Zika Virus

What You Need To Know

What is Zika?
Disease caused by the Zika virus
It is primarily spread to humans by any Aedes species mosquito
carrying the disease.
Most prevalent are the Aedes albopictus and Aedes aegypti

It can also be spread through human sexual intercourse from infected

male to female (Zika Virus, 2016).

Zika Through the Years

News on the virus has been minimal over the past 60 years.
There was thought to be no serious health risks from infection.
It was once thought to be linked to jaundice epidemic in 1954.
No correlation was found.

In 1956 scientist William Bearcroft investigated the affects of the virus by

allowing infected mosquitoes to bite him.
No significant or long-term affects occurred (Cohen, 2016).

The first major outbreak of the virus occurred in 2007 in the Island of
Yap otherwise known as the Federated States of Micronesia.
No major health concerns were reported (Hayes, 2009).

Zika and Brazil

In July of 2015, researchers discovered a possible correlation between the
Zika virus and Guillain-Barr syndrome (Zika Virus, 2016).
While rare, this syndrome is extremely devastating in which a persons immune
system begins to attack his or her own nervous system.
First symptoms include weakness and tingling in the extremities eventually leading to wholebody paralysis.
While paralysis is usually eliminated through treatment, individuals will usually possess longterm issues of weakness, numbness, and fatigue (Mayo Clinic Staff, 2016).

In October of the same year, linkage between the virus and microcephaly
was also determined (Zika Virus, 2016).
Microcephaly is a birth defect in which a baby is born with an abnormally small head.
The decrease in skull size is directly related to a decrease or halt in fetal brain development.
If severe, the birth defect may be accompanied by seizures, developmental delays, movement
and balance issues, difficulty swallowing, hearing loss, and vision problems (Facts, 2016).

2016 Rio Olympics

Major discussion has occurred since February 2016 on the safety of
athletes and spectators for this years games.
Some public health researchers are strongly against the games.
Athletes are at high risk for contracting the virus.
Spectators from across the world will be there.

Increases the chances of the virus spreading globally when they return home either through
local mosquito bites or sexual transmission (Attaran, 2016).

Several athletes have declined the invitation to the games or have taken
precautions before exposing themselves.

Northern Ireland golfer Rory Mcllroy decided against the Games to protect his future
children with current fiance Erica Stoll (Carter, 2016).
British long jumper Greg Rutherford froze his sperm to allow himself to compete in
the Games without worrying about transmitting the virus, if contracted, to his wife.
His wife and newborn son will not attend the games for precautionary reasons (Khomami,
2016).

Backlash from Scientists

223 scientists, doctors, bioethicists, and public health experts from across the
globe expressed their disapproval with the World Health Organizations decision
to keep the Games in Rio (Caplan, 2016).

Were confused upon how the World Health Organization labeled Zika an international health
emergency in February of 2016, but later ruled the Games as safe (Darlington, 2016).

An online poll by the Science Advisory Board was created to receive input from
medical experts worldwide from May 31 to June 9, 2016 (Caplan, 2016).
4,000 people participated.
Roughly 51% believed the Games should be postponed.
70% of Brazilian scientists were against postponing.

69% were dissatisfied with their governments response to the virus.

Expert belief that the Games would facilitate the global spread of Zika:
66% from North America
60% from India
>50% from the United Kingdom, Italy, Germany, Japan, and France

IOC and WHO Responses to Backlash

The International Olympic Committee stated that it sees no reason
to delay or move the Games because of the mosquito-borne disease
and that the Games will go on as planned, (Darlington, 2016).
The World Health Organization has also stated that cancelling or
changing the location of the 2016 Olympics will not significantly alter
the international spread of Zika virus (Zika crisis, 2016).
Their feeling is that the virus will dissipate due to Rio entering into its winter
season beginning in July.
The prevalence of mosquitoes is expected to drop during the winter.

Zika and the United States

As of June 22, 2016, there have been 820 cases of the virus reported
in the states of the U.S. (Zika virus disease, 2016).

None of the cases involved local mosquito bites.

819 of the cases occurred due to travel-related transmission.
1 case involved laboratory contamination.
11 of the 820 cases were also sexually transmitted.
4 individuals developed Guillain-Barre syndrome.

While there have been no cases as of yet to involve local mosquito

viral transmission, United States residents should still be aware of the
high probability of the virus entering certain regions of U.S. soil.

