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.
New and updated content
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
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.
For Healthcare Providers
OTSG/MEDCOM Memorandum: Zika Risk Assessment (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
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 8/2/16
CDC: Update: New FDA Recommendations 7/28/16
CDC: Interim Guidance for Zika Virus Testing of Urine — United States, 2016 5/10/16
CDC/NIOSH: Interim Guidance for Protecting Workers from Occupational Exposure to Zika Virus 4/10/16
CDC: Zika Action Plan Summit Presentations 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 Updated 7/29/16
CDC: Tools for Health Care Providers Updated 3/26/16
CDC: Zika Virus - What Clinicians Need to Know
CDC: US Zika Pregnancy Registry Updated 3/31/16
CDC: Clinical Guidance for Healthcare Providers Caring for Infants & Children Updated 8/25/16
CDC: Interim Guidelines for the Evaluation and Testing of Infants with Possible Congenital Zika Virus Infection — United States, 2016
CDC: Questions and Answers for Pediatric Healthcare Providers: Infants and Zika Virus Infection
FDA: Revised Recommendations for Reducing the Risk of Zika Virus Transmission by Blood and Blood Components Updated 8/16
FDA: FDA advises testing for Zika virus in all donated blood and blood components in the US
Diagnostic Testing and Reporting
AFHSB: Detecting and Reporting DoD Cases of Zika Virus Disease and Zika Virus Congenital Infection Guidance 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
CDC: US Zika Pregnancy Registry: What Parents Need to Know 4/22/16
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 Fact Sheet: DoD Insect Repellent System and Permethrin Treatment of Military Uniforms
APHC Fact Sheet: Mosquito Control around the Home
APHC Fact Sheet: Mosquito Trap-N-Kill Lethal Ovitrap
APHC Brochure: Use the DOD Insect Repellent System
EPA: Find the Insect Repellent that is Right for You
APHC Video: DEET Works
APHC Video: How to apply DEET
APHC Video: Permethrin Effectiveness - Mosquitoes on ACU that has been treated with permethrin
APHC Video: Deploying a pop-up bed net
APHC Video: Deploying a bed net with poles
APHC Video: Treating Civilian Clothing with Permethrin Repellent
AFPMB: Technical Guide 36 - Personal Protective Measures Against Insects and Other Arthropods of Military Significance
AFPMB: Dengue and Chikungunya Vector Control Pocket Guide