Zika virus infection, which is primarily spread to humans through the Aedes species mosquito, has become a public health concern in the United States, particularly for pregnant women. While the majority of Zika virus infections reported in the United States are among individuals who have traveled to regions with ongoing Zika virus transmission, on February 2, a local health department reported to the public the first Zika virus case in its county through sexual transmission. CDC expects that the number of cases among travelers with Zika will likely increase and that the virus will continue to spread to other areas, possibly including the continental United States.
To help support local health departments prepare for and respond to cases of Zika virus in their communities, NACCHO has assembled a running list of guidance, resources, and information. NACCHO will continue to update this page as new information and resources become available. See NACCHO’s ongoing Zika coverage.
Key Information
- On December 30, CDC released a Morbidity and Mortality Weekly Report sharing ten public health achievements related to Zika throughout 2016 as well as priorities for the future.
- On October 13, CDC announced it was working with Florida to respond to a new active Zika transmission area in Miami-Dade County.
- On September 2, CDC awarded $2.4 million to five jurisdictions – Chicago, Houston, New York City, Philadelphia, and Los Angeles County – to fight Zika.
- On August 2, CDC announced $16 million in funding to states and territories to fight Zika.
- On July 29, CDC reported first documented cases of locally acquired Zika, discovered in Florida.
- On July 15, CDC reported first documented case of female-to-male sexual transmission of Zika.
- On July 8, Utah reported the first Zika-related death in the continental United States.
- On June 17, CDC released a draft interim guidance document outlining the response plan for the first locally acquired cases of Zika virus infection in the continental United States and Hawaii.
- On May 13, CDC announced funds for states and territories to prepare for Zika.
- On April 13, CDC released a statement concluding that Zika virus is a cause of microcephaly and other severe fetal brain defects.
- On March 25, CDC issued interim guidance for the prevention of sexual transmission of Zika virus, including guidance for healthcare providers caring for women of reproductive age with possible Zika virus exposure. Additionally, a Morbidity and Mortality Weekly Report examines contraceptive needs and increasing access to contraception in response to the Zika virus disease outbreak in Puerto Rico.
- On February 26, the Secretary of Health and Human Services, Sylvia Burwell, determined that there is a significant potential for a public health emergency that has a significant potential to affect national security or the health and security of United States citizens living abroad and that involves Zika virus. Secretary Burwell declared that circumstances exist justifying the authorization of the emergency use of in vitro diagnostics for detection of Zika virus and/or diagnosis of Zika virus infection. For more information, see the FDA Emergency Use Authorization declaration, fact sheet for healthcare providers, fact sheet for pregnant women, and fact sheet for patients.
- On February 23, CDC published interim guidelines for the prevention of sexual transmission of Zika virus. As of February 23, CDC and state public health departments are investigating 14 additional reports of possible sexual transmission of the virus, including several involving pregnant women. While additional investigations are being completed, CDC issued a HAN Advisory as a strong reminder to state, local, and U.S. territorial public health departments, clinicians, and the public to be aware of and adhere to current recommendations for preventing sexual transmission of Zika virus, particularly for men with pregnant partners.
- On February 8, President Obama requested Congress to help combat Zika virus disease by providing $1.8 billion in emergency funding. More details are in the White House fact sheet.
- On February 2, a local health department reported to the public the first Zika virus case in its county through sexual transmission. CDC has issued new Interim Guidelines for Preventing Sexual Transmission of Zika Virus and updated Guidelines for Health Care Providers. These guidelines now recommend that clinicians offer testing for asymptomatic pregnant women who have traveled to areas with ongoing Zika virus transmission (February 5, 2016).
- There is no commercially available diagnostic tests for Zika virus; currently, Zika virus testing is performed by CDC and some state or local health departments. Local health departments and clinicians are advised to contact their state health department for more information on diagnostic testing (February 5, 2016).
- CDC has issued a health alert network (HAN) and travel advisories for Zika in certain areas of South American, Central America, Mexico, and the Caribbean.
- Stay updated on Zika by checking CDC’s Zika webpage | Spanish and the Pan American Health Organization’s Zika webpage.