The Aedes aegypti

Primary vector for the Zika virus (Surveillance,
2016)
Can also carry dengue, chikungunya, and yellow fever
viruses.
Possesses high vectorial capacity.

the ability for the organism to spread a virus to a host

(humans)

Origin
Africa
Spread to tropical, subtropical, and some temperate
climates through global trade.

Breeding
Natural and artificial water-holding containers

Used tires, containers, etc.

Eggs larvae pupae adult mosquito

Most common of the Aedes genus to spread Zika

and other viruses
high vectorial capacity
Only bites humans

Aedes aegypti mosquito landing on a

human arm (Surveillance, 2016).

The Aedes albopictus

Also known as the Asian tiger mosquito (Benedict,
Levine, Hawley, & Lounibos, 2007)
Referred to as the most invasive mosquito (Beck,
2016).
Vector for Zika, dengue, and chikungunya viruses
(Surveillance, 2016)
Does not carry yellow fever.

Origin
Asia
Spread to tropical, subtropical, and temperate climates
through global trade.

Breeding
Similar to Ae. aegypti
Lays eggs that can withstand colder climates for a longer
duration.

Allows it to live in more temperate regions of the U.S.

Less likely to spread viruses than Ae. aegypti

Will bite other animals.
Is not localized in suburban areas like its genus relative.

Aedes albopictus mosquito feeding on

a humans blood (Surveillance,
2016).

U.S. Regions at Risk for Mosquito Transmission

Representation of the
average amount of
people who travel to
the U.S. area from a
country containing a
high prevalence of the
Zika virus, and the
estimated number of
Ae. Aegypti mosquitoes
for that U.S. area
(Monaghan et al.,
2016).

Signs and Symptoms To Look For

Common signs and symptoms include (Symptoms, 2016)

Fever
Rash
Joint pain
Conjunctivitis

Uncommon symptoms include muscle pain and headaches.

Most cases involve mild symptoms with a duration from several days
to a week.
The big issue is that symptoms can be so mild that the individual may
not even know that he or she has contracted the virus.

Do I Have Zika?
While the prevalence of the virus is still lower in the U.S. than in
South America and U.S. territories, the chances of contracting the
virus through mosquito bites or sexual intercourse still exist (Zika
situation report, 2016).
If you think you may have Zika, contact your physician (Symptoms,
2016).
Those who have recently traveled outside of the United States are at a much
higher risk for the virus and should inform their physician when and where
they travelled.
Diagnosis includes either a blood or urine test.
These tests can also look for the presence of the dengue or chikungunya viruses.
Both have similar symptoms to Zika and are also transmitted by mosquitoes.

Similar Diseases
Dengue Fever (Dengue, 2016)

Present in tropical and subtropical regions

Mild dengue symptoms are high fever, rash, muscle/joint pain.
Severe dengue (dengue hemorrhagic fever) can cause shock (extreme drop in blood pressure), severe
bleeding, and death.
Recurrent exposure to dengue usually leads to more severe symptoms.
Last outbreak in the U.S. occurred in Hawaii in 2015.
More common for U.S. territories such as Puerto Rico and South American regions

Currently no vaccine or treatment

Chikungunya Virus (Chikungunya, 2016)

Present in tropical, subtropical, and some temperate regions

Most common symptoms are fever and joint pain.
Can also develop headache, muscle pain, joint swelling, or rash

Exposure to the virus usually leads to immunity to future infections.

In 2013, local transmission of the virus in the Americas was first identified in Caribbean countries.
Since 2014, cases of local transmission have increased to Florida, Puerto Rico, and the U.S. Virgin Islands .

Currently no vaccine or treatment

What Do I Do if I Have Zika?

As of now, there are no medications or vaccines to treat or prevent the
virus (Symptoms, 2016).
However, there are many options to alleviate symptoms.
Plenty of fluids and rest
Acetaminophen or paracetamol for fever and pain

Do not use aspirin or any other NSAIDS before ruling out dengue virus.
Reduces your risk of internal bleeding

If possible, avoid being bit by mosquitoes for at least one week.

Prevents spreading the virus to local mosquitoes that can further spread the virus to
non-infected individuals

Researchers have also noted that individuals who contract the virus will be
protected from a future Zika infection (Symptoms, 2016).
Based on Zikas similarity to other viruses that operate in this manner

Zika and Pregnancy

On June 9, 2016, the WHO stated that
women in areas of Zika activity should not
become pregnant (McNeil, 2016).
It is still unknown as to the likelihood that
the virus will pass from the mother to her
fetus (Zika and Pregnancy, 2016).
It is also unknown as to how likely an
infected fetus will develop microcephaly
and other developmental issues.
Current research suggests that a women
who contracts the virus and allows 10
days for the virus to leave her
bloodstream will not pose a risk for birth
defects in future children (Zika and
Pregnancy, 2016).

