Zika Virus Disease and Prevention Fairfax County Health Department

1. Fairfax County Health Department
Fairfax County
Health Department

2. Zika Virus
Epidemiology
Clinical Information
Pregnancy Registry
Prevention Strategies
Mosquito Bite Prevention and Control
Mosquito Biology
Zika Response Activities
Controlling Mosquitoes at Home
Preventing Mosquito Bites

3. 1st case in
Puerto Rico
2015-16 outbreak in Americas:
1st case of local transmission in Brazil
1st case in VA
traveler confirmed
WHO declares
Public Health
Emergency of
International
Concern
1947: Zika 1st
isolated
2015 2016
2007: Yap
Outbreak
2013–14: Fr.
Polynesia
outbreak
Local Zika
Transmission
confirmed in
Florida

4. http://www.cdc.gov/zika/geo/active-countries.html

5. http://www.cdc.gov/zika/intheus/maps-zika-us.html

6. http://www.cdc.gov/zika/intheus/maps-zika-us.html

7. Bite of an infected Aedes aegypti or Ae. albopictus mosquito
Pregnant woman infected with Zika, can pass Zika virus to her
fetus during pregnancy or around time of birth
Sexual transmission
Strong possibility passed through blood transfusions

8. Symptoms of Zika virus
• The most common symptoms
of Zika are:
Fever
Rash
Joint pain
Conjunctivitis (red eyes)
• Timeframe from exposure to
symptoms is 3-14 days
• No vaccine or medications to
prevent or treat Modified from CDC Zika 101 presentation

9. Clinical illness usually mild
Most people infected do not show any signs of illness
When symptoms do occur, last several days to a week
Severe disease requiring hospitalization is rare
Death is rare
Guillain-Barré syndrome reported in patients following suspected Zika
virus infection
Once a person has been infected, he or she is likely to be protected
from future infections

10. GBS is rare disorder where person’s own immune system
damages nerve cells, causing muscle weakness and
sometimes paralysis
Symptoms can last a few weeks or several months
Most people fully recover, but some have permanent
damage and, in rare cases, have died
GBS is very likely triggered by Zika in a small proportion of
infections, much as it is after a variety of other infections.
CDC investigating the link between Zika and GBS

11. Zika virus is a cause of microcephaly and other
severe fetal brain defects.
Defined by having a smaller than normal head or brain
circumference
Prognosis varies depending on severity of microcephaly
Brazil reporting increase in number of babies with
microcephaly and some have had lab-confirmed Zika
Rasmussen SA, Jamieson DJ, Honein MA, Petersen LR. Zika Virus and Birth Defects–Reviewing the Evidence for Causality. New EnglJ Med. 2016 Apr 13.

12. Purpose of registry:
To monitor pregnancy and infant outcomes following Zika virus infection
Who is included:
Pregnant women with lab evidence of Zika virus infection
exposed infants born to these women;
Infants with laboratory evidence of congenital Zika virus infection and their
mothers.

13. Pregnant or considering becoming pregnant?
CDC recommends women who are pregnant should not travel
to any area where Zika virus is spreading.
If your male partner travels to these areas, either use
condoms correctly from start to finish, every time you have
vaginal, anal, and oral (mouth-to-penis) sex, OR do not have
sex during the pregnancy.

14. Zika prevention strategies:
Sexual transmission
http://www.cdc.gov/zika/pregnancy/thinking-about-pregnancy.html

15. For all other travelers:
Pack to prevent (insect repellent, long-sleeved shirts, long pants, bed net,
condoms)
Avoid mosquito bites
Sleep indoors in rooms with screened windows or air-conditioning, or use
bed net if sleeping in rooms exposed to outdoors
Even if you do not feel sick, travelers returning to the United States from an
area with Zika should take steps to prevent mosquito bites for 3 weeks so
they do not spread Zika to local mosquitoes that could spread the virus to
other people.

