Diseases
Zika Virus 

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Zika is a mosquito-borne illness.  The U.S. Army is taking the Zika virus very seriously and assisting the Centers for Disease Control and Prevention (CDC) in any way possible.    Information on the virus is changing almost daily and getting the most up-to-date information is important.   The information below is to help individuals and health care providers with decisions on travel and risks in their area.  Women who are pregnant or could be pregnant need to discuss their risk with their health care provider.

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General

For Pregnant Women

For Healthcare Providers

Diagnostic Testing and Reporting

For Military Personnel and their Families 

Mosquito Identification

Mosquito Bite Prevention 



New and updated content 

AFHSB: Detecting and Reporting DoD Cases of Zika Virus Disease and Zika Virus Congenital Infection Guidance External Link 9/21/16

FDA: FDA advises testing for Zika virus in all donated blood and blood components in the US External Link 8/26/16

FDA: Revised Recommendations for Reducing the Risk of Zika Virus Transmission by Blood and Blood Components External Link 8/16

CDC: Clinical Guidance for Healthcare Providers Caring for Infants & Children External Link Updated 8/25/16

CDC: Contraception to Prevent Unintended Pregnancy during the Zika Virus Outbreak External Link 8/2/16

CDC: CDC issues travel guidance related to Miami neighborhood with active Zika spread External Link 8/1/16

Zika Hotline

 

 

 

General

Government

CDC: Zika Virus External Link

CDC: CDC issues travel guidance related to Miami neighborhood with active Zika spread External Link 8/1/16

CDC: Update: Ongoing Zika Virus Transmission - Puerto Rico, November 1, 2015-July 7, 2016 External Link 7/30/16

ALARACT 031/2016: HQDA ZIKA PREPAREDNESS AND RESPONSE MESSAGE External Link (restricted access - milSuite) 4/16/16

OPO­RD 16-­37 (ME­DCO­M Res­pon­se to Zik­a Vir­us)­ External Link (restricted access - AKO) 4/18/16

AFHSB: Global Zika Virus Surveillance Summary External Link 5/25/16

CDC: CDC Interim Response Plan External Link 7/31/16

CDC: Areas with Zika External Link

CDC: Zika Travel Information  External Link

Health.mil: Zika Virus External Link

APHC: Zika Virus Infographic  JUN 2016

APHC: Zika Virus Brochure  JUN 2016

APHC: Zika Virus Handout  JUN 2016

APHC: Zika Virus: Know How to Protect Yourself External Link (PowerPoint presentation) 6/17/16

APHC: Zika Virus Fact Sheet Updated 2/11/16

CDC: Update - Interim Guidelines for Prevention of Sexual Transmission of Zika Virus External Link Updated 7/29/16 

CDC: Increase in Reported Prevalence of Microcephaly in Infants Born to Women Living in Areas with Confirmed Zika Virus Transmission During the First Trimester of Pregnancy — Brazil, 2015 External Link 

CDC: Possible Association Between Zika Virus Infection and Microcephaly — Brazil, 2015 External Link

NIH: Zika Virus - A Pandemic in Progress External Link

WHO: Zika - Strategic Response Framework & Joint Operations Plan External Link

PHC: Zika Virus Infographic    
Updated JUN 2016    
Zika Infographic 


WHO statement on the first meeting of the International Health Regulations (2005) (IHR 2005) Emergency Committee on Zika virus and observed increase in neurological disorders and neonatal malformations External Link

Non-government

Entomological Society of America: Media Fact Sheet on the Zika Virus and the Aedes aegypti mosquito

 

For Pregnant Women

Zika virus can be spread from a pregnant woman to her fetus and has been linked to a serious birth defect of the brain called microcephaly in babies of mothers who had Zika virus while pregnant.

Other problems have been detected among fetuses and infants infected with Zika virus before birth, such as absent or poorly developed brain structures, defects of the eye, hearing deficits, and impaired growth.  

CDC recommends special precautions for pregnant women. Women who are pregnant should not travel to areas with Zika. If you must travel to one of these areas, talk to your healthcare provider first and strictly follow steps to prevent mosquito bites during your trip.

Get all the latest guidance from the CDC at their Zika & Pregnancy website. External Link 

 Zika and Pregnancy

Non-government

New England Journal of Medicine: Zika virus and birth defects — reviewing the evidence for causality External Link 4/13/16

Government

CDC Concludes Zika Causes Microcephaly and Other Birth Defects External Link 4/13/16

CDC: Preconception counseling guide for men and women living in areas with Zika External Link 3/26/16

CDC: Women and their partners who are thinking about pregnancy External Link  3/26/16

CDC: Zika Travel Information  External Link

CDC: Information for Parents about Zika Virus External Link 

CDC: Doctor’s visit checklist: For Pregnant Women who Travel to an area with Zika External Link 

CDC: Doctor’s visit checklist: For Pregnant Women Living in an Area with Zika External Link

CDC: Zika Virus Testing for Pregnant Women Living in an Area with Zika External Link

CDC: For Pregnant Women: A Positive Zika Virus Test, What Does it Mean for me? External Link 

 

 

For Healthcare Providers

OTSG/MEDCOM Memorandum: Zika Risk Assessment External Link (Restricted access, AKO login required) 9/14/16

CDC: Recognizing, Managing, and Reporting Zika Virus Infections in Travelers Returning from Central America, South America, the Caribbean, and Mexico External Link 

Zika virus infection should be considered in patients with acute onset of fever, maculopapular rash, arthralgia or conjunctivitis, who traveled to areas with ongoing transmission in the two weeks prior to illness onset. Clinical disease usually is mild. However, during the current outbreak, Zika virus infections have been confirmed in several infants with microcephaly and in fetal losses in women infected during pregnancy. We do not yet understand the full spectrum of outcomes that might be associated with infection during pregnancy, nor the factors that might increase risk to the fetus.

