Dover – The Delaware Division of Public Health (DPH) announced today the state’s second and third Zika cases, bringing the total number of Delaware cases to three. All three cases are travel-related and the result of a mosquito bite during visits to the countries where Zika is widespread. In the second case, an adult male was tested after showing symptoms of the disease from a January 2016 trip. In the third case, an adult female also showed symptoms of the disease following a late February-early March trip. Pregnancy is not an issue. Both cases were mild and risk of infection to others is extremely low.

Zika is primarily spread by mosquito bite, and is not spread through casual contact like hugging, kissing, shaking hands, sharing utensils, etc. It can also be transmitted from a pregnant mother to her baby during pregnancy. It is not yet known how often Zika is transmitted from mother to baby. In rare cases, it also may be transmitted sexually in semen. While Zika does not remain in the blood for longer than about a week, which means that transmission from person-to-person via mosquito bite must occur within a very tight timeframe, it is not known how long Zika remains in semen.

Zika is a very mild illness and the vast majority of people exposed to it do not develop symptoms. Symptoms typically begin two to seven days after being bitten by an infected mosquito. The most common symptoms of Zika virus are fever, rash, joint pain, or conjunctivitis (red eyes).

The most significant long-term health problems linked to Zika are serious birth defects. There have been reports of serious birth defects in infants whose mothers contracted the virus while pregnant. Microcephaly, a condition in which a baby’s head is smaller than expected when compared to babies of the same sex and age, and other poor pregnancy outcomes in babies of mothers infected with Zika are now being linked to the virus.

Because there is neither a vaccine nor antiviral medications available to prevent Zika virus infection, DPH joins the Centers for Disease Control and Prevention (CDC) in sharing precautions for pregnant women or women who may get pregnant:

• If you are pregnant, postpone travel to the countries where Zika virus transmission is ongoing.
• If you are pregnant and have traveled to the countries where Zika transmission is ongoing, talk to a healthcare provider about your travel even if you don’t feel sick. It is especially important that pregnant women see a doctor if they develop a fever, rash, joint pain, or red eyes during their trip or within two weeks after traveling to an area where Zika has been reported.
• If your male sexual partner has traveled to, or lives in, an area with active Zika virus transmission, a couple should use condoms the right way, every time, (Condom instructions for vaginal, anal, or oral (mouth-to-penis) sex. Discuss your male partner’s potential exposures and history of Zika-like illness with your doctor. If you are trying to become pregnant, talk to your doctor before you travel about your plans to become pregnant and the risk associated with Zika virus.
• If you are pregnant or may become pregnant and must travel to one of these areas, talk to your doctor first and strictly follow steps to prevent mosquito bites during your trip.
• If you are not pregnant, but your male partner lives in or has traveled to a country with Zika, consider using condoms.

“We are not surprised that there are additional Zika cases in Delaware given how often people travel and that the virus is now so widespread in South America, Central America, and the Caribbean,” said DPH Director Dr. Karyl Rattay. “With the upcoming spring break and a potential for even more travel to the countries where Zika is common, DPH reminds people to avoid being bitten and, if a woman is pregnant or trying to get pregnant, postpone travel if at all possible, and talk to your doctor if you plan to travel. It is also important to consider the risk of sexual transmission of the virus, and to use condoms if it is possible the male sexual partner has been exposed to the virus.”

Added DPH Medical Director Dr. Awele Maduka-Ezeh, “Zika transmission continues to spread to new countries and the best way for people to protect themselves from Zika or any mosquito-borne illness is to prevent mosquito bites during travel abroad and during Delaware’s mosquito season. It is possible that local transmission could occur either from mosquito bites once the season starts, from sexual transmission, or from mother to baby during pregnancy. Taking precautions is the best protection.”

Health care providers should ask all their patients about recent travel, and all pregnant women with a travel history should be evaluated for Zika. Because of the similar geographic distribution and clinical presentation of Zika, dengue, and chikungunya virus infection, patients with symptoms consistent with Zika virus should also be evaluated for dengue and chikungunya virus infection, in accordance with existing guidelines.

DPH and the Department of Natural Resources and Environmental Control (DNREC) always work together during mosquito season but, with the spread of Zika in other countries, this year is an especially important time to take steps to protect you and your family from mosquito bites. Visit the DPH Website for a joint DPH and DNREC Frequently Asked Questions flyer on Zika and preventing mosquito bites. For additional information on DNREC’s mosquito control efforts, visit their Newsroom for the recent press release on the start of their annual spring woodland-pool spraying campaign.

The number of countries with travel warnings aimed at anyone planning to travel there continues to expand. Those who recently traveled, or plan to travel, to areas where Zika transmission is ongoing, including, but not limited to, Mexico, Cuba, Brazil, Colombia, Venezuela, Barbados, the Dominican Republic, Haiti, Puerto Rico, Costa Rica, U.S. Virgin Islands, Jamaica, Mexico, Guatemala, El Salvador, Honduras, and Panama, could be at risk for exposure.

For the latest Centers for Disease Control and Prevention (CDC) list of countries, visit: http://wwwnc.cdc.gov/travel/notices.

The two new Delaware Zika cases were confirmed in the Delaware Public Health Lab (DPHL), which spent the last four weeks developing the capability to perform Zika tests locally. Previously, Delaware had to send samples to the CDC for Zika testing, which resulted in delays due to the volume of samples sent to the CDC from throughout the nation. To develop the ability to test locally, DPH needed to acquire the sample tests, train staff, develop protocols, and confirm with the CDC the testing protocols were accurate. If initial testing in DPHL is inconclusive, samples will be sent to CDC for further testing.

The first Delaware Zika case, an adult female, was announced in February and a result of a mosquito bite during travel. Pregnancy was not an issue. According to the CDC, there are almost 260 travel-related Zika cases in the U.S., six of which were contracted sexually.

To report a potential illness or receive further guidance on testing, call the DPH Office of Infectious Disease Epidemiology at 302-744-4990. For copies of flyers and more educational tools, see the below links.

For further information:
• CDC information on Zika: http://www.cdc.gov/zika/
• DPH Zika page: http://dhss.delaware.gov/dhss/dph/zika.html
• Flyer for pregnant women in English: http://www.dhss.delaware.gov/dhss/dph/files/zikaflyerforpregnantwomen.pdf
• Flyer for pregnant women in Spanish: http://www.dhss.delaware.gov/dhss/dph/files/zikaflyerforpregnantwomensp.pdf
• DPH special bulletin on Zika: http://www.dhss.delaware.gov/dhss/dph/files/dphbulletin1602zika.pdf
• Zika information in Spanish: http://www.cdc.gov/spanish/mediosdecomunicacion/comunicados/d_recomendaciones_viajeros_virus_del_zika_011516.html

A person who is deaf, hard-of-hearing, deaf-blind, or speech-disabled can call the DPH phone number above by using TTY services. Dial 7-1-1 or 800-232-5460 to type your conversation to a relay operator, who reads your conversation to a hearing person at DPH. The relay operator types the hearing person’s spoken words back to the TTY user. To learn more about TTY availability in Delaware, visit delawarerelay.com. Delaware Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. DPH, a division of DHSS, urges Delawareans to make healthier choices with the 5-2-1 Almost None campaign: eat 5 or more fruits and vegetables each day, have no more than 2 hours of recreational screen time each day (includes TV, computer, gaming), get 1 or more hours of physical activity each day, and drink almost no sugary beverages.

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