 2) educating the public and medical providers about Zika virus risks, transmission, and prevention strategies, particularly in areas with large populations of immigrants from areas with ongoing Zika virus transmission; 3) monitoring pregnant women with Zika virus infection and their fetuses and infants; 4) detecting local mosquito-borne transmission through both human and mosquito surveillance; and 5) modifying existing Culex mosquito control measures by targeting Aedes species of mosquitoes through the use of larvicides and adulticides. What is already known about this topic? Zika virus emerged in the Region of the Americas in early 2015, and imported cases have been detected in the United States, including New York City (NYC). What is added by this report? As of June 17, 2016, a total of 3,605 patients had been tested for Zika virus in NYC, 182 (5.0%) of which have been confirmed cases of Zika infection; 20 cases were in women who were pregnant at the time of diagnosis, and two cases of Guillain-Barré syndrome were diagnosed. The majority of cases were diagnosed by urine reverse transcription–polymerase chain reaction. The presence of a potentially competent Aedes mosquito vector in NYC necessitates a health department–wide response to identify and respond to potential local transmission of Zika virus, including sentinel surveillance and enhanced mosquito control. What are the implications for public health practice? In NYC, pregnant women and persons with a Zika-like illness who have been in Zika virus-affected areas should be tested for Zika virus infection. Providers should offer up-to-date information on the risk for birth defects so that pregnant patients can make informed decisions about pregnancy options. Preparedness for local transmission of Zika virus involves a robust emergency response infrastructure, targeted public health messaging, human and environmental surveillance strategies, and an integrated epidemiologic, clinical, and environmental response. Suggested citation for this article: Lee CT, Vora NM, Bajwa W, et al. Zika Virus Surveillance and Preparedness — New York City, 2015–2016. MMWR Morb Mortal Wkly Rep. ePub: 21 June 2016. DOI: http://dx.doi.org/10.15585/mmwr.mm6524e3.
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