A Brazilian mother holding her 3 month old son

who was born with microcephaly (Penner, n.d.).

How Can I Avoid Contracting Zika?

Zika is spread in two main conventions (Zika Virus, 2016).
Mosquito bites from infected mosquitos
Sexual intercourse

Currently, the only known convention for spreading the virus through
sexual intercourse is from a man to his partner (Zika and Sexual, 2016).
Includes vaginal, oral, or anal sex without a condom
The use of condoms has been noted as an excellent method to decrease the spread
of Zika; however, the best measure of prevention is to avoid sexual intercourse while
infected.
It has also been noted that the virus remains in semen longer than in blood.
While the duration in blood is presumed to be one week, the duration in semen is unknown.
The WHO has recently doubled the advised time for abstinence after virus contraction from 4
to 8 weeks (Caplan, 2016).

Preventing Mosquito Bites

The Aedes genus predominantly bites during the daytime (Surveillance,
2016).
Try to avoid mosquito-infested areas such as bodies of water during the day.

If unavoidable, there are multiple precautions you can take (Prevention,

2016).
Wear long-sleeved shirts and long pants.
Apply EPA-registered mosquito repellent to skin.
Must contain one of the following active ingredients
DEET, picaridin, IR3535, or para-menthane-diol
Two good products to consider are Sawyer Picaridin and Off! Deepwoods VIII (Byrne, 2016).

Safe to use when pregnant or breast-feeding (Prevention, 2016)

Treat clothing and gear with permethrin.

Can also purchase permethrin-treated gear.

Precautions When Applying Repellant

Never apply to skin that is covered with clothing (Prevention, 2016).
Never apply sunscreen after applying repellant.
Take extra precaution when applying to children.
Never use repellant on babies younger than 2 months.
Never use oil of lemon eucalyptus or para-menthane-diol on children younger
than 3 years.
Never apply repellant directly to a childs hands or face.

Precautions When Using Permethrin

You should never apply permethrin directly to skin (Prevention,
2016).
Permethrin is very toxic if ingested or exposed to skin in abundance
(Permethrin, 2009).
In general, avoid usage unless you intend on being exposed to a high
volume of mosquitos.

The Future of Zika

Currently, there are still many unknown facts about the virus.
Many organizations including the CDC and WHO are posting new
information about the virus weekly.
Talks of a possible vaccine for the virus have also appeared as of late.
Inovio Pharmaceuticals and GeneOne Life Science have partnered up to
develop the potential cure (Hertel, 2016).
On June 20, 2016, the two companies received approval to begin phase I
human trial with their vaccine.

What To Know About the Vaccine

The potential vaccine is planned to begin phase I human trial sometime in
July 2016 (Hertel, 2016).
For phase I trials, the main goal is to ensure the safety of the vaccine
(FAQ, 2008).
The FDA wants to ensure there are no severe side effects.
Volunteers for the trial will not be pre-exposed to Zika.

The time frame for phase I is usually anywhere from 4 months to a year
(Mohney, 2016).
If phase I is completed, the vaccine will need to be evaluated across three
more trial phases until it can be mass-distributed.
In an interview on June 21, 2016, CEO of Inovio Pharmaceuticals Joseph
Kim stated that it could be a few years until the vaccine is on the market
(Steel, 2016).

What To Do In the Time Being

Being that insight and new details are appearing almost every other
day on Zika, we encourage you to continue to stay up-to-date on new
events with the virus.
Please continue to check these links for further updates.
https://www.cdc.gov/zika/
http://www.who.int/mediacentre/factsheets/zika/en/
http://www.who.int/features/qa/zika/en/