Guidance
- CDC: Interim Guidance for the Diagnosis, Evaluation, and Management of Infants with Possible Congenital Zika Virus Infection
- CDC: Update: Interim Guidance for Healthcare Providers Caring for Pregnant Women with Possible Zika Virus Exposure—United States, July 2017 (July 24, 2017)
- CDC: Zika Interim Response Plan for CONUS & Hawaii (June 17, 2016)
- CDC: Official Health Advisory: CDC Guidance for Travel and Testing of Pregnant Women and Women of Reproductive Age for Zika Virus Infection Related to the Investigation for Local Mosquito-borne Zika Virus Transmission in Brownsville, Cameron County, Texas (December 14, 2016)
- CDC: Update: Guidance for Pregnant Women and Women and Men of Reproductive Age for Zika Virus Infection Related to Local Mosquito-borne Zika Virus Transmission in Miami-Dade County (October 19, 2016)
- CDC: Update: Interim Guidance for Preconception Counseling and Prevention of Sexual Transmission of Zika Virus for Persons with Possible Zika Virus Exposure — United States, September 2016 (September 30, 2016)
- CDC: Update: Interim Guidance for Prevention of Sexual Transmission of Zika Virus — United States, August 2016 (August 19, 2016)
- CDC: Update: Interim Guidance for the Evaluation and Management of Infants with Possible Congenital Zika Virus Infection — United States, August 2016 (August 19, 2016)
- CDC: Guidance for U.S. Laboratories Testing for Zika Virus Infection (July 27, 2016)
- CDC: Update: Interim Guidance for Health Care Providers Caring for Pregnant Women with Possible Zika Virus Exposure — United States, July 2016 (July 25, 2016)
- CDC: Update: Interim Guidance for Prevention of Sexual Transmission of Zika Virus — United States, July 2016 (July 25, 2016)
- CDC: Update: Interim Guidance for Health Care Providers Caring for Pregnant Women with Possible Zika Virus Exposure — United States, July 2016 (July 25, 2016)
- CDC: Zika Virus Response Planning: Interim Guidance for District and School Administrators in the Continental United States and Hawaii (July 14, 2016)
- CDC: Zika – Draft Interim Response Plan (June 17, 2016)
- CDC: Interim Guidance for Interpretation of Zika Virus Antibody Test Results (May 31, 2016)
- CDC: Interim Guidance for Zika Virus Testing of Urine – United States, 2016 (May 13, 2016)
- CDC: Interim Guidance for Protecting Workers from Occupational Exposure to Zika Virus (April 22, 2016)
- CDC: Interim CDC Recommendations for Zika Vector Control in the Continental United States (March 18, 2016)
- CDC: Biosafety Guidance for Transportation of Specimens and for Work with Zika Virus in the Laboratory (March 15, 2016)
- WHO: Pregnancy Management in the Context of Zika Virus (March 2, 2016)
- CDC: Collection and Submission of Body Fluids for Zika Testing (March 1, 2016)
- CDC: Travel Alert: 2016 Summer Olympics, Rio (February 26, 2016)
- CDC: Interim Guidelines for Health Care Providers Caring for Infants and Children with Possible Zika Virus Infection (February 19, 2016)
- CDC: Interim Guidelines for Prevention of Sexual Transmission of Zika Virus (February 5, 2016)
- CDC: Interim Guidelines for Health Care Providers caring for Pregnant Women and Women of Reproductive Age with Possible Zika Virus (February 5, 2016)
- American Red Cross: Red Cross statement on Zika virus (February 5, 2016)
- CDC: Interim Guidelines for the Evaluation and Testing of Infants (January 26, 2016)
- CDC: Interim Guidelines for Pregnant Women (January 19, 2016)
Resources
- CDC: Zika Action Day Toolkit (August 1, 2017)
- Asian & Pacific Islander American Health Forum: Zika Awareness Toolkit (available in Chinese, Vietnamese, Korean, Tagolog, Urdu) (May 10, 2017)
- American Academy of Pediatrics: Zika Virus – Psychosocial Support Videos (April 12, 2017)
