Zika Virus Update #4

The NH DHHS issued a health alert on August 2, regarding the updated Zika testing algorithm for pregnant women, updated guidance to prevent sexual transmission of Zika, and local transmission of Zika in Florida. 

Key Points and Recommendations:

• Healthcare providers should review the new Centers for Disease Control and Prevention (CDC) updated guidance on testing and care for pregnant women potentially exposed to Zika (http://www.cdc.gov/mmwr/volumes/65/wr/mm6529e1.htm?s_cid=mm6529e1_e) which includes a new recommendation to: o Test both blood and urine for Zika PCR up to 2 weeks after symptom onset (if symptomatic), or up to 2 weeks after possible exposure (if asymptomatic).

  • Test for both Zika and Dengue IgM serology for pregnant women presenting 2-12 weeks after possible exposure (whether symptomatic or asymptomatic).

• The CDC has also updated guidance to prevent sexual transmission of Zika from both men and women to their sex partners; further details can be found at: http://www.cdc.gov/mmwr/volumes/65/wr/mm6529e2.htm?s_cid=mm6529e2_e

  • The Florida Department of Health and the CDC announced that Zika is spreading locally in a defined area of northern Miami and issued recommendations: http://www.cdc.gov/zika/intheus/florida-update.html Pregnant women should not travel to this area. If travel is unavoidable, appropriate methods to prevent mosquito bites should be used.
  • Women and men who have traveled to this area any time after June 15, 2016 and who have a pregnant sex partner should avoid sex or use barrier protection with every sexual encounter for the duration of the pregnancy.
  • Pregnant women who have traveled to this area after June 15, 2016, or had unprotected sex with a partner who traveled to this area after June 15, 2016 should be tested for Zika according to the new CDC algorithm above.

• Healthcare providers should assess all pregnant women for possible exposure to Zika (through travel or sexual exposure) at every prenatal care visit.

• The New Hampshire Public Health Laboratories (PHL) can perform both Zika PCR and IgM testing locally. The PHL offers testing to: o All pregnant women potentially exposed to Zika (whether symptomatic or asymptomatic),

  • Persons with exposure and symptoms consistent with sexual transmission, and
  • Any person with a risk factor for Zika exposure and consistent clinical symptoms, only when a healthcare provider attests that testing will impact clinical management.

• Healthcare providers must call and confirm the testing indication with the NH Division of Public Health Services (DPHS). Clinical specimens sent to the PHL without approval may be rejected. NH DPHS’s number is 603-271-4496 (after hours 603-271-5300).

Read the Full DHHS Alert