References
Attaran, A. (2016, May). Off the Podium: Why Public Health Concerns for Global Spread of Zika Virus Means
That Rio do Janeiros 2016 Olympic Games Must Not Proceed. Harvard Public Health Review, 8.
Retrieved from: http://harvardpublichealthreview.org/off-the-podium-why-rios-2016-olympicgames-must-not-proceed/
Beck, J. (2016, May 02). The Other Zika Mosquito. The Atlantic. Retrieved from:
http://www.theatlantic.com/health/archive/2016/05/the-other-zika-mosquito-aedes-albopictusasian-tiger/480828/
Benedict, M. Q., Levine, R. S., Hawley, W. A., & Lounibos, L. P. (2007). Spread of the Tiger: Global Risk of
Invasion by the Mosquito Aedes albopictus.Vector Borne and Zoonotic Diseases (Larchmont,
N.Y.), 7(1), 7685. Retrieved from: http://doi.org/10.1089/vbz.2006.0562
Byrne, S. (2016, April 16). Mosquito Repellents that Best Protect Against Zika. Consumer Reports. Retrieved
from: http://www.consumerreports.org/insect-repellents/mosquito-repellents-that-best-protectagainst-zika/
Caplan, A. (2016, June 10). Scientists Say the Rio Olympics Should be Postponed Due to Zika. Forbes.
Retrieved from: http://www.forbes.com/sites/arthurcaplan/2016/06/10/scientists-say-the-rioolympics-should-be-postponed-due-to-zika/#1b2cb26a4b45
Carter, I. (2016, June 22). Rio 2016: Rory Mcllroy pulls out of Olympics because of fears over Zika virus. British
Broadcasting Corporation. Retrieved from: http://www.bbc.com/sport/golf/36595631

References
Chikungunya Virus. (2015, November 16). Centers for Disease Control and Prevention. Retrieved
from: https://www.cdc.gov/chikungunya/index.html
Cohen, J. (2016, February 08). Zikas long, strange trip into the limelight. Science. Retrieved from:
http://www.sciencemag.org/news/2016/02/zika-s-long-strange-trip-limelight
Darlington, S. (2016, June 07). Zika and Olympics: Rio organizers say Games are safe. Cable News
Network. Retrieved from: http://www.cnn.com/2016/06/07/health/zika-olympics/
Dengue. (2016, January 19). Centers for Disease Control and Prevention. Retrieved from:
https://www.cdc.gov/dengue/
Facts about Microcephaly. (2016, May 17). Centers for Disease Control and Prevention. Retrieved from:
http://www.cdc.gov/ncbddd/birthdefects/microcephaly.html
FAQ: ClinicalTrials.gov Clinical Trial Phases. (2008, April 18). U.S. National Library of Medicine. Retrieved
from: https://www.nlm.nih.gov/services/ctphases.html#top

References
Hayes, E. B. (2009). Zika Virus Outside Africa. Emerging Infectious Diseases,15(9), 13471350.
http://doi.org/10.3201/eid1509.090442
Hertel, B. (2016, June 20). Inovio Pharmaceuticals and GeneOne Life Science Receive Approval for
First-in-Man Zika Vaccine Clinical Trial. Retrieved from: http://ir.inovio.com/news/newsreleases/news-releases-details/2016/Inovio-Pharmaceuticals-and-GeneOne-Life-ScienceReceive-Approval-for-First-in-Man-Zika-Vaccine-Clinical-Trial/default.aspx
Khomami, N. (2016, June 07). Greg Rutherford freezes sperm over Olympics Zika fears. The Guardian.
Retrieved from: https://www.theguardian.com/sport/2016/jun/07/greg-rutherford-freezessperm-over-olympics-zika-fears
Mayo Clinic Staff. (2016, January 01). Diseases and Conditions: Guillain-Barre syndrome. Mayo Clinic.
Retrieved from: http://www.mayoclinic.org/diseases-conditions/guillain-barresyndrome/basics/definition/con-20025832
McNeil, D. (2016, June 09). Delay Pregnancy in Areas With Zika, W.H.O. Suggests. New York Times. Retrieved
from: http://www.nytimes.com/2016/06/10/health/zika-virus-pregnancy-who.html?_r=0
Mohney, G. (2016, June 21). What We Know About the First Zika Vaccine Trial by Inovio Pharmaceuticals. ABC
News. Retrieved from: http://abcnews.go.com/Health/bug-spray-hacks-avoid-summerbite/story?id=40103739

References
Monaghan, A.J., Morin, C.W., Steinhoff, D.F., Wilhelmi, O., Hayden, M., Quattrochi, D.A., . . . Ernst, K. (2016,
March 16). [Graphical illustration of estimated prevalence of mosquitos carrying Zika]. On the
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Steel, A. (Interviewer), Weisenthal, J. (Interviewer), Fu, S. (Interviewer), & Kim, J. (Interviewee). (2016, June
22). Inovio CEO: Zika Vaccine Could Take a Few Years [Interview video file]. Retrieved from:
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References
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Szabo, L. (2016, April 14). Study: Zika may affect babies even in later stages of pregnancy. USA Today.
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Zika Virus. (2016, June 02). World Health Organization. Retrieved from:
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