16. There has been no local transmission of Zika by mosquitoes in Fairfax County or anywhere in
Virginia
Communicable Disease/Epidemiology Unit conducting human surveillance
Disease Carrying Insects Program conducting mosquito surveillance
If either of these indicate an area at high risk for Zika transmission—Health Department will
conduct educational outreach and begin mosquito control activities, which may include:
Removal of mosquito breeding sites
Conducting pesticide treatments

17. Fairfax County Health Department,
Disease Carrying Insects Program

18. Prevent mosquito
bites
Eliminate container
habitats around
your yard and
common areas
Fairfax wants
you…
to help fight
Zika
A healthier community starts with you.

19. Egg to adult in 7 to
10 days during
summer months.
1. Egg
2. Larva
3. Pupa
4. Adult
Males: Nectar only
Females: Nectar
and blood
On average, mosquitoes live for about a month as flying, biting adults.

20. Yellow fever mosquito
(Aedes aegypti)
Asian tiger mosquito
(Aedes albopictus)
Dengue
Zika
Chikungunya
Yellow Fever
CDC
CDC
Rare in Virginia Common in Virginia
The Asian Tiger mosquito has the greatest potential to spread
Zika virus in Fairfax County.

21. Lay eggs and develop only in
containers
Feed on humans and other animals
Short flight range
Less than150 meters
Urban/sub-urban
Active during daytime
Peak @ dawn and dusk
Rest in vegetation
CDC
CDC

22. Education
Outreach materials
Community-based activities
PSAs
Yard inspections
Mosquito Surveillance
Collect adult mosquitoes and test
for Zika virus
Larval collections

23. Source reduction (Tip and Toss)
Eliminate larval habitats, especially
containers
Larvicides
Control larvae when standing water
cannot be emptied
Adulticides
Barrier treatments to control adult
mosquitoes

24. Infected during travel to Zika-affected area and returned to Fairfax County
Conduct site visit to case property and perform the following, as
necessary:
Educate
Source reduction
Larvicide
Collect mosquitoes
Adult mosquito control

25. Patient is symptomatic and lab-positive for Zika without recent travel history
to Zika-affected area
OR
Adult mosquitoes collected during surveillance test positive for Zika virus
THEN
Perform outreach, source reduction, larviciding, and adult mosquito control
at case property as previously described, and on additional properties in the
surrounding area

27. Neighborhood cleanups:
reduce container habitats
Everyone’s yard
Common areas
Streams where trash
accumulates
Share what you know

28. Check yard weekly
Tip, Pour, and Toss
Throw away containers
Store containers so they don’t hold water
Use larvicide if can’t empty water

31. Flood water
Ditches
Root-ball poolsWoodland poolsSalt marshes
Permanent swamps Polluted water Grass tussocks
Pooling streamsPonds with vegetation
Swimming pools
Stormwater management
structures

32. Follow label instructions
Make sure product states that
it controls mosquitoes
Use products that work for few
weeks after application
(“residual”)
Focus treatment on areas of
dense vegetation

33. Long-sleeved shirt
Long pants
Socks and shoes
Light colors
Loose fit
Permethrin-treated
clothing

34. Follow label instructions
Active Ingredients:
DEET, Picaridin, IR3535, or
Oil of Lemon Eucalyptus
Reapply insect repellent as
directed
Apply sunscreen before
repellent
CDC

35. Repellents
Follow label instructions
DEET: Children older than 2 months
Oil of Lemon Eucalyptus: Children older
than 3 years
Adults: Apply to hands and then apply to a
child’s face
Avoid hands, eyes, mouth, and cut or
irritated skin
Cover crib, stroller, baby
carrier

36. Follow label instructions
Permethrin is the active
ingredient
Apply to clothing, NEVER to
skin
Pre-treated clothing or DIY

37. Peak biting times: dawn and dusk
Asian tiger mosquitoes bite all day
Use air conditioning
Repair doors and window screens
Mosquitoes that spread Zika
sometimes enter homes

38. Pan American Health Organization (PAHO):
www.paho.org/zika
Centers for Disease Control and Prevention (CDC):
www.cdc.gov/zika
Virginia Department of Health (VDH):
http://www.vdh.virginia.gov/epidemiology/zika-virus-
update/
Fairfax County Health Department (FCHD)
http://www.fairfaxcounty.gov/hd/westnile/zika-
virus.htm