CDC: Contraception to Prevent Unintended Pregnancy during the Zika Virus Outbreak External Link 8/2/16

CDC: Update: New FDA Recommendations External Link 7/28/16

CDC: Interim Guidance for Zika Virus Testing of Urine — United States, 2016 External Link 5/10/16

CDC/NIOSH: Interim Guidance for Protecting Workers from Occupational Exposure to Zika Virus External Link 4/10/16

CDC: Zika Action Plan Summit Presentations External Link 4/8/16

CDC: Update: Interim Guidelines for Health Care Providers Caring for Pregnant Women and Women of Reproductive Age with Possible Zika Virus Exposure — United States, 2016 External Link Updated 7/29/16 

CDC: Tools for Health Care Providers External Link Updated 3/26/16

CDC: Zika Virus - What Clinicians Need to Know External Link

CDC: US Zika Pregnancy Registry External Link Updated 3/31/16

CDC: Clinical Guidance for Healthcare Providers Caring for Infants & Children External Link Updated 8/25/16

CDC: Interim Guidelines for the Evaluation and Testing of Infants with Possible Congenital Zika Virus Infection — United States, 2016 External Link

CDC: Questions and Answers for Pediatric Healthcare Providers: Infants and Zika Virus Infection External Link

FDA: Revised Recommendations for Reducing the Risk of Zika Virus Transmission by Blood and Blood Components External Link Updated 8/16

FDA: FDA advises testing for Zika virus in all donated blood and blood components in the US External Link 

 

Diagnostic Testing and Reporting

AFHSB: Detecting and Reporting DoD Cases of Zika Virus Disease and Zika Virus Congenital Infection Guidance External Link updated 9/21/16

The Zika virus clinical laboratory testing algorithm is complex.  MTFs must ensure clinical Zika specimen submission and testing on patients is coordinated with the MTF lab, MTF Preventive Medicine Department and the state/ local public health department.

Preventive Medicine personnel should report confirmed and suspected cases of Zika virus in the Disease Reporting System internet (DRSi) under “Any other unusual condition not listed.”  Include information on clinical presentation, recent travel and any relevant or pending laboratory testing.  Report Zika virus cases to the state or local health departments per state guidelines and to the CDC’s ArboNET.

 

For Military Personnel and their Families

Soldiers in areas where Zika virus transmission is ongoing and who are pregnant or trying to become pregnant should discuss the risk of infection with Zika virus versus the risk of wearing a permethrin-treated uniform with their OB/GYN and primary care provider.  Mosquitoes that spread Zika virus bite both indoors and outdoors, mostly during the daytime; therefore, it is important to ensure protection from mosquitoes throughout the entire day. The CDC indicates that permethrin-treated clothing and insect repellents containing DEET, picaridin, and IR3535 are safe for pregnant women when used as directed on the product label.

CDC: Information for Parents about Zika Virus External Link 

CDC: US Zika Pregnancy Registry: What Parents Need to Know External Link 4/22/16

 

Mosquito Identification

APHC: Technical Guide 371 - Mosquito Genera Identification Key, United States and Alaska

APHC: Technical Guide 370 - Mosquito Genera Identification Key, Southern Command Area of Responsibility

APHC: Technical Guide 369 - Mosquito Genera Identification Key, Africa Command Area of Responsibility and Egypt

 

 Mosquito Bite Prevention

To reduce the risk of contracting Zika virus, personnel in affected areas should avoid mosquito bites.  Use DEET or picaridin repellent on exposed skin, wear long-sleeved clothing and pants properly treated with permethrin.  Stay in air-conditioned quarters with screened windows, and when feasible, reduce the amount of time spent outdoors when mosquitoes are most active.  Eliminate standing water where mosquitoes can breed, such as old tires, buckets and other outdoor containers.

APHC Webpage: Mosquito Borne Disease and Control External Link 

APHC Video: Control of Mosquitoes in and around the Home External Link 

APHC: Pesticides and Child Safety 5/5/16

APHC: Using Insect Repellents on Children 5/4/16

APHC Fact Sheet: DoD Insect Repellent System External Link 

APHC Fact Sheet: DoD Insect Repellent System and Permethrin Treatment of Military Uniforms External Link

APHC Fact Sheet: Mosquito Control around the Home External Link 

APHC Fact Sheet: DoD Insect Repellent System External Link 

 Fight mosquitoes with these simple tips! video External Link    
2/26/16    
Fight mosquitoes with these simple tips! Video

 

APHC Fact Sheet: DoD Insect Repellent System and Permethrin Treatment of Military Uniforms External Link

APHC Fact Sheet: Mosquito Control around the Home External Link 

APHC Fact Sheet: Mosquito Trap-N-Kill Lethal Ovitrap External Link 

APHC Brochure: Use the DOD Insect Repellent System External Link

CDC: Prevention External Link

EPA: Find the Insect Repellent that is Right for You External Link

APHC Video: DEET Works External Link

APHC Video: How to apply DEET  External Link

APHC Video: Permethrin Effectiveness - Mosquitoes on ACU that has been treated with permethrin External Link

APHC Video: Deploying a pop-up bed net External Link

APHC Video: Deploying a bed net with poles External Link

APHC Video: Treating Civilian Clothing with Permethrin Repellent  External Link

AFPMB: Technical Guide 36 - Personal Protective Measures Against Insects and Other Arthropods of Military Significance External Link

AFPMB: Dengue and Chikungunya Vector Control Pocket Guide External Link