domingo, 14 de agosto de 2016

Zika Virus 6 Months Later | JAMA | JAMA Network

Zika Virus 6 Months Later | JAMA | JAMA Network



Zika Virus 6 Months Later FREE ONLINE FIRST

Thomas R. Frieden, MD, MPH1; Anne Schuchat, MD1; Lyle R. Petersen, MD, MPH1
JAMA. Published online August 08, 2016. doi:10.1001/jama.2016.11941
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On January 15, 2016, the Centers for Disease Control and Prevention advised pregnant women not to travel to areas where the Zika virus was spreading. Six months later, more than 60 countries or territories have reported new local transmission of Zika. By August 4, 2016, nearly 1700 cases of travel-associated Zika infection, including 479 in pregnant women, had been reported in the continental United States; Puerto Rico is experiencing rapid and extensive spread of the epidemic.1 Florida has documented 5 symptomatic and 8 asymptomatic locally acquired Zika infections in a 6-block area north of downtown Miami. Comprehensive mosquito control efforts, including reduction of standing water, provision of repellants containing diethyltoluamide (DEET), and application of pyrethroid insecticides and larvicides using backpack sprayers and trucks to eliminate adult and larval forms of mosquitoes, were initiated on confirmation of the first cases. Persistent findings of Aedes aegypti mosquitoes led to a decision to also use aerial spraying with naled and larvicide within 3 days of documentation of the risk of ongoing Zika transmission.
The association between Zika infection (both symptomatic and asymptomatic) and serious birth defects, including microcephaly, has been confirmed.2 Sexual transmission of Zika from both male and female partners can occur, and the virus may be able to remain viable in semen for months. The competent vectors—A aegypti as well as the less efficient vector Aedes albopictus—put 30 and 41 US states, respectively, at risk for local mosquito-borne transmission of Zika. Risk of microcephaly after Zika infection early in pregnancy may range from 1% to 13%; the full spectrum of congenital Zika virus syndrome is not known, nor is it known whether infants exposed to Zika during pregnancy who appear healthy at birth will have neurologic or other problems.

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