MDHHS confirms 69 cases of Zika virus among Michigan travelers 

For many Michigan residents, the winter months often include travel to warmer climates. The Michigan Department of Health and Human Services (MDHHS) is urging travelers to protect themselves from Zika virus while travelling to places with active Zika transmission. Zika virus is spread to people primarily through the bite of infected Aedes aegypti and Aedes albopictus mosquitoes, which have not been found in Michigan, but are common in tropical areas and some parts of the United States.

This year, the CDC is making it possible for you to get travel updates about the Zika virus on the go. By texting PLAN to 855-255-5606, you’ll receive helpful tips on how to:

• Pack and plan for your trip.
• Stay protected on your trip.
• Stay healthy when you return home.

“Before you travel, find out if Zika virus is a risk at your planned destination,” said Dr. Eden Wells, chief medical executive with the MDHHS. “Pregnant women and couples who are planning to conceive in the near future should avoid nonessential travel to areas with active Zika virus transmission because infection during pregnancy is linked to serious birth defects and miscarriage. Travelers can prevent Zika virus infection by taking precautions to avoid mosquito bites.”

People who travel to an area with Zika should:

• Wear long-sleeved shirts and long pants.
• Stay and sleep in places with air conditioning or that use window and door screens.
• If your plans include travel to more remote areas, take along a permethrin-treated bed net to use while sleeping.
• Use EPA-registered insect repellents with one of the following active ingredients: DEET, picaridin, IR3535, oil of lemon eucalyptus or paramenthane-diol, or 2-undecanone.

To date, Michigan has confirmed 69 cases of Zika virus disease in travelers, including three pregnant women. In the U.S., over 1,200 pregnant women have been identified with possible Zika infection, resulting in 41 Zika-affected infants to date. MDHHS is participating in the U.S. Zika Pregnancy Registry, an effort to learn more about the effects of Zika virus infection during pregnancy.

All of the Zika cases in Michigan are travel related. While the virus is primarily transmitted through the bite of an infected mosquito, it’s important that residents of reproductive age are aware of the risks associated with sexual transmission of Zika virus. Zika can be spread through sex without a condom. Most cases of sexual transmission have involved people who had symptoms of Zika virus infection. However, recent evidence suggests that asymptomatic males may be capable of transmitting Zika virus to their sex partners.

There is currently no vaccine or treatment for Zika.

Zika virus illness is typically mild. The most common symptoms are fever, rash, joint pain, and conjunctivitis (red eyes) lasting for several days to a week after being bitten by an infected mosquito. Zika has also been linked to Guillain-Barré syndrome (GBS), an uncommon condition of the nervous system following infections.

Zika virus is an emerging disease and recommendations are changing as new information becomes available. The CDC currently recommends the following for travelers:

• Pregnant women should not travel to areas with active Zika transmission. If they must travel, they should take precautions to prevent mosquito bites.
• For non-pregnant women who travel to areas with active Zika transmission, it is recommended they prevent pregnancy for at least eight weeks from symptom onset (if ill) or last possible exposure (if illness does not develop).
• For men who return from travel, it is recommended they use condoms and avoid conception for at least six months, regardless of whether they develop an illness consistent with Zika virus disease.
• Men who have been in an area with active Zika virus transmission and have a pregnant partner should either use condoms the right way every time they have sex, or not have sex for the duration of the pregnancy.

MDHHS is working closely with the CDC to find additional Zika cases in returning travelers or their partners, and is coordinating with local health departments to enhance mosquito surveillance programs.

Additionally, the MDHHS laboratory has added capacity to test for Zika infection to help improve public health response time. For the most current information about Zika, visit www.cdc.gov/zika.

Statewide case counts and Michigan-specific information can be found on the MDHHS Zika webpage www.michigan.gov/zika. MDHHS will provide updates on the total number of cases statewide, including the number of pregnant women. Additional information about the cases will not be made available due to health privacy concerns.

National statistics about pregnancies and pregnancy outcomes are available on the CDC website at http://www.cdc.gov/zika/geo/pregnancy-outcomes.html.

For information about Zika in a specific Michigan county, contact the local health department.

Two people in Kent County have tested positive for the West Nile Virus.

According to the Kent County Health Department, the two people who have tested positive are unrelated adults who are residents of Kent County. It is unknown where they contracted the disease.

West Nile Virus (WNV) is spread to people primarily through the bites of an infected Culex species mosquito. While this species is known to transmit WNV it is not known to transmit Zika virus.

WNV is not contagious from person to person. Its symptoms range from a slight headache and low grade fever to, in rare cases, swelling of the brain tissue. But it can result in death.

For three months, ending on Labor Day, the Kent County Health Department conducted weekly surveillance of Culex mosquitoes, testing for the presence of WNV. Tens of thousands of mosquitoes were collected from various areas of the county. Testing was performed on the liquefied remains of up to 50 mosquitoes at a time, and West Nile Virus was found in 20 of those samples.