- CDC: Fighting Zika 24/7: CDC’s Response to Zika (April 4, 2017)
- CDC and March of Dimes: Zika Care Connect Program (March 30, 2017)
- Virtual Training: Virtual Training: Vector Control for Environmental Health Professionals (January 9, 2017)
- National Healthcare Coalition: Ten Commandments for Zika Virus Planning, Preparation and Response in Health Care Facilities (December 14, 2016)
- The American Congress of Obstetricians and Gynecologists: Zika Toolkit for Providers with resources in English and Spanish (December 12, 2016)
- March of Dimes: Infographic – Learn about Zika and pregnancy: English, Spanish (December 6, 2016)
- CDC: Zika: The basics of the virus and how to protect against it: English, Spanish, Chinese, Vietnamese, Creole (October 28, 2016)
- CDC: Mosquito Bite Prevention for the United States: English, Chinese, Korean, Vietnamese, Tagalog, Arabic, Creole (October 28, 2016)
- CDC: Help control mosquitoes that spread dengue, chikungunya, and Zika: English, Chinese, Korean, Vietnamese, Tagalog, Arabic, Creole (October 28, 2016)
- CDC: For pregnant women in areas with Zika: Protect your pregnancy: English, Chinese, Korean, Vietnamese, Tagalog, Arabic, Creole (October 28, 2016)
- CDC: Pregnant? Protect yourself from mosquito bites: English, Chinese, Korean, Vietnamese, Tagalog, Arabic, Creole (October 28, 2016)
- CDC: Pregnant and living in an area with Zika?: English, Chinese, Korean, Vietnamese, Tagalog, Arabic, Creole
- CDC: Enjoy your vacation (Zika Prevention Travel Tips): English, Spanish, Portuguese (October 28, 2016)
- CDC/AUCD/NBCDDD: Zika 2.0 Toolkit (October, 14, 2016)
- CDC: Communication Materials in Multiple Languages (Spanish, Arabic, Tagalog, Vietnamese, Mandarin, Creole, Korean, etc) on travel information, insect repellent, sexual transmission, and mosquito control (October 12, 2016)
- HRSA: Resource Guide for States and Communities Caring for Infants and Children Affected by Zika Virus(October 10, 2016)
- CDC: Zika is in Your Area: What To Do (August 9, 2016)
- CDC: Zika Communication Toolkits (August 2, 2016)
- NACCHO: Policy Statement on Mosquito Control (July 25, 2016)
- CSTE: Position Statement on Zika Virus Disease and Zika Virus Infection Without Disease (July 25, 2016)
- CDC: Zika Response & Success Stories (updated on an ongoing basis)
- HHS: Fact Sheet: HHS Assistance to Puerto Rico to Fight Zika (June 16, 2016)
- ASPR TRACIE: Zika Virus Planning Resource Guide Introduction (June 2, 2016)
- ASPR TRACIE: High Risk Pregnancy and Microcephaly Planning Resource (May 31, 2016)
- ASPR TRACIE: Supporting Children with Special Healthcare Needs Planning Resource (May 18, 2016)
- CDC: Zika Crisis & Emergency Risk Communication Webinar Series (May 17, 2016)
- CDC: Clinical Guidance Page
- CDC: Fact Sheets and Posters (in multiple languages) on Zika and Zika Virus Prevention (May 9, 2016)
- CDC: FactSheet on Interim Guidance for Protecting Workers from Occupational Exposure to Zika Virus (April 22, 2016)
- Immunization for Women: Zika Virus Updates (April 8, 2016)
- American Congress of Obstetricians and Gynecologists: Zika Virus (April 8, 2016)
- CDC: Build Your Own Zika Prevention Kit (April 14, 2016)
- CDC: Vector Surveillance and Control (March 29, 2016)
- CDC: Tools for Healthcare Providers (March 26, 2016)
- CDC: Zika Communication Planning Guide for States (March 22, 2016)
- CDC: Zika 101 Slide Presentation | Spanish
- EPA: Find the Insect Repellent that is Right for You (March 21, 2016)
- CDC: Top 10 Zika Response Planning Tips: Brief Information for State, Tribal, and Territorial Health Officials (March 4, 2016)
- March of Dimes: Zika virus and pregnancy | Spanish (March 4, 2016)
