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  • Local Transmission of Zika virus -- Puerto Rico, November 25, 2015 - January 28, 2016

    February 12, 2016

    Download and read the full Morbidity and Mortality Weekly Report (MMWR).


    On December 31, 2015, Puerto Rico Department of Health (PRDH) reported the first locally acquired case of Zika virus disease in the United States in a patient from southeastern Puerto Rico. Passive and enhanced surveillance for Zika virus disease identified 27 laboratory-confirmed cases in patients with illness onset during November 25, 2015-January 28, 2016. Most (93%) patients resided in eastern Puerto Rico or the San Juan metropolitan area. The most frequently reported signs and symptoms were rash (81%), myalgia (74%), arthralgia (67%), and eye pain (67%). Four (15%) patients were hospitalized. One case occurred in a woman during the first trimester of pregnancy, and another occurred in a patient hospitalized for Guillain-Barre Syndrome. No microcephaly cases suspected to be associated with Zika virus infection have been reported in Puerto Rico. Because the most common mosquito vector of Zika virus, Aedes aegypti, is present throughout Puerto Rico, Zika virus is expected to continue to spread throughout the island. The public health response in Puerto Rico is being coordinated by the PRDH and CDC. Clinicians in Puerto Rico should report all cases of microcephaly, Guillain-Barre Syndrome, and suspected Zika virus disease to PRDH. To avoid infection with Zika virus, residents of Puerto Rico should strictly follow steps to avoid mosquito bites, including wearing pants and long-sleeved shirts, using an Environmental Protection Agency (EPA)-registered insect repellent, and ensuring that windows and doors have intact screens.


    What is already known about this topic?

    Zika virus emerged in the Region of the Americas in mid-2015, and since then, outbreaks have occurred in multiple South American and Caribbean countries and territories. Zika virus infection appears to be related with increased risk for fetal microcephaly and Guillain-Barré syndrome.

    What is added by this report?

    The first locally acquired case of Zika virus disease in Puerto Rico was identified in early December 2015. During the subsequent months, 29 additional laboratory-confirmed cases have been detected, including in one pregnant woman and in a man with Guillain-Barré syndrome.

    What are the implications for public health practice?

    Clinicians in Puerto Rico and other clinicians evaluating patients with recent travel to Puerto Rico should report all cases of suspected Zika virus disease to public health authorities. Residents of and visitors to Puerto Rico should strictly follow steps to avoid mosquito bites including using air conditioning or window and door screens when indoors, wearing long sleeves and pants, using permethrin-treated clothing and gear, and using insect repellents. When used according to the product label, Environmental Protection Agency-registered insect repellents are safe for pregnant women.

    Access the full report here.

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