“We have known through our testing that the threat for contracting West Nile Virus was in our community,” said Adam London, Administrative Health Officer at KCHD. “We also know that the threat will continue as long as mosquitoes are active. Even the first frost may not be harsh enough to extinguish the risk.”

West Nile Virus was first detected in the United States in 1999. Since the first case was diagnosed in Michigan in 2001, more than 1,100 people have been diagnosed with the disease and 92 people have died. In 2001 and again in 2012, Kent County had the second highest number of West Nile cases in the state.

The best treatment for WNV is prevention. The Kent County Health Department recommends wearing a mosquito repellant that contains 10–35 percent DEET, wearing light colored clothing and staying indoors during dusk. You can help stop mosquitoes from breeding by removing any standing water in your yard and keeping your lawn and shrubs cut.

More about West Nile Virus can be found at www.cdc.gov/westnile/index.html.

Earlier this month, the Michigan Department of Health and Human Services state laboratory began conducting diagnostic testing for Zika, dengue and chikungunya, which are mosquito-borne viruses.

This represents an expanded effort by the department to identify and monitor new cases of these viruses in Michigan travelers returning from areas where the viruses are currently circulating. These testing services are being provided to healthcare providers in Michigan through the department’s Bureau of Laboratories. It builds on the current testing the Bureau conducts for West Nile, Eastern equine encephalitis, St. Louis encephalitis and La Crosse encephalitis viruses.

Michigan is considered “low risk” for mosquito transmission of Zika, dengue, and chikungunya virus, as the mosquitoes that spread the diseases are not present in the state. Zika is a virus that is newly emerged in the western hemisphere; while its symptoms are not considered severe, the virus can cause birth defects in fetuses of pregnant women exposed to the virus. To date, there have been three travel-related cases reported in Michigan; none in pregnant women.

Dengue and chikungunya viruses can also infect people who travel to areas where these viruses are present in mosquitoes. These areas include tropical and sub-tropical destinations. There were 14 cases of dengue and eight cases of chikungunya reported in Michigan in 2015. All cases of dengue and chikungunya were in travelers returning from areas with ongoing transmission.

Zika, dengue and chikungunya virus disease are reportable conditions in Michigan. Healthcare providers and laboratories must report suspect and confirmed cases of these viruses to a local public health department.

The Centers for Disease Control and Prevention is advising those traveling to foreign countries to exercise caution because of the Zika virus, particularly pregnant women. It recommends:

*Pregnant women should not travel to areas with active Zika transmission. If they must travel, they should take precautions to prevent mosquito bites.

*For non-pregnant women and men who travel and experience no symptoms, it is recommended they avoid pregnancy for eight weeks.

*For men who return from travel and do have symptoms, it is recommended they use condoms for six months.

*Men who have a pregnant partner and have been in an area with Zika transmission should either use condoms the right way every time they have sex, or not have sex for the duration of the pregnancy.

For the most current information about Zika, visit www.cdc.gov/zika.

Spring break is the time of the year when many in West Michigan choose to travel and make memories with their friends, families, or loved ones. Unfortunately, this year, many of the foreign destinations favored by sun seekers are also those areas that are affected by the Zika virus. Because of the potential link between Zika and birth defects, the Kent County Health Department is urging pregnant women in any trimester to reconsider travel to those areas. Anyone travelling to an affected area is urged to take precautions against mosquito bites.

The Zika virus is spread primarily by the bite of an infected Aedes species mosquito. The disease has not been found in mosquitoes in the United States, but has been found in Puerto Rico, Mexico and much of Central and South America. (SEE MAP). The most common symptoms of Zika are mild and may include a fever, rash, joint pain and red itchy eyes. These symptoms usually last just a few days. The virus can also be spread sexually from infected men. Most people who get the virus will never experience any symptoms. Currently, no vaccine or cure exists for the Zika virus.

“For people who are travelling in those areas, avoiding mosquito bites is the best prevention against this virus,” said Adam London, Administrative Health Officer with the Kent County Health Department. “We encourage women who are pregnant or planning to become pregnant to consider postponing their trips out of an abundance of caution. Anyone who has travelled to one of these areas and experiences symptoms either while on the trip or within about a week of being home should contact their doctor.”

The CDC recommends using mosquito repellants that contain DEET or other EPA approved repellants. Use only as directed and reapply often. Dress in long, loose and light colored clothes while outside, especially during the day. The mosquito that spreads Zika is an aggressive day biter. Travelers going to an affected area can further protect themselves by choosing lodging with air conditioning or screens to keep mosquitoes out and by staying indoors during daylight hours.

More Information about Zika is available by going to https://accesskent.com/Health/CommDisease/zika.htm