- WHO: Microcephaly fact sheet (March 2, 2016)
- ASPR TRACIE: Zika: Resources at Your Fingertips (February 26, 2016)
- Association of Public Health Laboratories: Frequently Asked Questions on Zika Virus (February 24, 2016)
- National Center on Birth Defects and Developmental Disabilities: Zika Briefing (February 23, 2016)
- Video: Advising Pregnant Women About Zika: The Latest Guidance From CDC (February 17, 2016)
- Video: Zika Virus 101 (February 11, 2016)
- Emergency Legal Preparedness Concerning the Zika Virus: A Primer from the Network for Public Health Law (February 10, 2016)
- CDC: Fact Sheets (English and Spanish) on Mosquito Bite Prevention
Resources Developed by Local Health Departments
- Cook County (IL) Department of Public Health: Fight the Bite Campaign Website | Fight the Bite Campaign Posters and Marketing Materials | CBS TV Commercials on West Nile Virus and Zika Virus | Mobile Plus Geofencing Tool | Contact Kim Junius to request resources
- Louisville (KY) Department of Public Health and Wellness – Zika Action Plan (July 25, 2016)
- Portsmouth Health Department (VA) Mosquito Prevention Campaign Flyers for Specific Populations: Youth 1 | Youth 2 | Repellent | Dress and Defend | Dress and Defend Parents | Tip and Toss | Tip and Toss House | Tip and Toss Parents (April 25, 2016)
- Florida Department of Health in Orange County Zika Fever Specimen Collection Protocol and Specimen Collection Locations (March 7, 2016)
- Boston (MA) Public Health Commission Zika Virus and Pregnancy fact sheet in 8 languages (February 16, 2016)
- Dallas County (TX) Health and Human Services Zika webpage and fact sheet in 10 languages (February 10, 2016)
- Oklahoma City-County (OK) Health Department Zika virus fact sheet (February 10, 2016)
- Shelby County (TN) Zika virus & pregnancy blog (February 1, 2016)
Reports
- Vital Signs: Update on Zika Virus–Associated Birth Defects and Evaluation of All U.S. Infants with Congenital Zika Virus Exposure — U.S. Zika Pregnancy Registry, 2016 (CDC Morbidity and Mortality Weekly Report, April 4, 2017)
- Zika Virus —10 Public Health Achievements in 2016 and Future Priorities (CDC Morbidity and Mortality Weekly Report, December 30)
- Preliminary Report of Microcephaly Potentially Associated with Zika Virus Infection During Pregnancy — Colombia, January–November 2016 (CDC Morbidity and Mortality Weekly Report, December 9)
- Characteristics of Children Aged <18 Years with Zika Virus Disease Acquired Postnatally — U.S. States, January 2015–July 2016 (CDC Morbidity and Mortality Weekly Report, September 30)
- Local Mosquito-Borne Transmission of Zika Virus — Miami-Dade and Broward Counties, Florida, June–August 2016 (CDC Morbidity and Mortality Weekly Report, September 23)
- Zika Virus Disease Cases — 50 States and the District of Columbia, January 1–July 31, 2016 (CDC Morbidity and Mortality Weekly Report, September 13)
- Preliminary Findings from an Investigation of Zika Virus Infection in a Patient with No Known Risk Factors — Utah, 2016 (CDC Morbidity and Mortality Weekly Report, September 13)
- Hearing Loss in Infants with Microcephaly and Evidence of Congenital Zika Virus Infection — Brazil, November 2015–May 2016 (CDC Morbidity and Mortality Weekly Report, August 30)
- Likely Sexual Transmission of Zika Virus from a Man with No Symptoms of Infection — Maryland, 2016 (CDC Morbidity and Mortality Weekly Report, August 26)
- Guillain-Barré Syndrome During Ongoing Zika Virus Transmission — Puerto Rico, January 1–July 31, 2016 (CDC Morbidity and Mortality Weekly Report, August 26)
- Update: Ongoing Zika Virus Transmission — Puerto Rico, November 1, 2015–July 7, 2016 (CDC Morbidity and Mortality Weekly Report, July 29)
- Suspected Female-to-Male Sexual Transmission of Zika Virus — New York City, 2016 (CDC Morbidity and Mortality Weekly Report, July 14)
- Projected Zika Virus Importation and Subsequent Ongoing Transmission after Travel to the 2016 Olympic and Paralympic Games — Country-Specific Assessment, July 2016 (CDC Morbidity and Mortality Weekly Report, July 13)
- Zika Virus Surveillance and Preparedness — New York City, 2015–2016 (CDC Morbidity and Mortality Weekly Report, June 23)
- Screening of Blood Donations for Zika Virus Infection — Puerto Rico, April 3–June 11, 2016 (CDC Morbidity and Mortality Weekly Report, June 17)
- Reported Distribution of Aedes (Stegomyia) aegypti and Aedes (Stegomyia) albopictus in the United States, 1995-2016 (Journal of Medical Entomology, June 9, 2016)
- Possible Zika Virus Infection Among Pregnant Women – United States and Territories (CDC Morbidity and Mortality Weekly Report, May 20)
- Comparison of Test Results for Zika Virus RNA in Urine, Serum, and Saliva Specimens from Persons with Travel-Associated Zika Virus Disease – Florida, 2016 (CDC Morbidity and Mortality Weekly Report, May 13)
- Update: Ongoing Zika Virus Transmission – Puerto Rico, November 1, 2015-April 14, 2016 (CDC Morbidity and Mortality Weekly Report, May 6)
- Male-to-Male Sexual Transmission of Zika Virus – Texas, January 2016 (CDC Morbidity and Mortality Weekly Report, April 15)
- Patterns of Zika Virus Testing and Infection, by Report of Symptoms and Preganancy Status – United States, January 3 – March 5, 2016 (CDC Morbidity and Mortality Weekly Report, April 15)
- Survey of Blood Collection Centers and Implementation of Guidance for Prevention of Transfusion-Transmitted Zika Virus Infection — Puerto Rico, 2016 (CDC Morbidity and Mortality Weekly Report, April 8)
- Preparing for Local Mosquito-Borne Transmission of Zika Virus — United States, 2016 (CDC Vital Signs, April 1)
- Preventing Transmission of Zika Virus in Labor and Delivery Settings Through Implementation of Standard Precautions — United States, 2016 (CDC Morbidity and Mortality Weekly Report, March 22)
- Travel-Associated Zika Virus Disease Cases Among U.S. Residents — United States, January 2015–February 2016 (CDC Morbidity and Mortality Weekly Report, March 18)
- Revision to CDC’s Zika Travel Notices: Minimal Likelihood for Mosquito-Borne Zika Virus Transmission at Elevations Above 2,000 Meters (CDC Morbidity and Mortality Weekly Report, March 11)
- Increase in Reported Prevalence of Microcephaly in Infants Born to Women Living in Areas with Confirmed Zika Virus Transmission During the First Trimester of Pregnancy — Brazil, 2015 (CDC, March 8, 2016)
- Executive Orders and Emergency Declarations for the West Nile Virus: Applying Lessons from Past Outbreaks to Zika (CDC, March 4, 2016)
- Potential Research Priorities to Inform Public Health and Medical Practice for Domestic Zika Virus: Workshop in Brief (Institute of Medicine, February 29, 2016)
- Zika virus infection among U.S. pregnant travelers, August 2015-February 2016 (CDC Morbidity and Mortality Weekly Report, February 26, 2016)
- Transmission of Zika virus through sexual contact with travelers to areas of active transmission (CDC Morbidity and Mortality Weekly Report, February 26, 2016)
- Local Transmission of Zika Virus — Puerto Rico, November 23, 2015–January 28, 2016 (CDC Morbidity and Mortality Weekly Report, February 12, 2016)
- Notes from the Field: Evidence of Zika Virus Infection in Brain and Placental Tissues from Two Congenitally Infected Newborns and Two Fetal Losses — Brazil, 2015 (CDC Morbidity and Mortality Weekly Report, February 10, 2016)
- The Emerging Zika Pandemic: Enhancing Preparedness (Journal of the American Medical Association, January 27, 2016)